uterussubserosal

Uterus subserosal refers to a location of uterine fibroids (leiomyomas) that grow on the outer surface of the uterus just beneath the serosa, often projecting into the peritoneal cavity. This subtype is commonly described as subserosal fibroids, and they can be pedunculated (on a stalk) or broad-based along the outer uterine wall. Subserosal fibroids are one of several fibroid locations, with intramural and submucosal fibroids also occurring within the uterus.

Clinical features vary. Many subserosal fibroids are asymptomatic and discovered incidentally. When they cause symptoms, bulk-related effects are typical, including abdominal distension, pelvic pressure, urinary frequency, and constipation due to mass effect. Heavy menstrual bleeding is less common with subserosal fibroids compared with submucosal fibroids, but it can occur if the fibroid is large or distorts the endometrium.

Diagnosis generally begins with a pelvic examination, followed by imaging. Transvaginal ultrasound is the first-line tool to characterize size, number, and location of fibroids. Magnetic resonance imaging (MRI) provides detailed mapping of subserosal fibroids, which is particularly helpful for surgical planning or when planning non-surgical treatments.

Management depends on symptoms, fibroid size, patient age, and fertility goals. Asymptomatic fibroids may be observed. Medical therapy can help control symptoms or reduce size temporarily (for example, GnRH agonists or selective progesterone receptor modulators in some settings). Definitive treatment options include myomectomy to preserve the uterus, or hysterectomy when fertility preservation is not required. Non-surgical options include uterine artery embolization and MRI-guided focused ultrasound in selected cases. Recurrence or growth after treatment can occur.