Uterine Fibroids: Diagnosis & Treatment

Overview

Uterine fibroids are benign tumors that develop from the smooth muscle cells of the uterus. The condition is common, affecting 20% of women over the age of 35, with the highest prevalence in women aged 35 to 45 years. In most cases, fibroids shrink naturally after menopause.
Fibroids are classified into three main types:

• Submucosal fibroids – Grow beneath the uterine lining and may cause heavy menstrual bleeding.

• Intramural fibroids – Develop within the uterine wall, often leading to pelvic pain or pressure.

• Subserous fibroids – Form on the outer surface of the uterus and may cause pressure symptoms on adjacent organs.

Diagnosis

The following diagnostic tests are used to confirm the presence and location of fibroids:

• Transvaginal ultrasound – A highly accurate method for detecting fibroids.

• Abdominal ultrasound – Assesses the uterus and other pelvic organs.

• CT scan – Provides detailed imaging in complex cases.

• MRI of the pelvis – Offers the most precise assessment of fibroid size, location, and relation to surrounding structures.

Treatment

The treatment approach depends on fibroid size, symptoms, and patient preference:

1. Observation & MonitoringRegular follow-up every six months if fibroids are small and asymptomatic.
   

2. Medication TherapyHormone therapy with gonadotropin-releasing hormone (GnRH) agonists reduces estrogen levels, leading to a 40-60% decrease in fibroid size.
   

3. Surgical TreatmentMyomectomy – Removes fibroids while preserving the uterus, suitable for women planning pregnancy.
   Hysterectomy – Complete removal of the uterus in cases of large, symptomatic, or multiple fibroids.
   

Cost of Diagnosis & Treatment:

• 8,800,000 – 9,800,000 KRW