Myomas are benign tumors arising from the smooth muscle layer of the uterus. While myomas are more common in black people, they show symptoms in 20% of women after the age of 35. This rate increases with age. It increases to 40% in the pre-menopausal period. Although the reason why myomas form is not exactly known, it has been shown that they grow estrogen-dependently. The decrease in the size of myomas due to the decrease in ovarian functions in menopause, the increase in the size of myomas in the first months of pregnancy and their rapid decrease after birth are also indicators of this.
There are different types of myomas depending on their location. The symptoms caused by myoma vary depending on its location. Myomas often do not cause symptoms. Those that reach very large sizes may generally present as a palpable mass in thin patients. The most common problems
Abnormal uterine bleeding
It is one of the most important findings. They generally cause prolonged and excessive bleeding during menstrual periods. Spotting is common before menstrual periods. In such bleeding, anemia due to iron deficiency is often observed.
Pain
There is usually no pain, but after the blockage and infection of the blood vessels feeding the myoma and the pedunculated myomas turning around themselves. can be seen as a result. Sometimes, in myomas hanging into the vagina, pain in the groin, waist and legs due to nerve compression can be observed.
Compression-related symptoms
Frequent urination due to pressure on the bladder, difficulty urinating. They can cause problems related to the excretory system, such as difficulty. As a result of pressure on the urinary tract, swelling of the kidneys (hydronephrosis) may occur. Those that cause pressure on the rectum cause constipation and difficult defecation. Those located close to the cervix cause discharge, bleeding, difficulty during intercourse and infertility.
Reproductive symptoms
Myomas disrupt reproductive functions by causing mechanical obstructions or disrupting the attachment of the embryo (fetus) to the inner wall of the uterus.
Myomas are often diagnosed by ultrasonography, which also gives us information about their location and number. Additionally, computed tomography, magnetic resonance imaging are used for diagnosis. In some cases, advanced radiological examinations such as e.g. . Small myomas that do not cause any symptoms can be followed at intervals of 3-6 months. When there is abnormal uterine bleeding, it is useful to perform probe curettage before surgery. Surgery is indicated for myomas over 10 cm and myomas located in the cervix or isthmia over 5 cm. Although it varies depending on the patient's condition, hysterectomy, abdominal myomectomy, vaginal myomectomy, laparoscopic myomectomy or hysteroscopic myoma removal can be performed.
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