Cervical myomas are smooth, benign tumors of the cervix.

Cervical myomas are uncommon. Uterine myomas (fibroids) usually coexist. Large cervical myomas may partially obstruct the urinary tract or may prolapse into the vagina. Prolapsed myomas sometimes ulcerate, become infected, bleed, or a combination.

Symptoms and Signs

Most cervical myomas eventually cause symptoms. The most common symptom is bleeding, which may be irregular or heavy, sometimes causing anemia. Dyspareunia may occur. Infection may cause pain, bleeding, or discharge. Rarely, prolapse causes a feeling of pressure or a mass in the pelvis. Urinary outflow obstruction causes hesitancy, dribbling, or urine retention; UTIs may develop.

Diagnosis

• Physical examination

Diagnosis is by physical examination. Cervical myomas, particularly if prolapsed, may be visible with use of a speculum. Some are palpable during bimanual examination.

Transvaginal ultrasonography is done only for the following:

• To confirm an uncertain diagnosis
• To exclude urinary outflow obstruction
• To identify additional myomas

Hb, Hct, or CBC is measured to exclude anemia. Cervical cytology is done to exclude cervical cancer.

Treatment

• Removal of symptomatic myomas

Treatment is similar to that of fibroids (see Uterine Fibroids: Treatment). Small, asymptomatic myomas are not treated. Most symptomatic cervical myomas are removed by myomectomy (particularly if childbearing capacity is important) or, if myomectomy is technically difficult, by hysterectomy. Prolapsed myomas should be removed transvaginally if possible.

Last full review/revision December 2008 by S. Gene McNeeley, MD