Key Points

• Pelvic pressure and pain: Leiomyomas can cause pelvic pressure. While they rarely cause pain in themselves, by their relationship to surrounding structures, pain may occasionally occur. 
• In general, the severity of symptoms depends on the size and location of the leiomyoma.
• Impact on urinary system: Leiomyomas, even small localized lesions, can cause urinary frequency, urethral obstruction, and other urinary symptoms. The pressure exerted by leiomyomas on the bladder can lead to disturbances in urinary function.
• Impact on sexual function: Leiomyomas can contribute to dyspareunia (pain during sexual intercourse). The presence of leiomyomas, especially if they are large or located in certain positions, can cause discomfort or pain during sexual activity.
• Torsion and passage complications: Torsion (Type 7) or degeneration of a leiomyoma can occur, causing severe pelvic pain. In some cases, leiomyomas can pass through the cervix (transcervical passage), leading to pain and discomfort.
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