Myoma is a benign (non-cancerous) tumor of the uterus that originates from the smooth muscle cells of the uterus. Although it can be seen in any period of the reproductive age of women, it is most often seen in the reproductive period. Its incidence is quite high and it can be seen in approximately one in every three women during their lifetime. Although they are benign lesions, they have a malignancy potential of 0.1% (one in a thousand).
Why and how do myomas develop?
Although it is not clear how myomas develop or appear, genetics Predisposition, race, hormonal reasons and some medications may be effective. Myomas are hormone-dependent tumors and the fact that they are most common in the reproductive age and tend to shrink in the postmenopausal period is a result of this hormonal effect. Although myomas generally tend to shrink during the menopausal period, sometimes they may not shrink and may even change in size. Since myomas, which tend to grow especially in the postmenopausal period, have a risk of malignancy (cancer), the appropriate approach is to closely examine them and treat them under appropriate conditions.
What are the symptoms of myomas and why are they important?
Myomas are located in the uterus. It gives different symptoms depending on the location and size. Myomas can be found in places such as within the uterine cavity (submucous), within the uterine wall (intramural), outside the uterine wall (subserous), cervical (at the cervix) and extrauterine (in the abdomen; parasitic myoma). The most common symptom is irregular menstrual bleeding. While myomas in the uterine lining cause irregularities such as excessive menstrual bleeding, intermittent bleeding, and prolonged bleeding, myomas in the uterine wall cause long and excessive menstrual bleeding. Apart from this, cervical myomas can cause continuous bleeding in the form of spotting and bleeding after intercourse. Myomas can cause pain, a feeling of mass in the abdomen (overly large myomas), pressure symptoms and infertility. As myomas grow and put pressure on the bladder, they may cause symptoms such as frequent urination and urinary incontinence. They can also put pressure on the rectum/intestines, causing constipation and changes in bowel habits. Especially myomas that grow within the uterine cavity, myomas that compress the inner wall of the uterus and excessive Myomas that are large and cause uterine deformity may be the cause of infertility. Myomas generally tend to grow during pregnancy. Their blood flow increases and they may degenerate, causing pain during pregnancy. In addition, myomas during pregnancy can also cause complications such as miscarriage, premature birth, difficult birth, and postpartum hemorrhage.
How is myoma treated?
First of all, it should be noted that the treatment of myomas is surgery. Medical (drug) treatment for myomas is not performed to eliminate myomas. Medical treatment for myomas is applied to stop active bleeding or to shrink myomas before surgery. Indications (reasons) for treatment in myomas are that the myoma causes symptoms. In other words, pain, bleeding, menstrual irregularity, infertility, presence of pressure symptoms, recurrent miscarriages, rapid growth of the myoma, continuing to grow after menopause, and suspicion of cancer are indications for treatment of myomas.
Surgical treatment for myomas consists of removing the myoma or removing the entire uterus. is happening. Apart from this, myoma embolization is also a method that can be applied in selected cases. Myomas coming out of the cervix are removed vaginally. Afterwards, to check the continuity of the myoma, the inside of the uterus is checked with hysteroscopy and the remaining myoma piece, if any, is removed. Hysteroscopic myomectomy (removal of myoma) is the most commonly used surgical method for submucous myomas (in the uterine cavity). In hysteroscopic surgery, there is no incision on the body. The myoma is removed by entering the uterine cavity using camera imaging. Myomas in and outside the uterine wall are removed by abdominal operations. Here, open surgery can be performed, or myomas can be removed with the closed (laparoscopic) method, which is more comfortable today. In surgeries performed with the laparoscopic method, there is less pain, bleeding and adhesion, as well as more scarring, quicker recovery and return to daily life.
In some cases (who have completed their desire for children, there are many myomas that are too large and distort the shape of the uterus). Complete removal of the uterus is another surgical option. Removal of the uterus can be done as open surgery or closed (laparoscopic).
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