Obstetrics & Gynaecology · Gynaecology

A 45-year-old woman presents with a 12-month history of menorrhagia and a 14-week-sized uterus. Examination reveals multiple irregular uterine masses. Transvaginal ultrasound confirms multiple intramural and subserosal fibroids, the largest measuring 6 cm. She also reports significant urinary frequency. Which fibroid location is MOST responsible for the urinary symptoms?

  • A Subserosal
  • B Intramural
  • C Submucosal
  • D Cervical
Correct answer: A. Subserosal

Explanation

Subserosal fibroids project outward from the uterine serosa and can compress adjacent pelvic structures. An anteriorly located subserosal fibroid compressing the urinary bladder causes urinary frequency and urgency. Submucosal fibroids primarily cause heavy menstrual bleeding and infertility. Intramural fibroids cause menorrhagia and bulk symptoms but less direct bladder compression than subserosal lesions.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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