Uterine leiomyoma

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Definition

  • Benign smooth-muscle tumour of the uterus

Epidemiology

  • Most common pelvic tumour in reproductive-age women

Risk Factors

  • Family history
  • Early menarche

Clinical Manifestations

  • May be asymptomatic if small
  • Larger fibroids may have obstructive symptoms
    • Constipation
    • Urinary frequency or retention
    • Back and pelvic pain
    • Impaired fertility
  • Abnormal menstrual bleeding

Investigations

  • Imaging:
    • Ultrasound is first-line and has high sensitivity

Management

  • If asymptomatic: observation
  • If symptomatic
    • Hormonal contraception
    • Embolization
    • Surgical excision