Myomas are benign, slow-growing muscle tumors. The term fibroid usually refers to uterine fibroids. They usually occur in women between 35 and 50. Uterine fibroids (leiomyomas) are very common and arise from abnormally altered smooth muscle cells in the uterus.
You can find more information on fibroids and selected fibroid specialists here.
Myomas are muscular growths of the uterus. They are the most common benign tumors of the female genital tract. Some fibroids grow so large that patients suspect they are pregnant.
Fibroids can impair fertility or lead to infertility. This depends largely on the position of the fibroid in relation to the uterine cavity and the fallopian tubes. An assessment is only possible on an individual basis. However, infertility due to fibroids is rather rare.
There are different types of fibroids depending on where the tumor forms:
Myomas develop from uncontrolled growth of uterine muscle cells.
The exact cause of fibroids is still unknown. Doctors assume that the female sex hormone oestrogen plays a role. This is why fibroids are also classified as hormone-dependent tumors.
This assumption is based on the observation that fibroids no longer occur in women after the menopause. If fibroids are still present in these patients, they stop growing.
It is also assumed that the development of fibroids is genetically determined. Myomas tend to run in families. Ethnicity also plays a role.
Many women have no symptoms despite having fibroids. Fibroids only become a disease when symptoms occur. Which symptoms the tumor triggers depends on how large it is and where it is located.
The most common symptoms are
Less common are
on.
The unfulfilled desire to have children is also one of the possible symptoms of uterine fibroids.
Fibroids can cause pain in the abdomen @ SENTELLO /AdobeStock
Fibroids often grow faster during pregnancy. This can lead to
may occur. A caesarean section is then necessary. Myomas increase the risk of miscarriages and premature births. Sometimes they can also lead to ectopic pregnancies.
The benign tumors can often be detected by the gynaecologist by palpating the uterus from the vagina or rectum. This also makes it possible to diagnose whether several fibroids are present.
The doctor then checks his suspected diagnosis with the help of an ultrasound examination(sonography). It also shows him exactly where the fibroid is located and what size it is. The gynecologist usually performs the ultrasound via the vagina. Alternatively, an examination via the abdominal wall is also possible.
Some fibroids are not clearly visible on the ultrasound image. This is the case with intramural fibroids, for example. An MRI scan can therefore also be useful in selected cases.
Uteroscopy (hysteroscopy) and laparoscopy are also helpful. This allows the exact location of the fibroids to be determined and at the same time allows the doctor to remove some fibroids directly.
A complementary diagnostic procedure is a blood test. The gynecologist checks the iron levels to rule out or detect an iron deficiency. Iron deficiency can occur due to the sometimes high blood loss during menstruation.
Myomas that do not cause pain or heavy bleeding do not require treatment. In this case, monitoring through gynecological examinations every 6 to 12 months is sufficient.
Myomas of the uterus are non-invasive, i.e. they do not grow into the surrounding healthy tissue. They can therefore be surgically removed without leaving any residue.
However, the decision for surgery depends on
In younger women who may wish to have children in the future, the gynecologist often removes the tumor using laparoscopy. He removes them via tiny incisions in the abdominal wall, into which he inserts a long thin tube (laparoscope).
Embolization is a modern procedure. This does not remove the tumor, but simply cuts off its blood supply by obliterating the blood vessels. This prevents the fibroid from growing further and it dies. The success rate for symptom control is around 80%.
Another innovative procedure is MR-guided highly focused ultrasound. The patient lies on a special ultrasound device. Its high-frequency sound waves generate so much heat that the fibroid tissue is destroyed. This method also has a success rate of around 80%.
In the case of symptomatic fibroids and completed family planning,hysterectomy is an option. This method is the only one with a 100% success rate, as there are then definitely no more uterine fibroids or new ones can develop.
Surgically removed fibroids of various sizes © Arjun | AdobeStock
Fibroids can also be treated with medication. This involves the use of gestagens, which slow down the growth of the uterine lining. This also reduces the amount of bleeding. Gestagens may also have an influence on fibroid growth.
GnRH analogs suppress the production of oestrogen centrally, causing the fibroids to shrink. However, menopausal symptoms then occur, which are very stressful for most women. For this reason, this procedure is usually only used for a short time before a planned operation.
The most modern medicinal procedure is the progesterone receptor downregulator ulipristal acetate. It can be used both before an operation and as a long-term interval therapy. The side effects are significantly less pronounced than with GnRH analogs.
Which procedure is used for uterine myomatosus should be decided in a specialized myoma consultation, taking into account
should be decided.
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