What are the Different Types of Fibroids?
Uterine fibroids are classified by their location in the uterus.
Their location effects the symptoms they may cause and how they can be treated.
Although this classification scheme is widely used by clinicians, it suffers from the limitation that few leiomyomas are actually a single "pure" type!
Most fibroids span more than one anatomic location and, therefore, are hybrids (e.g., a predominantly intramural leiomyoma with a submucous component).
Other types of fibroids include parasitic myomas, receive their blood supply from structures other than the uterus (e.g., the omentum), and seedling myomas, which have a diameter of less than or equal to 4 millimeters.
If you have fibroids, you may have one or many.
You may also have one type of fibroid or a number of different types.
Tumors in subserosal and intramural locations comprise the majority (95%) of all leiomyomas; submucous leiomyomas make up the remaining 5%.
- Subserous myomas are on the outside wall of the uterus.
They may even be connected to the uterine corpus by a stalk (pedunculated fibroid) or or may be broad-based (sessile).
These do not need treatment unless they grow large but those on a stalk can twist and cause pain.
Subserous fibroids can grow to be very large.
However, this type of fibroid is the easiest to remove by laparoscopy.
- Intramural myomas are found predominantly within the thick wall of the uterus (myometrium) and can range in size from microscopic to larger than a grapefruit.
Many intramural fibroids do not cause problems unless they become quite large.
But may distort the uterine cavity or cause an irregular external uterine contour.
There are many alternatives for treating these type of fibroids but often they do not need any treatment.
They are the most common type of fibroids.
- Submucous fibroids are located just under the uterine mucosa (endometrium) and are partially in the cavity and partially in the wall of the uterus.
Like subserosal leiomyomas, they may be either pedunculated or sessile.
They can cause heavy menstrual periods (menorrhagia), as well as bleeding between periods.
If long enough, can hang through the cervix.
Many of these can also be removed by hysteroscopic resection.
- Intracavitary fibroids are inside the cavity of the uterus.
They will usually cause bleeding between periods and often cause severe cramping.
These fibroids can usually be easily removed by a method called hysteroscopic resection too.
This procedure can be done through the cervix without the need for an incision.
Cervical fibroids grow in the wall of the cervix (neck of the womb) and are difficult to remove without damaging the surrounding area.