Prof Saim Yılmaz, MD
"We can treat most uterine fibroids non surgically"
What are myomas and what are their symptoms?
Uterine fibroids (myomas) are benign tumors that originate from the uterine tissue and may generally vary in diameter from 1 to 15 cm. Fibroids are also sometimes called myomas, leiomyomas, leiomyomata, or fibromyomas. Fibroids are the most common tumors of the female genital organs; One in three women over the age of 35 has fibroids that can be detected by examination or ultrasound. However, if very small fibroids are included, some researchers believe that almost every woman develops fibroids until menopause. Most of the patients have more than one fibroid in the uterus, this number can sometimes exceed 50. Estrogen, known as the female hormone, causes fibroids to grow. For this reason, fibroids usually enlarge 2-3 times during reproductive age and pregnancy, and usually shrink in menopause if the patient does not use hormone medication.
Fibroids are divided into 3 groups according to their location in the uterine tissue:
Submucosal Fibroids
They are fibroids that grow towards the inner surface of the uterus. It is the least common type of fibroid. However, the most bleeding problem occurs in this type of fibroids. Bleeding is usually in the form of an increase in menstrual bleeding and/or prolongation of its duration.
Intramural Fibroids
They are fibroids located in the uterine muscle tissue. It is the most common type of myoma. Like submucosal fibroids, they may cause an increase in menstrual bleeding, prolongation of the menstrual period and result in anemia. At the same time, they can cause problems such as pain in the abdomen and a feeling of fullness as a result of enlargement in the uterus and frequent urination as a result of pressure on the urinary bladder.
Subserosal Fibroids
They are fibroids that grow towards the outer surface of the uterus. Typically, they do not cause bleeding problems. They cause more abdominal pain, back pain, feeling of fullness and pressure symptoms such as frequent urination and constipation.
What Are the Symptoms of Myomas?
Most uterine fibroids (myomas) do not cause any complaints and may not require treatment. However, serious complaints occur in approximately 10-20% of all patients with fibroids. The most common complaint is the long and heavy menstrual bleeding. These bleedings can sometimes be very profuse and clotted. Anemia may develop in patients due to chronic bleeding. Other common complaints in myoma patients are:
Abdominal pain and feeling of fullness
Back and leg pain
Pain with sexual intercourse
Frequent urination (as a result of fibroids pressing on the bladder)
Constipation and gas (as a result of fibroids pressing on the large intestine)
How are they diagnosed?
Most fibroids are detected by obstetricians and radiologists during uterine ultrasonography. However, in ultrasonography, only some of the existing fibroids can be seen, and some underlying diseases may be missed. With the magnetic resonance imaging (MRI) device, the uterus can be better evaluated from various angles and almost all fibroids can be visualized.
Therefore, when evaluating treatment options in myoma patients, MRI should be performed in every patient and the evaluation should always be done based on the MRI findings.