Fibroids

Fibroids are benign tumors that originate from the muscle structure of the uterine wall. Fibroids can grow inside or outside the uterus. Fibroids are not malignant and are not likely to become cancerous over the years. However, sometimes it may be difficult to distinguish between fibroids and malignant muscle tumors, which are also rare and originate from the uterine muscle layer.

Risk Factors

The causes of fibroids are unknown. However, it is known that fibroids are affected by female hormones such as estrogen and progesterone. Although many risk factors for fibroids have been defined, individuals without these risk factors may develop fibroids, or vice versa, individuals with one or more of these risk factors may not have fibroids:

• menstruation at a young age

• presence of certain genetic variations

• fat-carbohydrate diet

• number of pregnancies

Complaints and findings related to fibroids

Fibroids can range in size from millimeters to orange-grapefruit sizes and even larger sizes . Most fibroids are small in size and do not cause serious distress. However, as the number, size and location change, it can cause some serious problems. After the patient enters the menopause, the complaints of pain and bleeding due to fibroids tend to improve. If you have to change pads hourly or more frequently, or if your menstrual bleeding lasts more than 7 days, you should definitely consult your doctor. Individuals with heavy menstrual bleeding are at risk for iron deficiency anemia. In fact, when the size of the fibroids is very large, it may appear as if there is an external pregnancy. Depending on the location and size of the fibroids, it can cause various symptoms. For example, a large fibroid that puts pressure on the bladder can cause a person to urinate frequently and little. Or back to the rectum A large hanging fibroid can cause defecation problems or a feeling of incomplete ejaculation after defecation. However, if the fibroids suppress the endometrium, which is the inner membrane of the uterus, and distort the shape of the endometrium, the probability of pregnancy decreases. In addition, fibroids of similar shape and location increase the risk of miscarriage in pregnancies. Very large fibroids may increase the possibility of premature birth as well as cause excessive postpartum bleeding.

Another problem of fibroids during pregnancy is that about half of fibroids grow rapidly during pregnancy. As a result, it can cause severe pain during pregnancy, which can be confused with preterm labor pains.

Diagnosis of Myoma

Examination and ultrasound examination by a specialist in the diagnosis of myoma can be placed with In patients with difficult localization, multiple or surgical fibroids, when fibroid mapping is required, the number, size and localization of fibroids can be determined by Magnetic Resonance Imaging.

Treatment of Fibroids

If your existing fibroids do not cause you any discomfort, follow-up can be done without treatment. If you have complaints that affect your daily life and disrupt your comfort, drug treatment or surgical options may be available. When deciding on the most appropriate treatment option, the number, size, location of fibroids, the shape and severity of the complaints they cause, and whether the person has a desire to have a child in the future are important.

Medical Treatments:

Treatment is usually given to reduce vaginal bleeding, reduce the size of fibroids or control pain.

Iron supplementation: Excessive bleeding due to fibroids may cause anemia due to iron deficiency in the long term. For this reason, patients may be offered iron supplementation.

Non-steroidal anti-inflammatory drugs (NSAIDs): This drug group, which has painkilling and antipyretic effects, is used to reduce menstrual bleeding and cramps due to fibroids.

Birth control drugs: Oral form, applied to the skin� Hormonal birth control methods with augmented patch form, injection form and form that can be inserted into the uterus are effective methods to reduce menstrual bleeding. The most commonly used methods for this purpose are oral contraceptive pills and progesterone intrauterine device systems. Pregnancy is not possible during the use of these methods. After the discontinuation of these treatments, pregnancy can only be achieved.

Anti-fibrinolytic therapy: This group of drugs aims to reduce clot formation and bleeding by preventing clot dissolution in menstrual bleeding. Unlike hormonal methods, it does not prevent pregnancy. While reducing the amount of bleeding, it also reduces menstrual cramps.

GnRH Analogs: It is a group of drugs used for the purpose of suppressing estrogen and progesterone by creating a menopausal state, and reducing the size of myomas.

Surgical Treatments:

Myomectomy: It is the removal of myomas that cause complaints by preserving the uterus. Myomectomy is the surgical option that should be applied in patients who plan to have children in the future. It can be performed with minimally invasive methods such as laparoscopic and robotic systems, as well as in open surgery. size reduction is targeted. It is not suitable for patients who want to have children in the future because the uterine blood supply is impaired.

Magnetic resonance guided ultrasonographic ablation: It is aimed to shrink the fibroids with focused ultrasonic waves under MRI.

Endometrial ablation: Using heat of the endometrial cavity It is a treatment that aims to destroy the blood, thus reducing the bleeding. It is not a suitable option for individuals who are considering giving birth to a child in the future.

Hysterectomy: Removal of the uterus is the definitive and permanent solution for complaints related to fibroids. It can be performed by open or experienced surgeons with laparoscopic or robotic methods.

You should decide with your doctor the most appropriate treatment method for your fibroids.

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