Specifically, the cervix is often significantly longer on the scan, compared with the digital examination (which presumably represents the fact that TVS measures the whole cervical length, including the supravaginal
portion), and TVS captures the cervix in a passive state, whereas during a digital exam, touching the cervix will stretch it to a variable dilatation.
They arise either from the portio vaginalis presenting as a fibroid polyp or from the supravaginal cervix presenting either as an interstitial, subserous or submucous fibroid.
Management in cervical fibroid of supravaginal portion is hysterectomy if fertility is not desired and myomectomy if the patient is young and fertility is desired.
With the more common blunt dissection during vaginal hysterectomy, the surgeon pushes the supravaginal septum and vesicocervical space upward with a finger on a piece of gauze or with a sponge stick in an attempt to expose or enter the anterior peritoneum.
With tissue forceps, he grasps the tissue that is exposed between the cut edge of the vagina and the cervix--the supravaginal septum--and incises it with scissors, keeping the handles of the scissors below the horizontal axis.
DISCUSSION: Cervical fibroid constitutes 1-2% of total fibroids with 3 types- interstitial, supravaginal
As usual after clamping, cutting and ligating the uterine arteries, the uterus was bisected (figure 5) upto the supravaginal
portion of the cervix, after securing perfect hemostasis by ligating the vessels supplying the mass, the fibroid polyp was removed en mass.