Submucous Myoma or Submucosal Fibroid

Submucous Myoma or Submucosal Fibroid

A Submucous Myoma, also known as a Submucosal Fibroid, is a type of non-cancerous tumor that grows in the muscle layer just beneath the inner lining of the uterus. Here are some key points about submucous myomas:

1. Symptoms: They can cause heavy menstrual bleeding, prolonged periods, pelvic pain, and reproductive issues such as infertility or recurrent miscarriages.

2. Diagnosis: These fibroids are usually diagnosed through pelvic examinations, ultrasound imaging, or hysteroscopy, where a camera is inserted into the uterus.

3. Treatment: Treatment options vary based on the severity of symptoms, size, and location of the fibroid. They can include surgical options such as myomectomy (removal of the fibroid) or hysterectomy (removal of the uterus only in advanced age .Submucous fibroids are managed by hysteroscopic myomectomy or laproscopic myomectomy

4. Prognosis: The prognosis is generally good, especially if the fibroid is detected early and managed appropriately. Treatment can significantly improve symptoms and quality of life

Classification of Fibroids : 

Fibroids, also known as uterine leiomyomas or myomas, are classified based on their location within the uterus. The main types of fibroids are:

1. Submucosal Fibroids: These develop just under the lining of the uterine cavity (endometrium) and can protrude into the uterine cavity. They are often associated with heavy menstrual bleeding and fertility issues.

2. Intramural Fibroids: These are located within the muscular wall of the uterus (myometrium). They are the most common type of fibroids and can cause symptoms such as heavy menstrual bleeding, pelvic pain, and pressure.

3. Sub serosal Fibroids: These develop on the outer surface of the uterus and grow outward into the pelvic cavity. They can sometimes become quite large and may cause pressure symptoms on the bladder, rectum, or other pelvic organs.

4. Pedunculated Fibroids: These fibroids are attached to the uterus by a thin stalk. They can be submucosal or subserosal, depending on their location. Pedunculated fibroids can twist on their stalk, causing pain and potentially requiring surgical intervention.

5. Cervical Fibroids: These are located in the cervix, which is the lower part of the uterus that connects to the vagina. Cervical fibroids are less common and can cause symptoms related to urinary or bowel function.

6. Interligamentous (Broad Ligament) Fibroids: These fibroids develop in the broad ligament, which is the structure that supports the uterus in the pelvis. They are less common and can cause symptoms based on their size and location.

7. Parasitic Fibroids: These are rare fibroids that detach from the uterus and receive blood supply from other pelvic organs.

The classification of fibroids helps in determining the appropriate management and treatment plan.The classification of fibroids from 0 to 8 is known as the FIGO (International Federation of Gynecology and Obstetrics) leiomyoma subclassification system. This system helps in understanding the precise location of fibroids relative to the uterine cavity and wall. Here is the FIGO classification:

1. Type 0: Pedunculated intracavitary fibroid (completely within the uterine cavity).
2. Type 1: Submucosal fibroid with less than 50% of its diameter within the myometrium.
3. Type 2: Submucosal fibroid with 50% or more of its diameter within the myometrium.
4. Type 3: Intramural fibroid that contacts the endometrium but does not distort the uterine cavity.
5. Type 4: Intramural fibroid that is entirely within the myometrium and does not contact the endometrium.
6. Type 5: Subserosal fibroid with less than 50% of its diameter within the myometrium.
7. Type 6: Subserosal fibroid with 50% or more of its diameter within the myometrium.
8. Type 7: Subserosal fibroid that is pedunculated and located outside the uterine wall.
9. Type 8: Fibroids that do not fit into the other categories and can be found in other locations such as the cervix, broad ligament, or those that are parasitic.

Understanding this classification helps in diagnosing and determining the most appropriate treatment for uterine fibroids based on their location and potential impact on symptoms and reproductive health.