subserous uterine fibroid

What are Subserosal Uterine Fibroids?

Subserosal uterine fibroids are a type of noncancerous growth that develops on the outside of the uterus, near its outer layer or serosa. They can grow more towards the outside of the uterus and sometimes have a stalk that attaches to it (pedunculated fibroid).

Characteristics:

• Located outside the uterine cavity
• Protrude into the pelvic cavity
• Can be pedunculated, meaning they hang from a stalk inside the uterus
• Typically benign (not cancerous)
• May cause uncomfortable symptoms and interfere with nearby organ functions

Symptoms:

While subserosal fibroids are often asymptomatic, some people may experience: * Pelvic pain or pressure * Back pain * Bloating or feeling "heavy" in the pelvic area * Abdominal cramping

Importance of Treatment: It is crucial to get treatment for your subserosal fibroids to relieve painful symptoms and avoid complications. Treatment options, such as Uterine Fibroid Embolization (UFE), can help alleviate symptoms and improve quality of life.

References: [3] [5] [6] [7] [8] [9] [10]

Subserosal Uterine Fibroids: Signs and Symptoms

Subserosal uterine fibroids are a type of noncancerous tumor that grows on the outside of the uterus. While they can be large or small, their symptoms differ from those of other types of fibroids.

• Heavy menstrual bleeding: This is one of the most common symptoms of subserosal fibroids, caused by the larger size of the uterus [5].
• Pressure symptoms over nearby organs: The growth of a subserosal fibroid can put pressure on surrounding organs, leading to symptoms such as:
  • Frequent urination
  • Constipation
  • Bloating
  • Abdominal pain [5]
• Fullness in the pelvic area: Some people may experience a feeling of fullness or heaviness in the lower stomach area due to the presence of a subserosal fibroid [7].
• Enlargement of the lower abdomen: As the fibroid grows, it can cause the lower abdomen to become enlarged [7].
• Pain during sex: In some cases, subserosal fibroids can cause pain or discomfort during sexual intercourse [6].

It's essential to note that not all subserosal fibroids cause symptoms, and their severity can vary depending on factors such as size, location, and number. If you're experiencing any of these symptoms, it's crucial to consult a healthcare professional for proper diagnosis and treatment.

References: [5] - Symptoms caused by the larger size of the uterus. [6] - Typical Symptoms of Subserosal Fibroids:​​ [7] - Feb 19, 2021 — Feeling of fullness in the pelvic area (lower stomach area); Enlargement of the lower abdomen; Frequent urination; Pain during sex; Lower back ...

Diagnostic Tests for Subserosal Uterine Fibroids

Subserosal uterine fibroids are benign tumors that grow on the outside of the uterus, and their diagnosis can be challenging due to their location. While symptoms alone may not clearly indicate a subserosal fibroid diagnosis, various diagnostic tests can help confirm the presence of these growths.

• Imaging Tests: Imaging tests are essential for diagnosing subserosal uterine fibroids. These tests include:
  • Ultrasound: Transvaginal ultrasonography is highly accurate in detecting uterine fibroids, but it may miss subserosal fibroids or small fibroids [10]. A combination of transabdominal and transvaginal ultrasounds can provide a more comprehensive view of the uterus and surrounding tissues.
  • Magnetic Resonance Imaging (MRI): MRI is another imaging technique that can help diagnose subserosal uterine fibroids. It provides detailed images of the uterus, surrounding tissues, and blood vessels [1].
• Other Diagnostic Tests: In addition to imaging tests, other diagnostic tests may be performed to confirm the diagnosis of subserosal uterine fibroids:
  • Bimanual Pelvic Examination: A bimanual pelvic examination can detect an enlarged, irregular, mobile uterus, which may indicate the presence of a subserosal fibroid [12].
  • Hysteroscopy: This procedure involves inserting a scope through the cervix to visualize the inside of the uterus. While primarily used for diagnosing conditions within the uterine cavity, hysteroscopy can also help identify subserosal fibroids that have grown into the uterine cavity.

It's essential to note that while these diagnostic tests can confirm the presence of subserosal uterine fibroids, they may not always provide a definitive diagnosis. A healthcare provider will likely use a combination of these

Treatment Options for Subserosal Uterine Fibroids

Subserosal uterine fibroids are a type of benign tumor that grows on the outside of the uterus. While treatment is not always necessary, it may be recommended if the fibroids are causing problematic symptoms.

• Medications: Over-the-counter (OTC) pain medications such as ibuprofen or acetaminophen can be used to manage mild pain and discomfort caused by subserosal fibroids [11].
• Hormonal Therapies: Gonadotropin-releasing hormone agonists (GnRHa), such as Lupron, Synarel, and Zoladex, can cause a low-estrogen state, leading to a reduction in the size of the tumor and uterus [10]. However, these medications may not be suitable for everyone and should be used under the guidance of a healthcare provider.
• Levonorgestrel Intrauterine System (LNG-IUS): This is a type of hormonal IUD that can help reduce menstrual bleeding and alleviate symptoms associated with subserosal fibroids [14].
• Tranexamic Acid: This medication can be used to reduce menstrual bleeding and may also have some effect on the size of the fibroid.
• Anti-inflammatory Medicines: These medications can help manage pain and inflammation caused by subserosal fibroids.

Important Considerations

It's essential to note that treatment for subserosal fibroids is usually only recommended for individuals whose quality of life is impacted by their symptoms [12]. A healthcare provider will assess the individual's condition and recommend the most suitable course of action.

In some cases, more invasive treatments such as hysterectomy or myomectomy may be necessary. However, these should be considered as a last resort after other treatment options have been explored.

References

[10] Context result 10: The most effective medications for the treatment of fibroids are gonadotropin releasing hormone agonists (GnRHa), (including Lupron, Synarel, Zoladex). GnRH agonists cause a low-estrogen (menopause-like) state which causes reduction size of the tumor and uterus.

[11] Context result 11: If you have fibroids and have mild symptoms, your doctor may suggest taking medication. Over-the-counter drugs such as ibuprofen or acetaminophen can be used for mild pain.

[12] Context result 12: Treatment for subserosal fibroids is usually only recommended for individuals whose quality of life is impacted by their fibroids.

[14] Context result 14: Medicine for symptoms · Levonorgestrel intrauterine system (LNG-IUS) · Tranexamic acid · Anti-inflammatory medicines · The contraceptive pill · Oral progestogen.

The differential diagnosis for subserosal uterine fibroids includes several conditions that can mimic or be confused with a subserosal fibroid. Some of these conditions are:

• Endometrial polyp: A growth on the endometrium, the lining of the uterus, which can cause similar symptoms to a subserosal fibroid.
• Ovarian tumors: Tumors that develop on the ovaries, which can be mistaken for a subserosal fibroid due to their location and appearance.
• Leiomyosarcoma: A rare type of cancerous tumor that arises from smooth muscle cells in the uterus. It is often difficult to distinguish from a benign leiomyoma (fibroid) using imaging modalities alone.
• Uterine smooth muscle tumors of uncertain malignant potential: Rare tumors that have characteristics of both benign and malignant tumors, making their diagnosis challenging.

These conditions can be considered in the differential diagnosis of subserosal uterine fibroids, especially when trying to determine the nature of a uterine mass or growth. [1][2][3][4]

It's worth noting that the causes of subserosal fibroids are not yet fully understood, but certain factors may increase the risk of developing these growths, such as hormonal influences and genetic predisposition. [5]