Uterine fibroid location

The most common symptom of uterine fibroids is abnormal uterine bleeding occurring in 30% of women with fibroids [16], which commonly causes anemia and is associated with fibroids located in... 

Fig. 5.9. MRI of leiomyoma - locations. T2-weighted coronal image of a polyfibroid uterus. A subserosal pedunculated uterine fibroid white arrow) is easily identified by its low signal intensity and continuity with the right lateral aspect of the uterine fundus while sonographi-cally the lesion could not be separated from the right ovary (black arrow). (Reproduced with permission from [223])...

Hysterectomy is a definitive cure in patients with a symptomatic multifibroid uterus. Both abdominal and vaginal hysterectomy is associated with a low mortality and morbidity. However, given that uterine leiomyomas are benign lesions, the large number of hysterectomies performed worldwide to treat this condition appears to be disproportionate [16]. As an alternative to hysterectomy, uterus-sparing operative, ablative, and interventional radiological procedures are available, depending on location and size of fibroids present, the patient s age, desire to have children, and personal preferences. 

Depending on their location, leiomyomas can be resected or enucleated using a hysteroscopic or laparoscopic access or open laparotomy. Hysteroscopic resection is suitable to remove submucosal leiomyomas. Hysteroscopic resection is generally considered unsuitable for submucosal leiomyomas larger than 5 cm in size, if more than three fibroids are present, or if the uterine cavity is very large (length of uterine probe > 12 cm). Moreover, the size of the intramural... 

Magnetic resonance imaging (MRl) is the most accurate diagnostic modality for assessing uterine leiomyomas [37]. MRI enables assessment of the uterus in multiplanar orientation and without interference from superimposed structures. MRI provides not only accurate information on the number and size of fibroids but also on their location within the uterus (cervix, corpus, fundus) and within the wall (submucosal, intramural. 

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