Pedunculated Fibroid

Fibroid that grow in the uterus stalk is called pedunculated fibroid. If this fibroid grows outside the uterus it is called sub-serous fibroids and if it grows inside the uterus its called sub-mucosal fibroids.

They even grow big. Last year, I have seen the biggest fibroid case, reported in the East African Medical Journal. A 37 year old woman had an abdominal inflammation due to the large growth of this fibroid. Her surgeons diagnosed nearly 16 centimeters long and one and half a kilogram weighed fibroid.

One of the most startling things about this patients condition was that she had no symptoms other than the abdominal swelling. Other women who develop pedunculated fibroids have a much different experience.

In some women, submucosal pedunculated fibroids extend into the vaginal canal, which causes distress during sexual intercourse. Two patients treated by the American University of Beirut Medical Center were found to have such fibroids. A full 12 cm of one patients submucosal fibroid had grown into the vaginal canal, while the rest of the growth remained in her uterus.

Pedunculated fibroids can be painful, particularly if the peduncle becomes twisted. The risk of the peduncle twisting increases as the fibroid grows larger.

Other painful symptoms that are often associated with these fibroids are uterine cramps, as well as pressure on the uterus along with other organs.

This sub-mucosal fibroid even causes irregular bleeding during menstrual such as light spotting or regular bleeding all the time. Women with constant bleeding may undergo heavy bleeding during the menstrual cycle.

Often when the pedunculated fibroid has become severely twisted it will require surgical intervention. This occurs because the pain level becomes so great to the woman experiencing it that they will do anything to stop it.

A twisted peduncle can also create a blockage in the veins that deliver blood and nutrients to the growth. When the blood and nutrients are cut off, the fibroid begins to weaken. As the fibroid deteriorates, the pain increases greatly, as does the risk of infection.

When a peduncle is determined to be 2cm or more in width, a process called Uterine Artery Embolization is indicated. This procedure blocks the blood supply to the growths so that they begin to deteriorate and eventually die. This procedure has been found to be more successful with subserousal fibroids than with any other kind of fibroid.

The doctors in Bretonneau hospital of France suggests women to repeat Uterine Artery Embolization, as its diagnosed that 10% of women has re-growth of these fibroids after 2 years.

Another similar procedure for pedunculated fibroids is Myomectomy. This method is done to remove the fibroid but it is not 100% success and sometimes repairs the uterus. The University of South Dakota diagnosed a patient with bigger fibroid, in which the blood vessel has been ruptured after she gave birth. Since their attempt on Myomectomy failed, an immediate hysterectomy was done.

Often prior to a myomectomy the woman is required to sign an agreement to allow a hysterectomy to be performed should anything go wrong during the procedure, so women that undergo this procedure sometimes wake up without a uterus.