modifiable factors:

Non-modifiable factors:

Diet

Stress Age

Genetics

Early Menarche

Estrogen Dominance

Proliferation of cells in the uterus

Overgrowth of the endometrial lining Diagnostic Tests: -Transvaginal/ transrectal Ultrasonography , Interference in the vascular supply Development of uterine fibroid

Degeneration in the interior part of the fibroid

Degeneration in the interior part of the fibroid

Acute Hyaline degeneration Red or carneous infarction pelvic pain

Smooth muscle cells are replaced by fibrous connective tissue

Management: Continued growth of the fibroid Increase abdominal girth Endometrial distention -Subtotal hysterectomy -TAHBSO

pressure on the bladder

Rectosigmoid compression

Constipation Urinary frequency and urgency(at least 10-11 times preop) (at least 1-2 days before she defecate preop)