Benign tumors that arise from the smooth muscle cells of the myometrium, which we call the uterine wall, are called myomas. These are more common in women of childbearing age. These tumors rarely appear in young girls. Fibroids are classified according to their location. Fibroids located in the direction of the endometrial layer that cause bleeding in the uterus are called submucous fibroids. Fibroids located in the wall layer are called intrauterine fibroids, and fibroids that grow outside the uterus are called plunger fibroids.
The reason for this classification is that fibroids cause symptoms depending on their location. Submucosal fibroids are more common with prolonged and increased bleeding. Similarly, there is an increase in bleeding intrauterine fibroids. Dense fibroids usually do not cause many complaints. Fibroids can range from a few millimeters to tens of centimeters. Fibroids can cause many problems when they grow excessively.
Momootri tends to be more common in women who start menstruating early, have no children, are obese, have a family history of fibroids, and eat a lot of red meat. It is less common in women who have given birth and who exercise regularly.
What causes fibroids?
First Menstrual Period
Women who have their first period earlier than usual are more likely to develop uterine myoma because this is because the woman is exposed to estrogen for a longer period of time.
Obesity and diet
Because of the increased BMI, uterine fibroids are more common in obese women, as they will increase the incidence of uterine fibroids. In addition, fibroids are more common in women who eat rich red meat than in women who consume a lot of green vegetables. Also, drinking alcohol increases the incidence of uterine fibroids.
Number of Births
Women who have given birth less often have more uterine fibroids than women who have given birth more than once.
Myomas are more common in black women than in white women.
Increased Estrogen Level
The exact cause of fibroids is unknown, but it is believed that estrogen, the female hormone, causes fibroids to grow. Fibroids contain more estrogen receptors than the normal uterine muscle layer. As estrogen decreases during menopause, fibroids may also shrink or disappear altogether. Another female hormone, progesterone, plays a suppressive and stimulating role in the suppression of fibroids.
How does a uterine tumor form?
Symptoms of Uterine Myoma
Although most fibroids are small and cause no symptoms, many women have fibroids that cause a variety of problems and require treatment. Fibroids that do not cause any symptoms are diagnosed during routine gynecological examinations. Myometrial symptoms depend on where the masses form in the uterus, their size, and how much they are. Fibroids can be single and millimeter in size, or they can be more numerous and larger. Fibroids that are large in size are called giant fibroids. Apart from that, symptoms related to fibroids are evaluated in 4 different categories. Which:
1. Abnormal bleeding: Heavy or prolonged menstrual bleeding is the most common symptom of fibroids. In women with abnormal bleeding due to fibroids, other problems such as iron deficiency anemia, decreased quality of social life, and incompetence in business life may occur due to this bleeding. Abnormal bleeding depends on the location and number of the fibroids. In general, fibroids that appear under the outer layer of the uterus do not cause bleeding. However, fibroids that appear under the lining of the uterus often cause abnormal bleeding. Fibroids that develop between the muscle layer can also bleed
2. Symptoms of Compression Due to a Lump: Although not as obvious as abnormal bleeding, leiomyomas cause the symptoms of compression caused by their lumps. Large fibroids that arise from the anterior wall of the uterus press on the bladder and cause symptoms such as frequent urination, difficulty urinating, or the inability to urinate. In rare cases, they can cause the kidneys to enlarge by compressing the urinary tract between the kidneys and urine, preventing
urine flow Fibroids that protrude from the back wall of the uterus can press on the large intestine and cause constipation.
3-Pain: Women with fibroids experience more pain than women without fibroids. Women experiencing pain during menstruation may be caused by heavy bleeding during menstruation. These women feel more pain during intercourse than women without fibroids. The disorder of fibroids can also cause severe pain. Pain caused by fibroid degeneration is usually treated with pain relievers. Severe pain may occur when pedunculated fibroids rotate and may require surgical intervention.
