Myomas (also called fibroids Fibroids A fibroid is a noncancerous tumor composed of muscle and fibrous tissue. It is located in the uterus. Fibroids can cause pain, abnormal vaginal bleeding, constipation, repeated miscarriages... read more ) are benign tumors composed partly of muscle tissue. They seldom develop in the cervix, the lower part of the uterus. When they do, they are usually accompanied by myomas in the larger upper part of the uterus.
Large cervical myomas may partially block the urinary tract or may protrude (prolapse) into the vagina. Sores sometimes develop on prolapsed myomas, which may become infected, bleed, or both. Rarely, prolapsed myomas can also block the flow of urine.
Most cervical myomas eventually cause symptoms. The most common symptom is
Heavy bleeding can cause anemia, with fatigue and weakness. Sexual intercourse may be painful.
If myomas become infected, they may cause pain, bleeding, or a discharge from the vagina.
Rarely, prolapse causes symptoms such as a feeling of pressure or a lump in the pelvis.
Rarely, if a myoma blocks the flow of urine, women may have a hesitant start when urinating, dribble at the end of urination, and retain urine. Urinary tract infections are more likely to develop.
Doctors can often detect myomas during a physical examination. During a pelvic examination Pelvic Examination For gynecologic care, a woman should choose a health care practitioner with whom she can comfortably discuss sensitive topics, such as sex, birth control, pregnancy, and problems related to... read more , doctors may see a myoma, particularly if prolapsed. Or doctors may feel a myoma when they check the size and shape of the uterus and cervix (with one gloved hand inside the vagina and the other on top of the abdomen).
If the diagnosis is uncertain, doctors may insert an ultrasound device through the vagina into the uterus to obtain an image of the area. This procedure, called transvaginal ultrasonography Abnormal uterine bleeding is bleeding from the vagina that occurs frequently or irregularly or lasts longer or is heavier than normal menstrual periods. The most common type of abnormal bleeding... read more , is also used to check for additional myomas. Alternatively, MRI may be done.
Blood tests are done to check for anemia.
A Papanicolaou (Pap) or human papillomavirus (HPV) test (called cervical cytology tests Screening for Cervical Cancer Sometimes doctors recommend screening tests, which are tests that are done to look for disorders in people who have no symptoms. If women have symptoms related to the reproductive system (gynecologic... read more ) is done to rule out cancer of the cervix.
If myomas are small and do not cause any symptoms, no treatment is needed.
If myomas cause symptoms, they are surgically removed if possible (a procedure called myomectomy). If only the myoma is removed, women can still bear children. However, if myomas are large, removal of the entire uterus (hysterectomy) may be necessary. Either procedure can be done by making a large incision in the abdomen (laparotomy). Sometimes these procedures can be done with instruments inserted through one or more small incisions near the navel (laparoscopy).
If a myoma protrudes into the vagina, it is removed with instruments inserted through the vagina (transvaginally) if possible.