Myomas are tumors that arise in the uterus, originate from the tissue of the uterine wall, generally vary in diameter between 1-15 cm but can also reach larger diameters, are generally benign but rarely turn into malignant. These tumors are the most common tumors of the female genital organs. Myoma is detected in one in every four women over the age of 35 by examination or ultrasound. These myomas can be single or multiple, or even more than 20.
It is known that genetic predisposition is important in the emergence of myomas. Most patients are seen to have more than one myoma. Since estrogen causes myomas to grow, they are observed to grow especially during the reproductive age and pregnancy. During menopause, if the patient is not using hormone medication, it usually shrinks.
Myomas differ according to their location in the uterus, and they can grow into the uterine lining tissue and can also be located in the intrauterine muscle tissue. Additionally, myomas that grow outside the uterus and pedunculated myomas can also be seen in women. Apart from this, there may also be myomas that develop in the ovarian area.
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Myoma symptoms
The majority of myomas do not cause any symptoms and may not cause any complaints. However, the most common complaint about myomas is irregular bleeding. Additionally, as in pregnancy, a feeling of mass, pain and pressure may occur in the lower abdomen. This situation reduces urinary capacity and may cause the need to go to the toilet frequently. It can also cause urinary incontinence. Iron deficiency anemia may also develop in women with myomas due to irregular bleeding. Therefore, it is seen that problems such as weakness, fatigue, and shortness of breath also occur due to myomas. During pregnancy, it is possible that myomas, which occupy a large area, cause pressure and cause bleeding and premature birth. Myomas that grow into the uterine lining tissue can cause infertility and miscarriage. Myomas that put pressure on the large intestine can cause constipation in patients. There is a possibility that myomas may turn out to be malignant, albeit at a low rate (3/1000).
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Myoma diagnosis
It is not difficult to diagnose myoma. During gynecological examination, feeling that the uterus is larger than normal, has irregular borders, and has a hard structure raises suspicion. Very large myomas can even be felt through the abdominal wall. Myoma diagnosis is made by vaginal examination in married women and by abdominal ultrasonographic examination in virgins with a rate of 90%. In the diagnosis of myomas located in the uterus, ultrasonographic examination by injecting fluid into the uterus (sonohysterography), medicated film of the uterus (hysterosalpingography) can be used, and in the diagnosis of abnormally located myomas, computerized tomography and MRI can be used.
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Myoma treatment
In the treatment of patients whose complaints are not severe, medications are first used. can be tried. Painkillers that inhibit prostaglandin synthesis and birth control pills containing low hormones can be used for this purpose. At the same time, intrauterine hormonal spirals are among the treatments that can be chosen.
Myomas that have reached large sizes or cause very severe complaints will need to be removed. The operation to be chosen here is determined by the patient's age and pregnancy expectation. While removal of myomas is preferred in young patients, hysterectomy may be recommended for women who have completed their fertility and are close to menopause. The type of operation (open surgery or closed surgical technique) is determined by the patient's preferences.
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Non-surgical treatment of myomas >
It is a new form of treatment applied with the development of technology in recent years. The high-intensity focused ultrasound guided by magnetic resonance (MR-HIFU) procedure has been successfully applied to thousands of patients. This method, which does not require anesthesia or surgery, is suitable for only one in every four myoma patients. In order to achieve successful results, the cases must be selected correctly.
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