4-Reproductive symptoms: Fibroids destroy the uterus, preventing pregnancy or increasing the risk of miscarriage. The rate of infertility caused by fibroids is estimated to be around 2-3%. The fibroids most affecting pregnancy are known as submucosal fibroids. When they are removed with a hysteroscope, pregnancy rates increase. When women with myocarditis become pregnant, risks such as early separation of the child’s spouse, delayed child development, inversion of the child, and premature birth may occur
Muscular Ultrasound: A pelvic ultrasound is a must-do method in diagnosing uterine fibroids and often allows for a more accurate diagnosis. Ultrasound is an inexpensive and easily applicable diagnostic method. So if a woman is suspected of having fibroids, this is one of the first tests that should be done. It can be applied through the abdominal wall and the vagina. While an abdominal wall ultrasound can diagnose large fibroids, small fibroids may be missed and not clearly distinguish where the fibroids are. On the other hand, a transvaginal ultrasound shows millimeter-sized fibroids and shows exactly where the fibroids are located in the uterus.
Saline infusion ultrasound: Submucosal fibroids that grow in the inner lining of the uterus can sometimes not be completely distinguished by ultrasound. In such cases, a cannula is inserted into the uterus before ultrasound is performed on the patient. After the ultrasound probe is placed in the vagina, the inside of the uterus is inflated by sending fluid into the uterus through the previously placed cannula. This process is called saline fusion sonography. When the uterus is swollen, an intrauterine ultrasound is evaluated. Submucosal fibroids and endometrial polyps that malform inside the uterus can easily be seen and diagnosed by saline ultrasonography
Hysterosalpingography (HSG): Hysterosalpingography is not a very common method. Uterine film is used Often to investigate infertility. In this method, a cannula is inserted into the uterus and a radioactive opaque substance is injected into this uterus and the uterus is inflated. During this procedure, simultaneous radiographs are taken and the distribution of radiation opaque materials in the abdomen is monitored. If there is a blockage or adhesion in the tube, the distribution of this fluid in the abdomen cannot be seen. It is easy to understand which tube is going through and which tube is being cleaned.
Hysteroscopy: Hysteroscopy is performed by inserting a system containing a camera from the vagina into the uterus. First, the uterus is enlarged to allow the system to pass through the uterus. Then the system containing the optics and the cannula is inserted that allows the fluid to pass into the uterus. As the fluid is pumped through the cannula, the uterus swells. The presence of space-occupying lesions in the uterus is checked with the help of a camera. In particular, submucosal fibroids, intrauterine fibroids pressing on the endometrial cavity or endometrial polyps are clearly seen in this process. Another advantage of this system is that these fibroids can be removed during surgery using the tools provided by the system. Also assess if the inlet of the tube is clogged and whether the tube is open.
What are the methods used in the treatment of uterine myoma?
Fibroids cause complaints depending on their location and size. Treatment for a myoma is determined by the size of the fibroid and its signs and symptoms. No treatment is required for fibroids less than 5 cm in size and asymptomatic. In fibroids with minimal symptoms, treatment may be required. The treatment of myoma is a surgical intervention. Non-steroidal anti-inflammatory drugs, their analogues, and progesterone are used in medical treatments.
Frequently asked questions about uterine tumor
1-Is the uterine tumor recurring?
The risk of recurrence is very high in patients in the familial predisposition group.
2-What happens if fibroids are not treated?
Fast-growing and overgrown fibroids cause problems such as difficulty urinating and constipation and pressure on nearby organs with a mass effect. Fibroids, which differ in their complaints according to their location, cause anemia and the most severe pain when left untreated and seriously affect quality of life.
3-What should be considered after surgery?
It is very important to maintain weight control. Since fibroids are estrogen-dependent lumps, a cold may enlarge as the patient gains weight.
4-Does uterine tumors cause infertility?
Fibroids located in the uterus or with abnormal bleeding can cause infertility because they prevent the baby from attaching to the uterus.
5-What causes uterine myoma?
Fibroids are benign masses located in the uterus. The chance of them turning into cancer is very low.
6-How many centimeters does a myoma need to be to need surgery?
On average, fibroids between 6 and 7 cm in height are classified as large fibroids. Therefore, fibroids with a size of about 6-7 cm should be removed.