Abstract
A small, asymptomatic myomatous uterus usually may be left alone but should be periodically observed. A large myomatous uterus that is subject to bleeding or produces pressure on the bowel, bladder or ureters requires surgery—usually total hysterectomy, with retention of normal ovaries if the patient is young. When a myoma in an older woman shows accelerated growth, malignant degeneration should be suspected.