UTERINE FIBROIDS

Clinical Features

  • Benign uterine growths may be sub-serous, interstitial, or submucous.
  • They occur commonly in the age group about 30 years and above and are associated with nulliparity, low parity, sub-fertility, and infertility.
  • The condition presents with features of mass in the lower abdomen or dysmenorrhoea or heavy periods.
  • Vaginal examination reveals a mass that is firm, nodular, and non-tender and moves with the cervix. Diagnosis is essentially clinical.

 

Investigations

  • Haemoglobin, VDRL, blood group, blood urea, urinalysis
  • IVU in selected cases
  • Hysterosalpingography in subfertile and infertility cases
  • Ultrasound where facilities exist.

Management

  • Treat associated pelvic inflammatory disease: Antibiotics – amoxicillin/clavulanate 625mg BD for 7 days OR doxycycline 100mg BD for 7 days + metronidazole 400mg TDS for 7 days. NSAIDs –ibuprofen 400mg TDS for 3 days.
  • Correct any anaemia associated with menorrhagia by haematinics (ferrous sulphate 200mg TDS and folic acid 5mg OD for 1 month) or blood transfusion.
  • Where fertility is desired, plan myomectomy and where obstetric career is complete, plan hysterectomy with conservation of 1 ovary in women under 45
    years of age.