Fibroids are benign tumor tissues that can be seen in the uterus and cervix and develop from smooth muscle tissue. They are the most common tumor structures seen in the pelvic region in women.
In women, the age of appearance of fibroids is usually between 30-40 years. Fibroids are less likely to be seen in adolescents and adults. Myomas, which are also known to be affected by hormonal conditions, will shrink after menopause, as well as turn into malignant myomas. For this reason, fibroids should be checked at regular intervals after menopause. Although the exact cause is not known, there is a risk of developing cancer in 1 out of every 1000 myomas.
Fibroids are a condition that can be seen in approximately 20-25% of women. Many women with fibroids are generally unaware of it because fibroids, also called benign tumors, are an insidious disease. While some fibroids change the order of a woman's life, some fibroids do not make themselves noticed and do not pose a problem for people to continue their lives.
Fibroids are divided into 3 according to their regions;
Subserous Fibroids: Subserous fibroids grow towards the outer surface of the uterus. These fibroids tend to swell. Thus, depending on the location of the subserous fibroid, swelling may be seen in a part of the abdomen, which can be seen with the naked eye. This type of fibroids can press on the uterine cavity and pose a serious risk, especially during pregnancy. If subserous fibroids grow uncontrollably without treatment, they can cause extremely negative conditions such as premature birth, miscarriage, infertility and pregnancy loss.
Intramural Fibroids: These fibroids are the most common fibroids. These are usually found in the muscle layer inside the uterus. In case of overgrowth, the uterus may expand and swell to a certain extent when viewed from the outside.
Subcutaneous Fibroids: They are the least common fibroids but cause the most bleeding. These types of fibroids arise in the uterus.
Fibroids generally do not give any symptoms. Sometimes they are detected completely by chance during gynecological examinations. However; most of the time, they can give the following findings in proportion to their growth and settlement;
Race: Black women have fibroids 2-3 times more often than white women.
Birth history: Having one or more births reduces the risk of developing uterine fibroids. Birth age is also important. The risk of uterine fibroids is lower in women who gave birth at a later age than women who gave birth at an early age.
Early start of the first menstruation: Starting menstruation at an early age increases the risk of uterine fibroids.
Birth control pills: It has been noted that standard or low-dose birth control pills do not cause fibroids to grow. For this reason, it is known that the use of birth control pills is not contraindicated in patients with fibroids, and 3-month depot injections protect against fibroids.
Obesity: The relationship between fibroids and obesity (obesity) is not clear; It is thought to be an indirect rather than a direct relationship.
Nutritional habits: The risk of developing fibroids increases with consumption of red meat, vitamin A and D deficiencies, alcohol consumption, especially beer. There is no relationship between caffeine consumption and fibroids.
Genetic factors: It has been found that women with fibroids in their families have a higher rate of uterine fibroids.
Most of the fibroids are detected incidentally without causing any symptoms or complaints. In such fibroids, fibroids are followed periodically without any treatment.
Apart from this, if the detected fibroids cause some symptoms, some treatments can be applied. The treatment is generally applied by surgical methods. The decision for surgery is made according to the patient's age, complaints, number and location of fibroids, and whether the patient has children, and the scope of the surgery is determined.
These surgeries can be performed in several different ways:
Hysteroscopy: In this method, small fibroids that cause pain and cause frequent or severe bleeding are removed by vaginal entry. Fibroids located under the uterus or in its inner layer can be removed with a special imaging system.
Closed Surgery: Closed surgeries are performed with laparoscopic or robotic surgery methods. Fibroids larger than 4-5 cm are removed from the uterine bed and, if any, bleeding in the area is intervened and the area is stitched.
Open Surgery: This method includes the removal of very large tumors that have advanced to the upper part of the navel. Due to the large size of the fibroids, there is no area to work in the laparoscopic or robotic method, and the fibroids are cleaned by incision with the open surgical method.
Drug Treatment: In some suitable patients for whom surgery is not preferred, drug treatment can be applied. Although drug treatments do not eliminate fibroids, they can provide benefits such as reducing excessive bleeding caused by fibroids and shrinking fibroids.
In addition, in some suitable patients, the vessels feeding the fibroids are closed with a catheter advanced through the inguinal vein with interventional radiological techniques, thereby preventing the growth of the fibroid and even shrinking it.
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