• Shamshad Begum
  • Sameera Khan


Background: Fibroid is the commonest tumor of the reproductive tract and frequently encountered problem in gynecological practice. This study was carried out to observe the frequency of fibroids in relation to age, parity and clinical manifestations along with a critical review of its management. Methods: This study was carried out over a period of one year from 1st January to 31st December 2000 in Gynae “A” unit of  Khyber teaching hospital, Peshawar. All patients presenting with fibroid uterus were included in the study. Data collection included age, parity, menstrual pattern, presenting symptoms, medical and surgical treatment history. Diagnostic criteria were clinical and ultrasonography. Evaluation of medical treatment and surgery were carried out. Management outcome of minimal invasive surgery was also observed. Results and Conclusion: Total 146 cases were observed. Greater frequency was found in late reproductive and perimenopausal years (65.7%). There were 34.2% cases in reproductive age group. Majority was multiparous (72%) and 28% were nulliparous. Infertility was noticed in 16%. Myomas were mostly symptomatic (70%). Menstrual symptoms were commonest (81.5%), pain was second common symptom (27.3%). About 24% presented with abdominal mass and hyaline degeneration were in 50% of cases. Leiomyomas were multiple in 63.1% and commonest variety was interstitial (60.4%). Familial factor noticed in 5.4%, clinical diagnosis was made in 58.2% of cases, while ultrasound was used in 40.4% of patients, conservative treatment was given in 37.6% including medical therapy (8.2%), Surgery was performed in (62.3%). .Myomectomy (10.2%) and hysterectomy was carried out in 52.05%. Minimal invasive surgery was not possible in our set up.KeyWords: Leiomyoma, menorrhagia, degenration, myomectomy, hystrectomy, Fibroid uterus


Brandly JP. Uterine fibroids “What every women should know, treatment choices for benign uterine conditions. www.Obgyn.neta services of Elecon corp.

Benangiano G, Cronje H, Kivinen ST. BeZoladex (goserelin acetate) and anemic patient: results of a multicentre fibroid study. Fertility and sterility Amer J 1996;66:223-8

Rein MS, Barbieri RL, Friedman AJ. Progesterone: A critical role in pathogenesis of uterine myomas. Am J Obst Gynecol 1995;172(1)14-8.

Smith SK. Regulation of fibroid growth: time for a rethink? Br J Obst Gynaecol 1993;100:977-8.

Mayer DP, Shipilov V. Ultrasonography and Magnetic resonance imaging of uterine fibroids. Clin North America 1995;22:667-703

Dinaro FG, Bratta F, Romano F, Caradonna P. The diagnosis of benign uterine pathology using transvaginal endohysterosnography. In: Clinical Experiences in Obstetrics Gynecology 33rd edition. 1996.pp103-07

Bernard JP, Lecuru F, Darles C, Robin F, Taurelle R. Saline contrast sonohysterography as first-line investigation for women with uterine bleeding. Utrasound in Obstet Gynecol 1997:10:121-5.

Thompson JD, Rock JA. Leiomyomata uteri and myomectomy. In: Te Linde's operative gynecology, 8th edition, Lippincort -Raven publishers 1997 pp.731-91.

Kazamel MD. Medical and socioeconomic impact of uterine fibroids. Obst gynae clinics 1995;22:625-35

Frances Jr H. Abdominal myomectomy as a treatment for symptomatic uterine fibroids. Obstetrics and gynecology clinics North-America 1995;22(4):781-9.

Rutgers Jl, Spong CY, Sinow R, Heiner J. Leuprolide Acetate treatment and myoma arterial size. Obst Gynecol Amer J 1995;86 (3): 386-8.

Wallach EE, Vu KK. Uterine fibroids, Myomata uteri and infertility. Clinics of North America 1995; 22:791-9

Hutchins Jr FL. Uterine fibroids; Diagnosis and indications for treatment. Obs and Gyn Clinics of North America 1995;22(4):659- 64

Scot JR. Disorders of uterine corpous. In: Danforth obstetrics and gynaecology. 7th Edition, Parker publisher 1995; pp929.

Prayson RA, Hart WR. Pathologic considerations of uterine smooth muscles tumors. Clin N America 1995;22(4):637-57

Davis KM, Schlaff WD. Medical management of uterine fibromyomata. Clin N America 1995;22(4): 727-37

Harrison M, Woolrych BM, Robinson R. Fibroid growth in response to high dose progestogen. Fertility and sterility American journal 1995;64(1):191-2.

Reinsch RC, Murphy AA, Morales AJ, Yen SSC. The effect of RU 486 and Leuprolide acetate on uterine artery blood flow in fibroid uterus. Am J obstet gynecol 1994;170(6)1623-6.

Lumsden MA, West CP, Thomas E, Coutts J, Hillier H. Treatment with gonando trephine releasing hormone agonist "Goserelin" before hysterectomy for uterine fibroids. British journal of obstetrics and gynecology 1997;101:438-42.

Al-Taher H, Farquharson RG. Management of uterine fibroids. Br J Hosp Med 1993;50(2/3):133-6.

Neuwirth RS. Hysteroscopic submucous myomectomy. Obstet and Gynecol Clinics of North-America 1995;22(3):541-58

Iverson Jr RE, Chelmow D, Strohbehn K, Waldman L. Relative morbidity of abdominal hysterectomy and myomectomy for management of uterine leiomyomas. Obst gynecol 1996;88(3):415- 9.

Scott JR, Disaia PJ, Surgical treatment of leiomyomas. In: Danforth obstetrics an gynecology. 7th edition, Parker publisher 1995;pp 830-4.

SmithDC, Donohue LR, Waszak SJ. A hospital review of advanced gynecologic endoscopic procedures. American J Obstet gynecol 1994;170(6):1635-42.

Mais V, Ajossa S, Guerriero S. Mascia M. Laparoscopic versus abdominal myomectomy, A prospective randomized trial to evaluate benefits in early outcome. American J Obstet Gynecol 1996;174(2):654-8.