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Uterine Myomas

Christina N. Kufel, DO, MS and Michael P. Hopkins, MD, MEd Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Uterine leiomyomas are well-circumscribed, pseudoencapsulated, benign monoclonal tumors composed mainly of smooth muscle with varying amounts of fibrous connective tissue (1).

  • Three m...

DIAGNOSIS

HISTORY

  • Usually asymptomatic; 30% present with abnormal symptoms—usually enlarged uterus or heavy bleeding (3).

  • Symptoms include the following:

    • Abnormal uterine bleeding: usually heavy/prolon...

TREATMENT

  • Treatment must be individualized and based on symptoms, fertility desires, and time until menopause.

  • Medical therapy may be of benefit.

  • Patients with minimal symptoms may be treated with iron ...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Pelvic examination and ultrasound: every 2 to 3 months for newly diagnosed symptomatic/excessively large myomas

  • Hemoglobin and hematocrit: if ute...

REFERENCES

1
Parker WH. Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril.  2007;87(4):725–736. [View Abstract on OvidMedline]
2
Bulun SE. Uterine fibroids. N Engl J Med. ...

ADDITIONAL READING

Laughlin SK, Schroeder JC, Baird DD. New directions in the epidemiology of uterine fibroids. Semin Reprod Med.  2010;28(3):204–217. [View Abstract on OvidMedline] 

CODES

ICD10

  • D25.9 Leiomyoma of uterus, unspecified

  • D25.2 Subserosal leiomyoma of uterus

  • D25.1 Intramural leiomyoma of uterus

  • D25.0 Submucous leiomyoma of uterus

ICD9

  • 218.9 Leiomyoma of uterus, unspecified

  • 21...

CLINICAL PEARLS

  • Uterine myomas are benign smooth muscle tumors composed mainly of fibrous connective tissue.

  • Usually incidental finding on pelvic exam or ultrasound but may cause pelvic pain and pressu...

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