Exophytic fibroid
Definition
An exophytic fibroid is a type of uterine fibroid that grows outward from the surface of the uterus, usually into the pelvic cavity. These fibroids can be identified by their peduncle, which is a thin stalk that connects them to the uterus.
Location
Exophytic fibroids can grow either within the wall of the uterus or outside of it. Subserosal fibroids, the most common type of exophytic fibroid, begin on the outer wall of the uterus and extend into the surrounding connective tissue or the pelvic cavity. Submucosal fibroids, on the other hand, are located within the endometrial cavity and project outward through the endometrium.
Symptoms
Exophytic fibroids can present with a variety of symptoms, depending on their size and location. Some of the most common symptoms include:
- heavy or persistent menstrual bleeding
- pelvic pain or pressure
- frequent or urgent urination
- dyspareunia (pain during sexual intercourse)
- lower back pain or leg pains
- pain during defecation or constipation
In rare cases, exophytic fibroids can twist or prolapse, presenting with sudden, severe pain due to their increased size and the loss of their blood supply.
Risk Factors
The exact cause of exophytic fibroids is unknown, but some factors may increase the risk of their development. These include:
- genetics: a family history of fibroids may increase the likelihood of developing them
- hormones: estrogens and progestins, which regulate the menstrual cycle, may promote fibroid growth
- early menarche, or the start of menopause, early onset
- obesity
- race: black women are more likely to develop exophytic fibroids
Diagnosis
Exophytic fibroids are often diagnosed through a physical examination, including a pap smear and endometrial biopsy, and imaging tests such as ultrasound or MRI. Ultrasound is particularly useful for visualizing the size, shape, and position of fibroids within the pelvis.
Treatment
Treatment for exophytic fibroids depends on the severity of symptoms and the size and location of the fibroids. Options may include:
-watchful waiting: monitoring the fibroids for any changes
-medications: to suppress fibroid growth, such as birth control pills or leuprolide acetate
-surgery: myomectomy (removal of the fibroid from within the uterus) or hysterectomy (total removal of the uterus)
-embolization: cutting off the blood supply to the fibroid to cause it to shrink
-fibroid ablation: using heat, cold, or high-frequency ultrasound to destroy the fibroid tissue
-Preliminary data suggests that vitamins D, A, B3, E, and K may be useful for improving the size and symptoms of fibroids.
Prevention
While there is no known way to prevent exophytic fibroids, healthy lifestyle changes such as maintaining a healthy weight, engaging in regular physical activity, and eating a balanced diet with plenty of fruits and vegetables may lower the risk of developing fibroids.
Conclusion
Exophytic fibroids are noncancerous growths that can cause significant discomfort and pain. They are usually diagnosed during a routine gynecological exam or during pregnancy. Treatment options include medical management with medication, surgical procedures, or embolization. Regular screening and appropriate treatment can help manage symptoms and prevent complications associated with exophytic fibroids.
