Cervical Fibroids

(Cervical Leiomyomas)

ByDavid G. Mutch, MD, Washington University School of Medicine;
Scott W. Biest, MD, Washington University School of Medicine
Reviewed/Revised May 2023
VIEW PROFESSIONAL VERSION

Cervical fibroids are benign (noncancerous) smooth muscle tumors of the cervix.

  • A cervical fibroid may cause vaginal bleeding or a discharge, interfere with urinating, or cause pain during sexual activity.

  • Doctors can see or feel most fibroids during a pelvic examination.

  • Fibroids that cause symptoms can be removed surgically.

Fibroids (also called leiomyomas or myomas) are benign tumors composed partly of muscle tissue. They are very common in the body of the uterus, but sometimes they develop in the cervix (the lower part of the uterus). When they do, they are usually accompanied by fibroids in the larger upper part of the uterus.

Large cervical fibroids may partially block the urinary tract or may protrude into the vagina. Sores sometimes develop on prolapsed fibroids, which may become infected, bleed, or both. Large cervical fibroids can block the flow of urine.

Sometimes a pedunculated submucosal fibroid (a fibroid that is located under the lining of the uterus and has a stalk that makes it protrude into the uterine cavity) prolapses. This is not a cervical fibroid, but it can be visible at the opening of the cervix or extend into the vagina. Sores sometimes develop on prolapsed fibroids, which may become infected, bleed, or both.

Symptoms of Cervical Fibroids

Most cervical fibroids eventually cause symptoms. The most common symptom is

  • Bleeding from the vagina, which may be irregular or heavy

Heavy bleeding can cause anemia, with fatigue and weakness. Sexual activity may be painful.

Rarely, if a fibroid 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.

Diagnosis of Cervical Fibroids

  • Pelvic examination

  • Sometimes imaging tests such as ultrasonography or magnetic resonance imaging (MRI)

Doctors can often detect fibroids during a physical examination. During a pelvic examination, doctors may see a cervical fibroid. Or doctors may feel a fibroid 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, is also used to check for additional fibroids and blockage of urine flow. Alternatively, MRI may be done.

Blood tests are done to check for anemia if the woman has heavy or frequent vaginal bleeding.

A Papanicolaou (Pap) or human papillomavirus (HPV) test (called cervical cytology tests) is done to rule out cancer of the cervix for any woman with a cervical mass. Sometimes, a biopsy of the cervix is done.

Treatment of Cervical Fibroids

  • If cervical fibroids cause symptoms, surgery

If fibroids are small and do not cause any symptoms, no treatment is needed.

If cervical fibroids cause symptoms, sometimes they can be surgically removed in a procedure using instruments passed through the vagina. However, if a cervical fibroid is large, removal of the entire uterus (hysterectomy) may be necessary.

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