Myoma
Prof. Dr. Süleyman Salman
Myoma
Fibroids are benign tumors found in the uterus and usually originate from muscle tissue. These tumors can be asymptomatic in many women and are often discovered incidentally during gynecological examinations. Fibroids are one of the most common uterine conditions in women of reproductive age.
This condition is more common in women aged 30 and older and can continue to grow until menopause. However, they usually begin to shrink after menopause. While fibroids are often harmless, they can cause various health problems depending on their size, location, and number. While the exact cause of fibroids is unknown, hormones, particularly estrogen and progesterone, are thought to play a significant role in their development. Furthermore, genetic factors indicate an increased risk of developing fibroids in women with a family history of fibroids.
Some studies have also suggested that obesity, high blood pressure, and high estrogen levels may contribute to the development of fibroids. Fibroids can vary in size, number, and location. The location of fibroids in different parts of the uterus determines their symptoms and treatment requirements. Fibroids are most commonly found in the following locations:
Submucosal Fibroids: Fibroids are located near the inner surface of the uterus. These fibroids can affect the uterine lining and can often cause problems such as menstrual irregularities, excessive bleeding, and infertility. Submucosal fibroids usually require surgery.
Intramural Fibroids: Fibroids are located in the muscle layer of the uterus. These fibroids can often grow large and can alter the shape and size of the uterus. Symptoms vary depending on the fibroid's size and the degree to which it compresses the uterus. Intramural fibroids can often cause pain, bleeding, and infertility problems.
Subserous Myomas: Fibroids are located near the outer surface of the uterus. These fibroids are usually larger and can press on the abdomen, causing symptoms such as pelvic pain, frequent urination, and constipation. Subserous fibroids are often associated with pain and pressure symptoms.
The size and number of fibroids can affect the severity of symptoms. Small fibroids are often asymptomatic, while large fibroids can affect the uterus and cause serious health problems. Fibroids can cause irregular periods, heavy bleeding, pain, and even infertility. While some women experience no symptoms related to fibroids, others can be severely affected.
Symptoms of fibroids vary depending on their size and location. The most common symptoms include:
Menstrual irregularities, especially heavy bleeding or prolonged periods
Pain, pressure, or discomfort in the pelvic area
Pain during sexual intercourse
Frequent urination or constipation
Increased risk of infertility or miscarriage
Abdominal swelling or enlargement
Fibroids are usually diagnosed through a gynecological examination and imaging studies. A gynecologist may feel a uterine lump or mass during a physical examination. Ultrasound is also a common imaging technique used to determine the size, location, and number of fibroids. If necessary, more advanced techniques such as magnetic resonance imaging (MRI) may be used. A biopsy may also be performed to assess the potential for fibroids to become cancerous.
Treatment for fibroids varies depending on the patient's symptoms, the fibroid's size and location, and the woman's age. Some fibroids do not require treatment and can simply be monitored. However, if symptoms are severe or the fibroids are large, treatment options may include medication, surgery, or more advanced treatment.
Drug Treatment: Medication can help prevent fibroid growth and relieve symptoms. Hormonal therapies, specifically those aimed at regulating estrogen and progesterone levels, can help prevent fibroid growth and reduce bleeding. Medications such as GnRH analogs can also help stop fibroid growth and shrink cysts before surgery.
Surgical intervention: Surgery may be necessary if fibroids are large, causing severe symptoms, or causing infertility. Fibroid removal is usually performed laparoscopically. This method is minimally invasive and offers a faster recovery time. Laparoscopic removal of fibroids preserves the uterus. In some cases, complete removal of the uterus (hysterectomy) may be necessary. Hysterectomy is preferred, particularly for large fibroids or conditions that carry a risk of cancer.
Uterine Artery Embolization (UAE): This treatment blocks the blood vessels supplying the uterus to prevent fibroids from growing. This procedure is typically performed to shrink fibroids and does not require surgery. UAE can be a suitable option for patients who are generally not candidates for surgical treatment.
Alternative Treatment Methods: Some women may seek alternative treatment methods to treat fibroids. Alternative approaches such as acupuncture, herbal remedies, and dietary changes are used by some women to alleviate symptoms. However, there is limited scientific evidence regarding the effectiveness of these treatments and they should always be used with the advice of a specialist.
If fibroids are left untreated, symptoms can worsen over time and lead to serious health problems. Therefore, it is important for women with suspected fibroids to have regular gynecological checkups. Fibroids generally do not carry a risk of becoming cancerous, but in rare cases, they can develop into cancerous fibroids. Therefore, monitoring fibroids and treating them when necessary is crucial for women's health. Fibroid treatment should be personalized to each woman's specific needs, and the treatment process should be managed by a specialist physician.
