Fibroid tumors are a benign clinical entity in gynecological diseases, commonly appearing during reproductive age and usually remaining tacit during menopause.
They are benign tumors consisting of fiber tissue, mainly developing inside the uterus.
Our system itself produces them for no specific reason. They feed on and grow from the basic hormone of the human body , estrogens, which are high during reproductive age. Depending on their specific anatomic position and their size, they define possible symptoms which will call for their future treatment.
Depending on their position they are defined as:
- Intramural, inside the uterus cavity, in the muscle area.
- Submucosal, either presented in full, or partly hidden inside the uterus cavity.
- Suborogon, under the uterus orogonus, in the outer layer.
- Stem or outer, laying outside the uterus, connected with a stem.
Their commonest symptoms are:
- Heavy and prolonged menstruations: with pigments, anemia, fatigue, dizziness and numbness. In this case they are inside the uterus preventing its natural contractions at the end of the menstruation.
- Infertility: fibroids, even when small in size, when they press against or alter the cervix or cover the oviducts, they prevent the sperm from reaching the oviducts, where fertilization takes place.
- Frequent urination: common urinary infections, urinary incontinence. Big fibroids usually put pressure on the bladder which is very close to the uterus, preventing it from working normally.
- Miscarriage during the first 3 months of pregnancy: fibroids usually take up space in the uterus cavity, thus preventing the embryo from being implanted successfully inside the endometrium.
- Abdominal pain: usually of gradual development and intermitted or constant nature. Due to their size, fibroids give a sense of carrying extra weight, and because of their insufficient blood reception, they cause intense ischemic pain, similar to the one the heart produces during myocardium heart attack. Acute and severe pain may also be experienced in rare cases during the twist of a stem fibroid around its axis.
How do we get a diagnosis?
Clinical ways for a diagnosis are the following:
- ultrasound of the uterus mostly through the vagina or abdominal.
- Hysterosalpingography. With this examination we can see the flow of a special sciagraphic fluid inside the uterus and the oviducts. This way we can check and acquire important information about the uterus cavity and the condition of the oviducts.
- hysteroscopy, where we examine in detail the endometric cavity using endoscopium through the cervix. This procedure usually takes place a few days after the end of menstruation, when the endometrium is thin and the opening of the oviducts easier to see.
- laparoscopy, performed with general anesthesia.
- magnetic resonance. This way we can determine the exact position and the size of fibroids, as well as to ascertain whether fibroids alter the cavity of the uterus.
Even though it is a very precise examination, it is rarely used for fibroid diagnosis. It is mostly used for their differential diagnosis and topographical correlation.
Is it treatable?
Yes, it is. Fibroid treatment is determined by its position, size, symptoms and the age of the patient. We usually perform a denuclearization (extraction), which happens laparoscopically, laparotomically or hysteroscopically, and in some cases we provide patients with preoperational hormonical formulas (GnRH-it depends), to diminish their size and their reception of blood. In women of older age who have accomplished their reproductive procedure, we usually follow conservative treatment.
Treatments:
- Solely medical-conservative treatment aiming at:.
– symptom relief (bleeding)
– size deterioration - Surgical treatment
- Laparoscopic removal (for fibroids larger than 8 to 10 cm)
Fibroids are benign tumors, that’s why over 50% of women who have fibroids, have the ability to conceive successfully!