Uterine fibroids are the most common benign tumors of the female genitalia; they are most common in women aged 30-50, most common in those aged 40-50, and rare in those under 20
Classification.
(i) according to the location of the fibroids are divided into.
1.Uterine body fibroids (92% of cases)
2.Cervical fibroids (accounting for 8%)
(ii) According to the relationship between fibroids and the uterine muscle wall, they can be divided into the following three categories.
1.Interstitial myomas account for 60%-70%; myomas are located in the myometrial wall of the uterus and are surrounded by the myometrium.
Subplasma fibroids account for about 20% of the cases; the fibroids grow toward the plasma surface of the uterus, and the surface of the fibroids is only covered by the plasma layer of the uterus.
3.Submucosal fibroids account for 10%-15%; fibroids grow toward the mucosa of uterus and protrude into the uterine cavity, covered only by the mucosal layer.
Myoma degeneration: When myoma loses its original typical structure, it is called myoma degeneration.
Common degenerations.
Vitreous degeneration, cystic degeneration, red degeneration, sarcomatous degeneration, calcification.
Clinical manifestations.
1. Symptoms: Most of the symptoms are not obvious. The symptoms are closely related to the site of myoma, growth rate and myoma degeneration, and not much related to the size and number of myoma.
(1) Menstrual changes: shortened cycle, increased menstrual volume, prolonged menstrual period, irregular vaginal bleeding, etc.
(2) Abdominal mass: The patient complains of abdominal distension and a mass is found in the middle of the lower abdomen.
(3) Increased leucorrhea.
(4) Abdominal pain, lumbago, lower abdominal cramping.
(5) Compression symptoms.
(6) Infertility: It may be that the myoma is distorting the fallopian tubes by compression; or the uterine cavity is deformed, preventing fertilization of the egg.
(7) Secondary anemia
2. Signs: related to the size, location, number and presence of degeneration of the myoma.
Abdomen: hard, irregular, nodular masses are palpated.
Gynecological examination: intermural leiomyoma: enlarged uterus, irregular surface, single or multiple nodular protrusions.
Subplasmalemmal leiomyoma: hard, bulbous masses with thin tissues attached to the uterus, mobile.
Submucosal fibroids: enlarged uterus, dilated uterine orifice, fibroids located in the orifice or prolapsed in the vagina.