Prof Saim Yılmaz, MD
"In intramural fibroids and multiple fibroids, embolization is the ideal treatment"
What are the types of fibroids?
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 a 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 cause an increase in menstrual bleeding, prolongation of the menstrual period and subsequent anemia. At the same time, they may 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.
In many patients, two or all of the above types of fibroids may coexist. In this case, clinical complaints caused by each type of myoma can be seen in the same patient.
The location of the fibroids is important in determining the most appropriate treatment for the patient. In general, fibroids with outgrowing stems are suitable for classical fibroid surgery (myomectomy). In addition, fibroids that grow into the uterus and are connected to the uterus by a thin stalk can be removed from the vagina by hysteroscopic myomectomy if they are below 2-3 cm. Although embolization may still be possible in such cases, it should be considered the treatment of choice in all types of fibroids except these two rare conditions.