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Fibroids


Fibroids are the most common benign uterine masses of women originating from a single smooth muscle cell. Fibroids are also commonly referred to as leiomyomas or fibroids.

Frequency of fibroids

While fibroids are seen in 20-30% of all women, this rate reaches 50% in autopsies. This is due to the fact that most of the fibroids are asymptomatic and cannot be diagnosed before autopsy. Typically, it is more common in African-Americans (about 50%), while it is approximately 25% in Asian and Caucasian races. While fibroids are rarely seen under the age of 18, they often shrink and disappear after menopause.

Types of fibroids;

In general, fibroids are divided into three main types according to the layer of the uterus where they are located. Fibroids may rarely spread throughout the body, but may remain benign; This condition is called Myomatosis.

Subserous: They settle just below the outermost layer of the uterus. Subserous ones may be stalked and may originate and grow from a small stalk from the uterus. Stem fibroids can be vascularized from other adjacent organs, such as the ovary or other intra-abdominal organs; then it is called parasitic fibroids.

Intramural: Fibroids develop within the smooth muscle of the uterus.

Submucosal: These types are located under the innermost layer of the uterus and often cause abnormal bleeding. Submucosal fibroids may be pedunculated and may even protrude from the cervix.

Myomlarda değerlendirme ve tanı koyma;

Miyom tanısı rutin genital muayene sırasında düzensiz büyük rahimin hissedilmesi üzerine şüphe ile konulur. Miyomdan şüphelenilir ise ultrasonografi en iyi ve en ucuz seçenektir. Karından (büyük miyomlar için), vajinadan (küçük myomlar için) ultrasonografi yapılabilir.

Treatment

Before starting treatment, all patients presenting with abnormal bleeding after 35-40 years of age should be sampled from the uterine lining to exclude uterine cancer or thickening. Ultrasonography evaluates the number, location and diameter of myoma. For the evaluation of anemia, a complete blood count is requested and bleeding-coagulation tests should be performed.

Most women with fibroids are asymptomatic and are simply followed up without any treatment. The best follow-up method is ultrasonographic examination every 6 months until the fibroids stop growing, and then a yearly genital examination. If the patient has symptoms, the symptoms should be treated. The first step in the follow-up is drug therapy and the priority in surgery is uterine-sparing surgical treatment.

What are the drugs in the treatment of myoma?

The first-line treatment is anti-inflammatory drugs and they are used in case of painful menstruation. This treatment reduces excessive menstrual cramping and pressure pain. The first treatment in bleeding is hormonal therapy. Progesterone medications and low-dose birth control pills can be used to treat bleeding without causing fibroids to grow. Apart from these, other hormone treatments are also used, but to a lesser extent.

Surgical treatment of myoma;

There are surgical alternatives if the treatment with drugs is insufficient, if the drugs have side effects, or if the patient does not want to take drugs. If the fibroid is small (not larger than 3-5 cm), removal of the fibroid and similar treatments can be performed for bleeding control.

Conservative surgical treatment is uterine-preserving fibroid removal surgery. The fibroid is removed and the uterus is preserved. This treatment can be performed as robotic surgery, laparoscopy, hysteroscopy or open surgery. Definitive treatment (with or without removal of the ovaries) is removal of the uterus. Removal of the ovaries depends on the hormonal status and age of the patient. These surgeries can be performed vaginally, robotically, laparoscopically or open (depending on the size of the uterus and the surgeon's experience).

The content of our website has been prepared to inform the visitor. The information on the site can never replace a physician's treatment or consultation. Based on this source, it is strongly not recommended to start drug therapy or change current therapy. The content of our website should never be evaluated for personal diagnosis or selection of treatment method. There is no intention to make advertisements or advertisements contrary to the content of the law on the site.

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