What is myoma? What types of problems does it cause? How are they treated?
Myomas (also known as uterine leiomyoma, uterine fibroid) are benign tumors with a very high rate (99%) in smooth muscle structure originating from cells called endothelium that line the inner surface of the vessels feeding the uterus. Many women are not even aware that they have a fibroid, they are detected during regular obstetrics visits.
While most women with fibroids do not have any complaints, some women may experience painful and heavy bleeding menstrual periods due to their fibroids, may experience frequent urination due to pressure on the bladder, may experience pain during sexual intercourse, and may experience constant pain in the lower back. Although rare, it may be faced with difficulties in defecation and failure to develop pregnancy despite the desire.
Although the reasons for its development are not fully known, it has been partially associated with familial predisposition, being overweight and excessive red meat consumption.
Diagnosis can be made easily by gynecological examination and gynecological ultrasonography.
20%-80% of women have one or more fibroids in the uterus until they are around 50 years old. With menopause, their size and the problems it causes generally decrease because fibroids tend to grow with the effect of female hormone (estrogen).
Typically fibroids;
1. Outside the uterus (subserosal)
2.In the uterine muscle layer (intramural)
3. Near the uterine cavity or inside the uterus (submucous and intracavitary). Submucosal fibroids are the most common type of fibroids.
4. Myomas located in the cervix (cervical), sometimes with a thin tissue, arising from the uterine canal into the vagina (reservoir)
5. They are classified as parasitic fibroids attached to the uterus by a thin band and located in the abdominal cavity.
(Although different nomenclatures are used in the medical classification, patients are generally informed with these terms for clarity)
There are several approaches to treatment.
1. The use of painkillers in case of painful menstruation and iron supplementation to prevent the development of anemia if heavy bleeding is accompanied.
2.Suppressing the female hormone with certain drugs, thereby reducing the symptoms (generally, after the drug is stopped, myomas grow larger than before, it is not preferred because of its expensiveness and side effects. However, if the decision for surgery is taken, it can be used to facilitate surgery in some cases)
3. Blocking the uterine artery that feeds the uterus (uterine artery embolization)
4.Surgical removal of fibroids if there is frequent urination, difficult defecation and constipation, constant pain, intense and/or painful menstrual pain and difficulty in CONCERNING.
5. Surgical removal of the entire uterus in rare cases
Fibroids rarely have a malignant character or turn into a malignant character. The most characteristic feature of these cases, called leiomyosarcoma, is their VERY RAPID GROWTH.
According to surgery, location of fibroids, problems caused, age, physical condition and complaints of the patient;
1.Closed (with laparoscopic method)
2.Open (laparotomic method
3. It can be done by entering the uterine cavity (hysteroscopic method).
When it comes to infertility, that is, the inability to get pregnant, the effect of fibroids is only around 3%, and there are usually fibroids located in the submucous or uterine cavity. Myomas rarely have adverse effects on conception and delivery, and most can be interpreted before pregnancy.
The tendency to develop fibroids is less in women with a fruit and vegetable-based diet and normal vitamin D levels.
It is known that fibroids develop partly as a result of genetic predisposition. If a mother has fibroids, the probability of developing fibroids in girls has increased 3 times compared to the average.
If there are uncountable fibroids in a uterus, it is called uterine leiomyomata. If it does not cause a special complaint, follow-up at regular intervals is sufficient. Sometimes fibroids bleed into themselves, sometimes their nutrition is impaired and they become defenerrated and necrosis, sometimes they become calcified. In all cases, the treatment is planned in line with the patient’s complaints; In most cases, follow-up at regular intervals is sufficient.
