Fibroids are abnormal tissue that occurs in the uterus during childbearing age. Fibroids, which are among the most common gynecological diseases, originate from the muscle layer of the uterus. Fibroids, which can also be defined as benign or, in other words, benign tumors, can turn into cancer in very rare cases.
What is Myoma?
Fibroids are frequently seen in women between the ages of 30 and 40. It is not possible to prevent these formations, which are also known as fibroids or leiomyomas in the medical language. Tissues that are not fully understood are thought to be largely caused by hormonal changes. In other words, the hormone estrogen is thought to accelerate fibroid growth.
Fibroids, which usually do not cause symptoms in the person, may cause symptoms such as change in menstrual pattern, abdominal pain, bloating sensation and bleeding after sexual intercourse in some cases. Fibroids, which usually occur between 1 and 15 cm in size, are pink in color and round in shape. Fibroids that can form in the uterus and cervix are mostly classified according to their location.
Do Myomas Become Cancerous?
Fibroids, which are defined as benign tumors or tumors formed in the uterus, have a very low risk of transforming into cancer. are tissues. Fibroids, which exist in one of every 4 women, arise from the smooth muscle tissue in the uterus. The number of women with fibroids during puberty is extremely low.
Fibroids, which usually occur between the ages of 30 and 40, tend to shrink with the menopause period. However, fibroids that continue to grow in the postmenopausal period should be followed up regularly to make sure they do not turn into malignant tumors.
Fibroids can be of different sizes. Some fibroids may be too small to be seen with the naked eye, while others may be large enough to enlarge the uterus. In rare cases, fibroids can grow excessively and extend up to the person's rib cage. Fibroids, which can occur at any time in many women's lives, often go unnoticed. In cases where it does not cause symptoms, the person can live with fibroids for life. Fibroids that tend to grow, grow excessively or cause symptoms can even lead to infertility.
What are the Types of Fibroids?
Types of fibroids can be found in the region where the fibroid is located. are classified under different names. Fibroid types can be listed as follows:
- Intramural Fibroids: Intramural fibroids, which are the most common type of fibroids, are seen in the muscle tissue of the uterus. It can expand and stretch the uterus.
- Subserous Fibroids: Subserous fibroids that develop on the outside of the uterus can cause one side of the abdomen to appear more swollen.
- Submucous Myoma: In the middle layer of the muscle tissue of the uterus or In other words, it develops in the myometrium. Submucous fibroids are rare.
- Myoma with Stem: The fibroids in this product are connected to the uterus by a thin stalk. Stem fibroids can turn around over time and cause pain. In cases that protrude beyond the uterus, the pedunculated fibroids need to be surgically removed.
What are the Symptoms of Myoma?
Fibroids are benign tumors that do not usually cause symptoms. Many women can live a lifetime of health without realizing they have fibroids. In cases with symptoms, the severity of the symptoms; fibroids vary in number, size, and location. Some of the symptoms frequently encountered in the presence of fibroids can be listed as follows:
- Increased amount of menstrual wedge,
- Longer duration of menstrual bleeding than normal,
- Between two menstrual periods shortening of the period,
- Interim bleeding,
- Anemia,
- Pressure in the abdomen,
- Digestive problems,
- Constipation,
- Pain in the rectum during defecation,
- The need to urinate frequently,
- Inability to empty the bladder completely,
- Pain during sexual intercourse ,
- Bleeding after sexual intercourse,
- Back pain,
- Leg pain,
- Abdominal pain,
- Pregnancy resulting in miscarriage
- Infertility (infertility)
What Causes Myoma?
Although the exact cause of fibroids is not yet understood, the uterus It is thought to originate from stem cells in muscle tissue. Many cells that arise from the uncontrolled division and proliferation of a single cell form a different structure from the neighboring tissue. Fibroids that can grow slowly or rapidly can sometimes stay the same size. While some develop as growth spurts, some may disappear spontaneously. Played a role in the formation of fibroids The factors that are thought to be considered can be listed as follows:
Hormonal Changes: Estrogen, also known as the female hormone among the people, is thought to play a role in the development of uterine fibroids. Estrogen, which increases and decreases from time to time during the menstrual cycle, can accelerate the growth of existing fibroids. The same reason explains why fibroids tend to shrink during menopause. This is why fibroids may tend to grow during pregnancy. Some of the fibroids present during pregnancy may shrink spontaneously or completely disappear after delivery.
Race: The incidence of fibroids is higher in women of black race. Fibroids occur at an earlier age in black people and their size is larger. Factors such as low consumption of fruit, vegetables and dairy products and alcohol use are also thought to play a role in the formation of uterine fibroids.
How to Diagnose Myoma?
Myoma is diagnosed during a vaginal examination performed during routine health checkups. . However, in the presence of symptoms due to fibroids, additional laboratory tests and radiological imaging tests may be requested to clarify the diagnosis. Bleeding disorders and thyroid disorders are investigated with laboratory tests.
Ultrasound is at the forefront of radiological imaging methods. On ultrasound, he can see fibroids in the uterus. However, in cases where ultrasound does not provide enough information to clarify the diagnosis, magnetic resonance (MR) imaging may be performed.
Hysterosonography is another test for the diagnosis of myoma. For the hysterosonography procedure, the uterus is first expanded with the help of a sterile liquid, and then imaging is performed. In some cases, hysterosalpingography (HSG) or hysteroscopy may be required. In the hysteroscopy method, an optical imaging device is inserted through the cervix and the inside of the uterus is viewed. Findings
How to Treat Myoma?
Myoma can be treated with many different methods. In many women, fibroids that do not cause symptoms or cause mild symptoms do not need to be treated. It is recommended to monitor such fibroids regularly. Mostly slow-growing types of fibroids shrink spontaneously with menopause.
Myoma can be treated with medication. Estrogen and progesterone hormone production is inhibited by drugs defined as GnRH (gonadotropin releasing hormone). Thanks to this treatment, which causes the person to enter menopause temporarily, the person's menstrual bleeding is stopped and fibroids are reduced.
Another type of medicated treatment is done with an intrauterine device (IUD). Thanks to the intrauterine device that secretes progestin, the severity of excessive bleeding due to myoma is alleviated. However, this method does not shrink fibroids. Apart from these, different drug treatments may be recommended to reduce the patient's complaints.
One of the treatment methods that do not require surgery is radiofrequency (RF) ablation. Radiofrequency energy is given to the myoma by entering with a special needle inside the fibroid. In this type of treatment, which causes an increase in temperature in myoma, anesthesia is required.
In embolization treatment, which is one of the minimally invasive procedures, the blood flow to the small vascular structures that feed the fibroids is cut off. Non-fed fibroids shrink over time.
The surgical method applied in the treatment of myoma is defined as myomectomy. Myomectomy is performed with the laparoscopic method and the uterine fibroids are surgically removed.
The only treatment method with proven efficacy in the treatment of myoma is hysterectomy. In the hysterectomy procedure, the uterus is completely removed. After the hysterectomy procedure, which does not cause the person to enter the menopause, the person cannot become pregnant.
What are the Problems Experienced After Myomectomy?
Although the reproductive potential increases after the fibroids are removed, it is possible to experience some problems. Among these problems;
- re-formation of myoma,
- bleeding,
- hematoma (accumulation of bleeding in the tissue),
- adhesion,
- tearing of the uterus during pregnancy can be counted.
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