Fundal Fibroid in Uterus, Meaning, Location, Symptoms, Treatment, and Pregnancy Effects (Subserosal & Intramural Types)

Fundal Fibroid in Uterus:

• What is Fundal Fibroid in Uterus?
• Meaning
• Location
• Symptoms
• Treatment
• Pregnancy Effects (Subserosal & Intramural Types)

What is Fundal Fibroid in Uterus?

A fundal fibroid is a type of uterine fibroid that grows in the fundus, which is the top portion of the uterus. Fibroids (also called leiomyomas or myomas) are non-cancerous tumors made of smooth muscle cells and fibrous tissue. They vary in size and may grow within the uterine wall, on the outer surface, or protrude into the uterine cavity. Fundal fibroids specifically develop at the upper part of the uterus and can be subserosal, intramural, or submucosal in nature.

Because the fundus is a structurally important area of the uterus, fundal fibroids may influence menstrual cycles, fertility, and pregnancy depending on their size and depth. Many women have no symptoms at all, while others may experience significant discomfort. Understanding the type and behavior of a fundal fibroid is essential for determining treatment and assessing reproductive implications.

Meaning

The term “fundal” refers to the anatomical location — the fundus, which is the upper-most rounded portion of the uterus. A fundal fibroid simply means a fibroid located in this region. This location can affect how the uterus expands during pregnancy and may influence symptoms such as pelvic pressure or heavy bleeding.

Fundal fibroids can be classified into different types depending on where they grow within the uterine layers: subserosal (toward the outer surface), intramural (within the muscular wall), or submucosal (toward the inner cavity). Each type has different impacts on reproductive health and symptom severity.

Location

A fundal fibroid sits at the top portion of the uterus. Its precise location influences how it behaves. For example:

• Subserosal fundal fibroid: grows outward on the surface of the uterus.
• Intramural fundal fibroid: grows within the muscular wall of the fundus.
• Submucosal fundal fibroid: grows toward the inner uterine cavity, though this is less common in the fundal region.

Location determines symptoms — subserosal fibroids may cause pressure without heavy bleeding, while intramural ones often cause menstrual disturbances. Large fundal fibroids may also push upward into the abdominal cavity.

Symptoms

Symptoms depend on size, type, and growth direction. Many fundal fibroids cause no symptoms at all. When symptoms do appear, they may include:

• Pelvic pressure or fullness
• Heavy menstrual bleeding (menorrhagia)
• Prolonged periods
• Lower back pain
• Abdominal bloating or visible mass effect
• Pain during intercourse if pressure is exerted
• Difficulty conceiving (intramural or submucosal types)

Subserosal fibroids tend to cause pressure-related symptoms, while intramural types are more likely to disrupt menstrual cycles. A very large fundal fibroid can also press on nearby organs like the bladder or intestines.

Treatment

Treatment for a fundal fibroid depends on symptoms, size, fertility goals, and overall health. Options include:

• Watchful waiting: For small, asymptomatic fibroids.
• Medications: Hormonal therapies (e.g., GnRH agonists), birth control pills, or tranexamic acid for bleeding control.
• Non-surgical procedures: Uterine fibroid embolization (UFE), MRI-guided HIFU.
• Surgical removal: Myomectomy (laparoscopic or open), especially for women wanting future fertility.
• Hysterectomy: Definitive treatment for severe cases in women not desiring future pregnancies.

The best treatment depends on whether symptoms affect quality of life, whether the fibroid is growing, and whether the patient hopes to become pregnant in the future.

Pregnancy Effects (Subserosal & Intramural Types)

Fundal fibroids can affect pregnancy in different ways depending on whether they are subserosal or intramural.

Subserosal fundal fibroids:
These usually grow outward and rarely interfere with implantation or fetal growth. However, large ones can cause:

• Abdominal discomfort
• Increased risk of malpresentation
• Pressure on surrounding organs

They typically do not reduce fertility significantly.

Intramural fundal fibroids:
These grow within the uterine muscle and may affect uterine shape, blood flow, and implantation. Potential effects include:

• Difficulty conceiving
• Higher risk of early miscarriage
• Preterm labor due to decreased uterine space
• Increased risk of cesarean delivery
• Placental implantation issues

Some intramural fundal fibroids enlarge during pregnancy due to increased hormones, potentially causing more pressure and pain.

Overall, many women with fundal fibroids have healthy pregnancies, but monitoring by an obstetrician is recommended to track growth and manage symptoms.