Fibroid that grow in the uterus stalk is called pedunculated fibroid. If this fibroid grows outside the uterus it is called sub-serous fibroids and if it grows inside the uterus its called sub-mucosal fibroids.

Pedunculated fibroids can become quite large. An article in the East African Medical Journal last year reported that a 37-year-old woman presented with significant, increasing abdominal swelling. Surgeons removed a 1.5 kg pedunculated fibroid that was almost 16 cm in length.

But this woman did not have any other symptom expect swelling. But many are not so lucky with their pedunculated fibroids.

Occasionally pedunculated submucosal fibroids can protrude into the vaginal canal, bringing pain during sexual intercourse. The American University of Beirut Medical Center has reported two women that had prolapsed pedunculated submucosal fibroids, one of these patients fibroids had 12 centimetres of the fibroid prolapsed into the vaginal canal while the rest of it remained in the uterus.

When the stalk becomes twisted they can create great pain, and while this doesnt happen to every woman, the risk of it occurring grows with the growth of the fibroid attached to the stalk.

Women with these fibroids also often experience pain in the uterus and significant uterine cramping. The pain can often extent to other organs as well.

This sub-mucosal fibroid even causes irregular bleeding during menstrual such as light spotting or regular bleeding all the time. Women with constant bleeding may undergo heavy bleeding during the menstrual cycle.

Often when the pedunculated fibroid has become severely twisted it will require surgical intervention. This occurs because the pain level becomes so great to the woman experiencing it that they will do anything to stop it.

A twisted peduncle can also create a blockage in the veins that deliver blood and nutrients to the growth. When the blood and nutrients are cut off, the fibroid begins to weaken. As the fibroid deteriorates, the pain increases greatly, as does the risk of infection.

If the stalk is 2 centimeters or more, a Uterine Artery Embolization is suggested. The intention is to obstruct the blood supply to the fibroids, which reduces the growth and shrinks and later dies. But the University of Toronto stated these sub-serous fibroids have failed with Uterine Artery Embolization expect in other types of fibroids.

Doctors at the Bretonneau Hospital in France have begun recommending for women who have undergone the procedure to undergo it again after 2 years as it has been found that approximately 10% experience growth of the fibroids again within that time. They have also discovered that the procedure does not inhibit fibroids from growing back.

Another procedure often used to treat pedunculated fibroids is a myomectomy. In this procedure, the surgeon removes the fibroid and repairs the uterus. Myomectomy is not always 100% successful. In one case reported by the University of South Dakota, an unsuccessful myomectomy was performed, leading to an emergency hysterectomy for the patient.

Often prior to a myomectomy the woman is required to sign an agreement to allow a hysterectomy to be performed should anything go wrong during the procedure, so women that undergo this procedure sometimes wake up without a uterus.

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