Subserosal Fibroid: Symptoms, Pregnancy, Treatment

• Fibroid Type 5: Subserosal, ≥50% intramural
• Fibroid Type 6: Subserosal, <50% intramural
• Fibroid Type 7: Subserosal, pedunculated

Most cases of uterine fibroids do not cause noticeable symptoms. However, women that do experience subserosal fibroid symptoms will generally experience ‘bulk’ symptoms caused by increasing fibroid and uterus size. Pain and pelvic pressure are the most commonly reported subserosal fibroid symptoms. Women with enlarged subserosal fibroids may also experience bloating, a feeling of fullness, urinary urgency, or constipation caused by the fibroid(s) pressing against the stomach, the bladder, or other nearby organs [4]. Heavy bleeding is another common symptom of uterine fibroids, and may also be present in the case of subserosal fibroids.

Pregnancy complications and challenges aren’t typically attributed to subserosal fibroids because they aren’t located near the endometrium or the uterine cavity [2]. If a subserosal fibroid extends to the endometrium, it is typically classified as submucosal rather than subserosal. Many women with uterine fibroids are able to become pregnant and deliver their baby without a problem, but pregnancy complications such as miscarriage, c-section, preterm labor and postpartum hemorrhage occur in approximately 10 to 40% of pregnancies when fibroids are present [5,6].

Subserosal fibroid treatments vary from conservative medical therapy, to minimally invasive interventions, to surgical removal of the entire uterus. The optimal subserosal fibroid treatment will depend on your desire to preserve fertility, your age, any other existing medical issues, ability to take time off for recovery, as well as other factors. Some therapies treat symptoms while others eliminate the fibroids completely. Some treatment options, while less invasive, may require subsequent treatment or re-intervention. These are all factors to consider when deciding which subserosal fibroid treatment option is best for you, and some treatment options are only viable for certain types of fibroids.

Get Relief From Subserosal Fibroids

Medications

The most conservative treatment option for uterine fibroids is medical therapy. Medicine can be effective if symptoms are mild, if a woman is in perimenopause (so treatment is only needed in the short term), or if pre-operative intervention to reduce the size of the fibroids would make a surgery less technically challenging [7, 8]. Nonsteroidal anti-inflammatory drugs (NSAIDs), hormones (estroprogestins or progestogens), and oral contraceptives can help with symptomatic bleeding and fibroid pain. Gn-RH analogues and selective progesterone receptor modulators (sPRMs) like ulipristal acetate (UPA) help treat bulk symptoms such as pelvic pressure, pelvic pain, and frequent urination [9]. Medical treatments are only used for the short-term due to the significant health risks associated with long-term use of these medicines [7].

Uterine Fibroid Embolization

Uterine fibroid embolization, also known as uterine artery embolization, is a minimally invasive procedure performed by an interventional radiologist or vascular specialist. During the procedure, small spherical beads are injected into the blood vessels that supply the fibroids with oxygen and other nutrients. The beads occlude the blood vessels, essentially starving the fibroids and causing them to shrink. UFE is an outpatient procedure with a recovery time around 1 to 2 weeks.

Myolysis

Myomectomy

Hysterectomy