Uterine fibroids, also known as leiomyomas or myomas, are very common non-cancerous growths that develop in the muscle tissue of the uterus. They are composed of smooth muscle and fibrous connective tissue. A 9-centimeter fibroid is considered a large mass, often causing symptoms that require medical attention rather than simple observation.
Visualizing a 9 cm Fibroid
A 9-centimeter fibroid falls into the category of medium to large tumors. To visualize this size, a 9 cm growth is comparable to a large orange or a baseball. Due to its substantial diameter, this mass occupies significant space, often causing the uterus to enlarge considerably, sometimes mimicking the size of a pregnancy.
If observed during a surgical procedure, a fibroid has a distinct appearance, being generally round or oval in shape. The texture is typically firm and dense, described by surgeons as rubbery because it is made of muscle and fibrous tissue. Its color is usually paler than the surrounding uterine muscle tissue.
Impact of Location: Subtypes and Placement
The specific effects of a 9 cm fibroid depend entirely on its location within the uterine structure. Subserosal fibroids grow on the outer surface of the uterus, expanding outward toward the pelvic cavity. A mass of this size in this location often causes pressure symptoms by pushing against nearby organs like the bladder or bowel.
Intramural fibroids are the most common type, developing within the muscular wall of the uterus itself. When an intramural fibroid reaches 9 cm, it severely distorts and enlarges the overall size and shape of the uterus, leading to heavy menstrual bleeding and significant pelvic pain. Submucosal fibroids, which grow just beneath the inner uterine lining, are the most impactful, often causing severe bleeding even when small. A 9 cm submucosal fibroid is rare, but its presence would almost completely obstruct the uterine cavity, leading to extremely heavy and prolonged menstrual flow.
Symptoms Caused by a Large Mass
A 9 cm fibroid creates a variety of symptoms, including bleeding and bulk effects. Heavy menstrual bleeding, medically termed menorrhagia, is a frequent complaint, especially with intramural and submucosal types. This excessive blood loss can lead to secondary health issues like anemia, causing persistent fatigue and weakness due to low red blood cell counts.
The mass causes significant pressure on surrounding pelvic and abdominal structures. This pressure often results in frequent urination or a feeling of incomplete bladder emptying because the fibroid is pressing on the bladder. Pressure on the rectum can lead to constipation, and compression of nerves in the pelvis may cause chronic lower back or leg pain.
Medical Approach to 9 cm Fibroids
Diagnosis of a 9 cm fibroid starts with a pelvic examination, where a provider may feel an enlarged or irregularly shaped uterus. The initial imaging tool is usually an ultrasound, which confirms the presence, size, and approximate location of the growth. A pelvic MRI may also be used to provide a detailed map of the fibroid’s exact position, which is necessary for surgical planning.
A fibroid of this magnitude often requires intervention rather than simple observation, as it is likely to be symptomatic. Treatment options are tailored to the patient’s symptoms and desire to preserve fertility. Surgical removal of the fibroid, known as a myomectomy, is often performed to maintain the uterus. Other procedures include Uterine Artery Embolization (UAE), which shrinks the fibroid by blocking its blood supply, or a hysterectomy, the definitive surgical solution for women who do not wish to retain their uterus.