Types
By location, three main groups are distinguished:
- Intramural — within the muscle layer, the most common form
- Subserosal — grows outward from the uterus
- Submucosal — grows into the uterine cavity; less common, but with more pronounced symptoms and a possible cause of infertility
Symptoms
Some fibroids cause no symptoms and are found incidentally. In symptomatic cases:
- Prolonged, heavy menstrual bleeding with clots
- Groin and lower-back pain, pain during intercourse
- Frequent urination, bloating and a feeling of pressure in the abdomen
- Bleeding between periods
Diagnosis and monitoring
The diagnosis is made with a gynecological exam and ultrasound, with MRI added when necessary. For small, symptom-free fibroids regular ultrasound monitoring is enough — not every fibroid means surgery.
Treatment: two surgical paths
In symptomatic cases the main methods are: myomectomy — only the fibroid is removed, the uterus and reproductive function are preserved, the preferred choice at reproductive age; and hysterectomy — removal of the uterus, only when other methods fail or there are serious indications. The decision is individual, based on age, the wish to become a mother and the clinical situation. Pregnancy is possible after myomectomy.