The word fibroid (or myoma or fibroid) indicates a growth of the muscle tissue of the uterus: it is the most frequent female benign neoplasm, so much so that one in three women after the age of 35 has one or more small myomatous formations. Fibroids can be tiny, and stay that way forever, or grow rapidly - the causes are not yet known.
Likewise, they may not give any symptoms and only be discovered during a gynecological examination. The diagnosis can be confirmed by a transvaginal ultrasound, which allows you to determine where the fibroids are, their size and characteristics. As for the treatment, fibroids can be removed surgically, but it is not possible to give general rules.
There are many variable elements from woman to woman to consider, and only the patient with the help of her doctor can make the best decision for her case, considering the pros and cons that each surgery itself has (surgical risk, bleeding, anesthesia, adhesion formation ...). Also because, unfortunately, in uteri that tend to form more fibroids, even a flawless surgical removal in at least 30% of cases is often followed by a relapse.
I SINTOMI - In addition to the size, the most important aspect to consider is the "place" where the fibroid was formed: if it is located under the endometrium - the mucous membrane that lines the uterine cavity and flakes off with menstruation - or inside of the muscle wall even if it is small it can cause particularly heavy menstruation (menoraggie) and sometimes painful, because it interferes with the mechanism of contraction of the uterine walls.
Heavy menstruation can cause anemia - i.e. iron deficiency - and therefore weakness, hair loss, depression. If the fibroid has grown out of the uterus it may not cause any symptoms, while rarer fibroids on the cervix can stimulate vaginal discharge or small blood loss.
FERTILITY AND PREGNANCY - Fibroids only rarely cause infertility in themselves. However, they make the situation worse if the couple has other problems that make them infertile. In addition, they can cause problems during pregnancy, when the concentration of estrogen in the blood increases, hormones that - among other functions - stimulate the growth of the uterus to accommodate the fetus.
If the woman has fibroids, they can grow together with the muscles of the uterine part and increase their volume two to three times, causing malpositioning of the fetus or difficulty in its growth. Sometimes the increase in volume is so explosive that the fibroid "breaks", causing pain and therefore contractions that require hospitalization due to the danger of premature births or miscarriages.
However, all this does not always and does not necessarily occur: therefore, the decision to surgically remove the fibroid in view of a pregnancy must be taken on a case-by-case basis, based on its position, size and medical "history" of the woman.
THE SURGERY - Surgical removal of the fibroid, if necessary in case of menstruation that compromises the quality of life or to start a pregnancy peacefully, can be done through a laparotomy, that is, a large incision of the abdominal wall, or through a laparoscopy, i.e. with the help of an optical probe that allows only a small cut. This second, less invasive technique is not always possible for fibroids because it depends on their placement: removal can be difficult and time-consuming, even causing greater blood loss.
There is another technique, namely theembolization: the artery that feeds the fibroid is identified by radiography and occludes it, causing it to "die". The procedure, however, is not as simple as it seems, and the resorption of the fibroid often involves pain and disturbances for the structure of the uterus for the woman. Each technique must therefore be used selectively and the decision is always up to the doctor.
DRUGS - The contraceptive pill has been shown to be useful in reducing the growth rate of fibroids, the amount of flow per cycle and menstrual pain. However, there are no drugs to eliminate fibroids definitively, even if the administration of natural progesterone or progestin in some cases can slow down their growth, but only during their intake. The same applies to other drugs (a monthly injection that blocks the production of female hormones) that create a "chemical" menopause for women by rapidly reducing the fibroids in view of surgery to remove them with less blood loss: on their effective usefulness , however, there is no agreement among the doctors.
TAG:
- fibroma
- myoma
- fibromyoma
- uterus
- benign female neoplasm
- fertility
- infertility
- abundant menstruation
