Chronic pelvic pain. Nocturia and dyspareunia.
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Multiple uterine fibroids, including two large subserosal fibroids, one arising anteriorly and one posteriorly. Note the preserved junctional zone and endometrial contour.
One of the key factors in assessing myometrial fibroids is to note their location and consider this in relation to patient symptoms. These fibroids have considerable mass effect, with pressure on the bladder, which would account for the presenting complaint. On the other hand, there is no mass effect onto the endometrium, and these fibroids are unlikely to have resulted in any abnormal bleeding even prior to menopause (though menstrual history is unknown).