What Is a Pedunculated Fibroid?

Pedicled subserosal fibroidectomy is a surgical treatment for uterine fibroids.

Pedicled subserosal fibroidectomy

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Pedicled subserosal fibroids

Pedicled subserosal fibroidectomy

Pedicled subserous myomectomy; pedunculated subserous myomectomy

Obstetrics and Gynecology / Gynecological Surgery / Abdominal Surgery / Benign Disease Surgery / Uterine Fibroid Surgery

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Uterine fibroids are the most common benign tumors in female genitalia, and they occur in middle-aged women. According to the growth site of fibroids, it can be divided into cervical fibroids and uterine body fibroids. According to the relationship between fibroids and uterine muscle wall, it can be divided into intramural uterine fibroids (Intramural Myoma), subserous uterine fibroids (Subserous Myoma) and submucosal uterine fibroids (Submucous Myoma). The treatment method can be non-surgical treatment or surgical treatment. The treatment should be determined based on the comprehensive judgment of fibroid size, location, clinical symptoms, patient age, fertility needs, and the general condition of the patient. Surgical treatment is currently the most commonly used treatment method. Its indications are menstrual bleeding and irregular vaginal bleeding; there are obvious symptoms of compression; fibroids exceed the size of 12 weeks of pregnancy; fibroids grow rapidly and may be malignant; There are pedicled fibroids under the mucous membrane, especially those that have protruded beyond the cervix; cervical fibroids; zygomatic fibroids have complications such as twisted pedicles, degenerative changes or infection. There are a variety of surgical methods for uterine fibroids, including pedicled fibroids removal in the vagina; pedicled subserosal uterine fibroids resection, abdominal uterine fibroids enucleation; broad ligament fibroids resection; cervical fibroids Resection; subtotal uterus and total hysterectomy.

Pathological and imaging findings of subserosal fibroids.

Pedicled subserous fibroid resection is suitable for:

1. Large fibroids, or those who have oppressive symptoms.

2. Although the fibroids are not large, the tumor pedicles are longer and the twist may occur.

3. Complications such as twisted fibroid pedicles.

1. Multiple uterine fibroids, without the possibility of retaining the uterus.

2. Cervical lesions, especially those suspected of malignant lesions.

3. Fibroids have a tendency to malignancy.

4. Acute pelvic inflammation.

1. Preparation before abdominal surgery in general gynecology.

2. Focus on understanding the patient's menstruation, fertility, the presence or absence of children, and the requirements for reproductive function retention.

3. Cervical smear for cancer cells.

Epidural anesthesia, general anesthesia or subarachnoid anesthesia are generally used. The supine position was taken in the surgical position.

1. Exact hemostasis. If there are thick blood vessels in the tumor pedicle, it should be ligated separately.

2. The rough bread at the broken end is buried well, and if necessary, it is covered with the omentum, and some are covered with amniotic membrane to prevent intestinal adhesion.

3. Fibroids near the uterine horn, be careful not to hurt the fallopian tube when clamping.

The following treatments are performed after pedicled subserosal fibroids resection:

1. Same as general gynecological abdominal surgery.

2. If the fibroid pedicle is deep, contraception should be maintained for more than 1 year after resection.

3. Follow up for a long time, pay attention to the presence or absence of recurrent fibroids.

4. If necessary, add antibiotics to prevent infection.