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UTERINE FIBROIDS
INTRODUCTION
 Benign tumours (leiomyomata) of uterine smooth muscle
 Common  25% of women in a lifetime
 The most common uterine tumor
 Occurring in about 30% of women above the age of 30 years.
 Occurs up to 75% of hysterectomy specimens
 Symptomatic in 1/3 of cases
 More common in the obese
 Less common in smokers
 Age:
30-40 years.
Rare before 30 or after 40 years
 Parity:
Common in nulliparas, patients with low parity.
It is rare in multiparas.
 Race:
3-9 times more common in negroids.
 Family history:
Usually positive.
 Hyper-estrenemia:
Estrogen receptors (ER) more than the surrounding myometrium but less than those in the
endometrium
 Common in low parity.
 Atrophies and shrinks after menopause.
 Common association with other hyper-estrenic conditions as endometriosis, endometrial
hyperplasia and endometrial carcinoma.
ETIOLOGY
 Genetic changes: Many fibroids contain changes in genes that
differ from those in normal uterine muscle cells.
 Hormones: Estrogen and progesterone, two hormones that
stimulate development of the uterine lining during each
menstrual cycle in preparation for pregnancy, appear to
promote the growth of fibroids. Fibroids contain more estrogen
and progesterone receptors than normal uterine muscle cells
do. Fibroids tend to shrink after menopause due to a decrease
in hormone production.
 Other growth factors: Substances that help the body maintain
tissues, such as insulin-like growth factor, may affect fibroid
CLASSIFICATION
DIAGNOSTICS
INTRAMURAL & SUBMUCOUS FIBROIDS
SUBSEROUS FIBROID AT
LAPAROSCOPY
SUBMUCOSAL FIBROID
Uterine fibroids

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Uterine fibroids

  • 2. INTRODUCTION Benign tumours (leiomyomata) of uterine smooth muscle Common 25% of women in a lifetime The most common uterine tumor Occurring in about 30% of women above the age of 30 years. Occurs up to 75% of hysterectomy specimens Symptomatic in 1/3 of cases More common in the obese Less common in smokers
  • 3. Age: 30-40 years. Rare before 30 or after 40 years Parity: Common in nulliparas, patients with low parity. It is rare in multiparas. Race: 3-9 times more common in negroids. Family history: Usually positive. Hyper-estrenemia: Estrogen receptors (ER) more than the surrounding myometrium but less than those in the endometrium Common in low parity. Atrophies and shrinks after menopause. Common association with other hyper-estrenic conditions as endometriosis, endometrial hyperplasia and endometrial carcinoma.
  • 4. ETIOLOGY Genetic changes: Many fibroids contain changes in genes that differ from those in normal uterine muscle cells. Hormones: Estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids. Fibroids contain more estrogen and progesterone receptors than normal uterine muscle cells do. Fibroids tend to shrink after menopause due to a decrease in hormone production. Other growth factors: Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid