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UTERINE FIBROIDS
DEFINITION
• Uterine fibroid is a leiomyoma (benign (non-
cancerous) tumor from smooth muscle tissue)
that originates from the smooth muscle layer
(myometrium) of the uterus
CAUSES
• unknown.
• Family history
• Genetic alterations.
• Hormones.
• Other chemicals.
RISK FACTORS
• Heredity.
• Race.
• Pregnancy and childbirth.
• Nulliparity Obesity
• Oral contraceptives.
TYPES
• BODY OR
CORPOREAL
FIBROIDS
• Intramural or
interstitial fibroids
• Subserosal fibroids
• Submucosal fibroids
• CERVICAL FIBROIDS 1-2 %
SECONDARY CHANGES IN
FIBROID
• Degenerative changes
• Hyaline degeneration:
• Cystic degeneration:
• Calcification:
• Fatty degeneration:
• Red degeneration:
• Septic degeneration:
• Infection
• Atropy
• Necrosis
• Vascular changes
• Sarcomatous changes
CLINICAL FEATURES
• 75 % remains asymptomatic
• Menustrual abnormalities
– Menorrhagia (30%)
– Metrorrhagia or irregular bleeding
• Dysmenorrhea
• Infertility(30%):
• Pain lower abdomen
• Abdominal swelling (lump)
• Pressure symptoms
• Abdominal examination
• Feel is firm more towards hard may be cystic
in cystic degeneration.
• Margins are well defined except the lower
pole.
• nodular may be uniformly enlarged
• Mobility is restricted from above downwards
but can be moved from side to side.
• Percussion : swelling is dull
• Pelvic examination
• Bimanual examination reveals uterus
irregularly enlarged
• Uterus is not felt separated from the swelling
and as such a groove is not felt between the
uterus and the mass.
• The cervix moves with the movement of the
tumour felt per abdomen.
DIAGNOSIS
• An abdominal, transvaginal or pelvic
ultrasound
• An endometrial biopsy
• A hysteroscopy
• Hysterosalpingography
• Laparoscopy
TREATMENT
• For symptomatic fibroids
• Medication to control symptoms
• Medication aimed at shrinking tumours
• Ultrasound fibroid destruction
• surgically aided methods to reduce blood
supply of fibroids
• Myomectomy or radio frequency ablation
• Hysterectomy
• Treatment for infection and anemia
• Embolization
Medications
• Oral contraceptive pills
• GnRH agonists
• The antihormonal drug RU-486
(mifepristone)
• Danazol (Danocrine)
• Antifibrinolytics (tranexamic acid)
• Nonsteroidal anti-inflammatory agents
• Progesterone receptor modulator named
Ellaone
SURGERY
• Myomectomy
• Hysterectomy
• Uterine artery embolization,
• Uterine artery ligation
• Radio frequency ablation
• Endometrial ablation
COMPLICATIONS
• Menorrhagia.
• Abdominal pains
• Premature birth, labor problems,
miscarriages
• Infertility
• Leiomyosarcoma
• Twisting of the fibroid
• Anemia
• Urinary tract infections
• A c-section may be needed
• Some pregnant women with fibroids
have heavy bleeding immediately after
giving birth.
NURSING DIAGNOSIS
• Acute pain related to post operative wound as
manifested by facial expression and pain scale
score
• Imbalanced nutrition less than body
requirements related to pain as manifested by
decreased food intake.
• Impaired bowel elimination , constipation
related to decreased activity, pain on straining
• Disturbed sleep pattern related to pain and
hospitalization
• Risk for infection related to the surgery
• Low Self-Esteem related to changes in
femininity as evidenced by Withdrawal,
depression
Uterine fibroids

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Uterine fibroids

  • 2. DEFINITION • Uterine fibroid is a leiomyoma (benign (non- cancerous) tumor from smooth muscle tissue) that originates from the smooth muscle layer (myometrium) of the uterus
  • 3. CAUSES • unknown. • Family history • Genetic alterations. • Hormones. • Other chemicals.
  • 4. RISK FACTORS • Heredity. • Race. • Pregnancy and childbirth. • Nulliparity Obesity • Oral contraceptives.
  • 5. TYPES • BODY OR CORPOREAL FIBROIDS • Intramural or interstitial fibroids • Subserosal fibroids • Submucosal fibroids
  • 7. SECONDARY CHANGES IN FIBROID • Degenerative changes • Hyaline degeneration: • Cystic degeneration: • Calcification: • Fatty degeneration: • Red degeneration: • Septic degeneration:
  • 8. • Infection • Atropy • Necrosis • Vascular changes • Sarcomatous changes
  • 9. CLINICAL FEATURES • 75 % remains asymptomatic • Menustrual abnormalities – Menorrhagia (30%) – Metrorrhagia or irregular bleeding
  • 10. • Dysmenorrhea • Infertility(30%): • Pain lower abdomen • Abdominal swelling (lump) • Pressure symptoms
  • 11. • Abdominal examination • Feel is firm more towards hard may be cystic in cystic degeneration. • Margins are well defined except the lower pole. • nodular may be uniformly enlarged • Mobility is restricted from above downwards but can be moved from side to side. • Percussion : swelling is dull
  • 12. • Pelvic examination • Bimanual examination reveals uterus irregularly enlarged • Uterus is not felt separated from the swelling and as such a groove is not felt between the uterus and the mass. • The cervix moves with the movement of the tumour felt per abdomen.
  • 13. DIAGNOSIS • An abdominal, transvaginal or pelvic ultrasound • An endometrial biopsy • A hysteroscopy • Hysterosalpingography • Laparoscopy
  • 14. TREATMENT • For symptomatic fibroids • Medication to control symptoms • Medication aimed at shrinking tumours • Ultrasound fibroid destruction • surgically aided methods to reduce blood supply of fibroids • Myomectomy or radio frequency ablation • Hysterectomy • Treatment for infection and anemia • Embolization
  • 15. Medications • Oral contraceptive pills • GnRH agonists • The antihormonal drug RU-486 (mifepristone) • Danazol (Danocrine) • Antifibrinolytics (tranexamic acid) • Nonsteroidal anti-inflammatory agents • Progesterone receptor modulator named Ellaone
  • 17. • Uterine artery embolization, • Uterine artery ligation • Radio frequency ablation • Endometrial ablation
  • 18. COMPLICATIONS • Menorrhagia. • Abdominal pains • Premature birth, labor problems, miscarriages • Infertility
  • 19. • Leiomyosarcoma • Twisting of the fibroid • Anemia • Urinary tract infections • A c-section may be needed • Some pregnant women with fibroids have heavy bleeding immediately after giving birth.
  • 20. NURSING DIAGNOSIS • Acute pain related to post operative wound as manifested by facial expression and pain scale score • Imbalanced nutrition less than body requirements related to pain as manifested by decreased food intake.
  • 21. • Impaired bowel elimination , constipation related to decreased activity, pain on straining • Disturbed sleep pattern related to pain and hospitalization • Risk for infection related to the surgery • Low Self-Esteem related to changes in femininity as evidenced by Withdrawal, depression