Uterine fibroids have been a major problem for women throughout the centuries manifesting themselves primarily with bladder, bowel, and pressure symptoms relating to their size; and abnormal uterine bleeding and infertility depending upon their location. They have prompted the use of a number of therapeutic approaches including hysterectomy, hysteroscopic surgery, and various laparoscopic approaches including excision, thermogenic, and cryogenic myolysis. The most recent development in the management of uterine fibroids is the use of arterial embolization.

This publication addresses all of the areas in regards to fibroids in an expansive, thorough, and interesting fashion. Chapters include an overview of the incidences of fibroids, and the changing nature as far as treatment is concerned in regards to an aging population interested in fertility. Histopathology is explored, as well as attention to physiology and unicellular origin of fibroids.

Diagnostic imaging, with the appearance of the CAT scan and MRI, has changed the nature of our understanding of myomas in that now penetration into the cavity and other anatomical distortions can be more precisely delineated prior to definitive surgery and/or treatment. The chapter on laparoscopic management includes discussions of all of those techniques that have required an invasive approach in order to manage the patient with symptomatic myomas.

The pregnant patient with myoma represents a special challenge. These myomas may cause premature labor, and are problematic in cesarean sections.