A pedicle myoma or pedicle fibroids that is fixed to the uterus by a stalk, called a peduncle. Pedicle fibroids that grow outside the uterus are called pedicle subserous fibroids, and those that grow inside the uterus are called pedicle submucosal fibroids. They can grow very large and one of the largest I found was reported in the East African Medical Journal last year. A 37-year-old woman had an abdominal swelling that increased in size. His surgeons found a pedicle myoma almost 16 centimeters long that weighed 2 kilograms in almost a year and a half. The woman with the fibroid did not experience symptoms, except for the swelling, but other women are not so lucky with their pedicle fibroids.
A pedicle submucosal fibroid can protrude into the vaginal canal, causing pain during intercourse. The University of Beirut Medical Center reported two women with prolapse of pedunculated sucmucosal fibroids in a 12-centimeter patient, that fibroid had prolapsed in the vaginal canal and the rest was still in the uterus. They can cause severe and acute pain when the stem is twisted, and although this does not happen to all women, the risk of this happening increases as the fibroid attached to the stem grows. Other types of pain associated with these fibroids include uterine cramps , and a feeling of pressure on the uterus and other organs.
Another symptom of pedicle submucosal fibroids is bleeding between periods. This bleeding can be from a slight spot to constant bleeding similar to having the period all the time. Women with continuous bleeding find that the bleeding becomes heavier when menstruation arrives. Pedunculated fibroids may require immediate surgery. This is because the pain can be so unbearable that the woman cannot do anything to mitigate it. Another consequence of the crooked peduncle is a blockage or narrowing in the veins that supply the fibroid with blood and nutrients. When the supply is blocked, the fibroid will begin to die, in itself it is extremely painful, and may increase the risk of infection. The embolization of the artery that feeds it is recommended when the stem is 2 centimeters or wider. The purpose of this procedure is to block the blood supply to the fibroids, so they stop growing and begin to shrink and die. But the University of Toronto reported that pediatric subserous fibroids were more likely to fail with embolization than any other type of fibroid. At the Bretonneau hospital in France, doctors recommend that women who have uterine artery embolization should repeat the procedure after 2 years, as they found that 10% of women experience a new growth of fibroids after 2 years. They also found that uterine artery embolization did not cause fibroids to grow back. Myomectomy is another common procedure for pedicle fibroids. This is when the surgeon cuts the fibroid, but the uterus is maintained. This surgery is not 100% successful and the University of South Dakota reported a case in which a blood vessel in a large pedicle fibroid had ruptured after the patient had just given birth. A myomectomy was attempted, but it was not successful, so they had to perform an emergency hysterectomy. It is very common for women to have to sign the papers before their surgeries to agree on a hysterectomy if something goes wrong, so sometimes women wake up without a uterus.