UTERINE FIBROID

MYOMA
(LEIOMYOMAS)

BSN 2E GROUP 7
Overview:
• Definition
• Etiology
• Clinical manifestations
• Pathophysiology
• Nursing Interventions
• Medical Surgical Intervention

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 What is MYOMA?
 Myomas are smooth, non-cancerous tumors that may develop
in or around the uterus. Made partly of muscle tissue, myomas
seldom develop in the cervix, but when they do, there are
usually myomas in the larger, upper part of the uterus as well.
This often develop during childbearing years.
 Uterine fibroids also called leiomyomas or myomas, are
tumors that grow in a woman's womb (uterus). These growths
are typically not cancerous (benign), and do not become
cancerous.

Prepared by: GROUP 7 3

DIFFERENCE BETWEEN NORMAL UTERUS VS. UTERUS WITH
FIBROID

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 Types of Uterine Fibroids:
• Intramural fibroids: These fibroids are embedded into the
muscular wall of your uterus. They’re the most common type.

• Submucosal fibroids: These fibroids grow under the inner lining

of your uterus.

• Subserosal fibroids: This type of fibroid grows under the lining of

the outer surface of your uterus. They can become quite large and
grow into your pelvis.

• Pedunculated fibroids: The least common type, these fibroids

attach to your uterus with a stalk or stem. They’re often described as
mushroom-like because they have a stalk and then a wider top.

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 ETIOLOG
Y is multifactorial
The etiology of Myoma
and involves various genetic, hormonal,
and environmental factors such as:
• Genetic Predisposition
• Hormonal Influences
• Reproductive Factors
• Race and Ethnicity
• Obesity
• Environmental Factors
• Dietary Factors
• Inflammation and Immune Dysregulation

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CLINICAL
MANIFESTATIONS
• Heavy menstrual bleeding or painful periods.
• Longer or more frequent periods.
• Pelvic pressure or pain.
• Frequent urination or trouble urinating.
• Growing stomach area.
• Constipation.
• Pain in the stomach area or lower back, or pain during sex.
• Infertility or recurrent miscarriage.
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 PATHOPHYSIOLOGY

The underlying pathophysiology is uncertain. The

pathogenesis of leiomyomas is not well understood.
Genetic predisposition, environmental factors, steroid
hormones, and growth factors important in fibrotic
processes and angiogenesis all play a role in the
formation and growth of uterine fibroids.

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 NURSING INTERVENTIONS

INDEPENDENT:

 Discuss significant signs/symptoms that require reporting to healthcare

providers.
 Monitor vital signs including cognitive status. Note vital sign response to
activity or procedures and time required to return to baseline.
 Periodically determined, intake and output. Note urine color, and measure
specific gravity.

DEPENDENT:

 Administer fluid and blood replacement therapy as prescribed.

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 NURSING INTERVENTIONS

COLLABORATIVE:

 Arrange time with a nutrionists/dietician to determine or adjust

individually appropriate diet plans.

 Administer IV fluids, as indicated. Replaced blood products/plasma

expanders as ordered.

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 Medical Management
• The use of medications and focus on treating the symptoms.
• Medicines for uterine fibroids target hormones that control the menstrual cycle.
They treat symptoms such as heavy menstrual bleeding and pelvic pressure. They
don't get rid of fibroids, but they may shrink them. Medicines include:

• Gonadotropin-releasing hormone (GnRH) agonists such as elagolix (Oriahnn)

and relugolix (Myfembree).
• Progestin-releasing intrauterine device (IUD)
•Tranexamic acid (Lysteda, Cyklokapron)
• Other Medicines :NSAIDS

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 SURGICAL INTERVENTIONS
1. Hysteroscopic Myomectomy
• Removal of submucous Fibroids

2. Myomectomy
• The removal of fibroids
• Fertility sparing fibroid removal
• Can be laparotomy and laparoscopy

3. Hysterectomy
• Surgical removal of uterus
• Indicate for women who do not wish to be pregnant in the
future.
• Can he achieved via open surgery, laparoscopically,
vaginally, depends upon the size, number and location of
fibroid. 12
HYSTERECTOM
Y

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HYSTEROSCOPIC
MYOMECTOMY

LAPAROSCOPY and
LAPAROTOMY
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 REFERENCES:
1. Islam MS, Protic O, Stortoni P, et al. Genetics and biology of endometrial cancer. Transl Res. 2019;211:62-77.
2. Commandeur AE, Styer AK, Teixeira JM. Epidemiological and genetic clues for molecular mechanisms involved in uterine leiomyoma development and
growth. Hum Reprod Update. 2015;21(5):593-615.
3. Bulun SE. Uterine fibroids. N Engl J Med. 2013;369(14):1344-1355.
4. Parker WH. Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril. 2007;87(4):725-736.
5. Wise LA, Laughlin-Tommaso SK. Epidemiology of Uterine Fibroids: From Menarche to Menopause. Clin Obstet Gynecol. 2016;59(1):2-24.
6. Kjerulff KH, Langenberg P, Seidman JD, Stolley PD, Guzinski GM. Uterine leiomyomas. Racial differences in severity, symptoms and age at diagnosis. J
Reprod Med. 1996;41(7):483-490.
7. Wise LA, Palmer JR, Harlow BL, Spiegelman D, Stewart EA, Adams-Campbell LL, Rosenberg L. Risk of uterine leiomyomata in relation to tobacco,
alcohol and caffeine consumption in the Black Women's Health Study. Hum Reprod. 2004;19(8):1746-1754.
8. Gore AC, Chappell VA, Fenton SE, Flaws JA, Nadal A, Prins GS, Toppari J, Zoeller RT. EDC-2: The Endocrine Society's Second Scientific Statement on
Endocrine-Disrupting Chemicals. Endocr Rev. 2015;36(6):E1-E150.
9. Wise LA, Radin RG, Palmer JR, Kumanyika SK, Boggs DA, Rosenberg L. Intake of fruit, vegetables, and carotenoids in relation to risk of uterine
leiomyomata. Am J Clin Nutr. 2011;94(6):1620-1631.
10. Borahay MA, Asoglu MR, Mas A, Adam S, Kilic GS, Al-Hendy A. Estrogen Receptors and Signaling in Fibroids:Role in Pathobiology and Therapeutic
Implications. Reprod Sci. 2017;24(9):1235-1244.

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MEMBERS:
Sulgan, Geralyn B.
Surio, Precelda C.
Tagle, Remon Ian
Tapit, Honeylyn C.
Tapong, Recha D.

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Thank You!
GROUP 7