Leiomyoma
DEFINITION
- Benign smooth muscle tumors of the myometrium, also known as fibroids. Uterine fibroids are the most common gynecological tumor and leading cause for hysterectomy1,2,3
- Can be submucous, subserous or intramural4
SYMPTOMS
- Women are often asymptomatic5
- Around 25 to 50% of women have symptoms: HMB, pelvic pain or pressure3
- May lead to subfertility, miscarriage and obstetric complications6
DIAGNOSIS
- Transvaginal ultrasound6
- For submucosal fibroids: ultrasound and hysteroscopy4
TREATMENT
- Treatment should be individualized, depending on symptom severity, distortion of the uterine cavity and desire for future children2
- Medical treatment: Oral contraceptives, oral progestins, levonorgestrel intrauterine system. Selective progesterone receptor modulators and GnRH analogues can be used pre surgery, to reduce fibroid size2
- Minimally invasive procedures: uterine artery embolization, MRI guided focused ultrasound surgery, endometrial ablation, hysteroscopic myomectomy2
- Surgical treatment: laparoscopic or abdominal myomectomy, hysterectomy2
Leiomyoma Library
Find more information and download materials on leiomyoma in the teaching and resources library.
References
- Stewart EA. N Engl J Med 2015;372:1646–55.
- Vilos GA, et al. J Obstet Gynaecol Can 2015;37:157–78.
- Borah BJ, et al. Am J Obstet Gynecol 2013;209;319e1–319e20.
- Munro MG, et al. Int J Gynaecol Obstet,2011; 113, 3–13.
- Brito L, et al. Reprod Health 2014;11:10.
- Van den Bosch T, et al. Ultrasound Obstet Gynecol 2015;46:284–98.
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