Pedunculated fibroids are fibroids which are attached by a stalk to the uterus; this stalk is known as a peduncle. Those pedunculated fibroids that appear on the outside of the uterus are known as subserous pedunculated fibroids, while those that appear inside the uterus are known as pedunculated submucosal 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.

One of the most startling things about this patients condition was that she had no symptoms other than the abdominal swelling. Other women who develop pedunculated fibroids have a much different experience.

In some women, submucosal pedunculated fibroids extend into the vaginal canal, which causes distress during sexual intercourse. Two patients treated by the American University of Beirut Medical Center were found to have such fibroids. A full 12 cm of one patients submucosal fibroid had grown into the vaginal canal, while the rest of the growth remained in her uterus.

Pedunculated fibroids can be painful, particularly if the peduncle becomes twisted. The risk of the peduncle twisting increases as the fibroid grows larger.

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.

Yet another possible symptom brought on by pedunculated submucosal fibroids is bleeding between periods. This bleeding can range from light spotting, to constant bleeding very similar to that of a light period. Those who have constant bleeding report that the intensity of the bleeding becomes heavier at the arrival of their time of the month.

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.

When a peduncle is determined to be 2cm or more in width, a process called Uterine Artery Embolization is indicated. This procedure blocks the blood supply to the growths so that they begin to deteriorate and eventually die. This procedure has been found to be more successful with subserousal fibroids than with any other kind of fibroid.

The doctors in Bretonneau hospital of France suggests women to repeat Uterine Artery Embolization, as its diagnosed that 10% of women has re-growth of these fibroids after 2 years.

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.

Before hysterectomy surgeries, it is very reasonable to sign papers as an approval, as things may go wrong or sometimes for very few women uterus has to be removed.