Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- asymptomatic
- heavy menstrual bleeding
- irregular firm central pelvic mass
Otros factores de diagnóstico
- pelvic pain
- pelvic pressure
- dysmenorrhea
- bloating
- fatigue and loss of productivity in working
- infertility
- urinary complaints
- constipation
- enlarged uterus (regular contour)
- dyspareunia
Factores de riesgo
- increased patient weight
- age in the 40s
- black ethnicity
- hypovitaminosis of vitamin D
- hypertension
- early menarche (under 10 years)
- use of oral contraceptives (if started before age 16 years)
- nulliparity
- younger age at first birth
- poor vitamin A intake
- dietary intake high in beef and other red meat
- sex hormone exposure
- menstrual history
- smoking
- alcohol consumption
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- ultrasound
- endometrial biopsy
Pruebas diagnósticas que deben considerarse
- sonohysterography
- hysteroscopy
- MRI
- laparoscopy
Pruebas emergentes
- sonoelastography
- MR elastography
Algoritmo de tratamiento
fertility desired
fertility not desired
Colaboradores
Autores
Ayman Al-Hendy, MD PhD FRCSC FACOG CCRP
Professor (visiting) and Director
Translational Research
Department of Obstetrics and Gynecology
University of Illinois
Chicago
IL
Divulgaciones
AAH serves on the external advisory board of Bayer, AbbVie, Myovant, Pfizer, ObsEva and Allergan, and has received research funding from the National Institutes of Health. AAH is an author of references cited in this topic.
Obianuju Sandra Madueke-Laveaux, MD MPH
Assistant Professor of Obstetrics and Gynecology
Department of Obstetrics and Gynecology
University of Illinois
Chicago
IL
Divulgaciones
OSML declares that she has no competing interests. OSML is an author of references cited in this topic.
Vuslat Lale Bakir, MD
Assistant Professor of Obstetrics and Gynecology
Department of Obstetrics and Gynecology
Haseki Training and Research Hospital
Health Sciences University
Istanbul
Turkey
Divulgaciones
VLB declares that she has no competing interests.
Agradecimientos
Dr Al-Hendy, Dr Madueke-Laveaux, and Dr Bakir would like to gratefully acknowledge Dr Mohamed Mitwally, Dr Intisar Elnahhas, and Dr Robert J. Fischer, the previous contributors to this topic.
Disclosures
MM, IE, and RJF declare that they have no competing interests.
Peer reviewers
Everett Magann, MD
Chairman
Department of Obstetrics and Gynecology
Naval Medical Center
Portsmouth
VA
Disclosures
EM declares that he has no competing interests.
Amy Niederhauser, MD
Doctor
Department of Obstetrics and Gynecology
Naval Medical Center
Portsmouth
VA
Disclosures
AN declares that she has no competing interests.
Adam Magos, BSc, MB, BS, MD, FRCOG
Consultant Gynaecologist
University Department of Obstetrics and Gynaecology
Royal Free Hospital
London
UK
Disclosures
AM declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Stewart EA, Cookson CL, Gandolfo RA, et al. Epidemiology of uterine fibroids: a systematic review. BJOG. 2017 Sep;124(10):1501-12.Full text Abstract
Marshall LM, Spiegelman D, Barbieri RL, et al. Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol. 1997 Dec;90(6):967-73. Abstract
American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 228: management of symptomatic uterine leiomyomas. Jun 2021 [internet publication].Full text
Wise LA, Laughlin-Tommaso SK. Epidemiology of uterine fibroids: from menarche to menopause. Clin Obstet Gynecol. 2016 Mar;59(1):2-24.Full text Abstract
American College of Radiology. ACR Appropriateness Criteria®. Fibroids. 2022 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Adenomyosis
- Endometrial polyp
- Endometrial hyperplasia
More DifferentialsGuidelines
- ACR appropriateness criteria: clinically suspected adnexal mass
- ACR appropriateness criteria: fibroids
More GuidelinesPatient information
Fibroids
Fibroids: questions to ask your doctor
More Patient informationLog in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer