Fibroids are common benign tumors of smooth muscles forming the uterus and are quite common. About 20% of the Caucasian race and 50% for the African race and African Americans, suffer from fibroids. It appears more often in first-degree relatives to see women with fibroids, and much less frequently in women that have had many pregnancies. These fibroids grow in size due to the presence of female hormones such as estrogen. This means that logically, their existence is most common in reproductive age. It is not known what affects the increase of these cells and the creation of these benign tumors of smooth muscle of the endometrium, but it is certain that local growth factors are not one of the causes.
It is very common to see these benign tumors decline during menopause. There is a very small probability for it to become a inomyosarkoma, which is a malignant tumor of myomitrio, but this usually happens in older women, over 70 years old. So far there is no way to remove fibroids just to avoid the possibility of becoming a inomyosarkoma or how the whole process takes place.
There are essentially three types of fibroids. The ones inside the uterine wall called endotoichomatika, the ones on the surface of the uterus, called ypoorgonia. There are those that raise as icebergs in the endometrial cavity called hypovlenogonia.
The hypovlenogonia fibroids play an important role in infertility. Must usually be removed with either hysteroscopic surgery or open surgery to increase the chances of implantation and pregnancy.
COMPLICATIONS
The complications that can happen to a woman who has fibroids may be the twist of the fibroids, the death of the calcification, etc
Depending on their position they could put pressure on the bladder and then there is frequent urination or even constipation because of pressure on the large intestine.
An other Very common symptom is minomitrorragia, ie the increase of blood flow during menstrual. There is no direct scientific evidence for the above symptoms, but perhaps hypovlenogonia fibroids play a greater role in the mechanism creating this symptom. One explanation is that hypovlenogonia fibroids increase the total area of the endometrium, but this has not been documented yet.
The tests required in order to find fibroids is an atrial ultrasound, which can very clearly see the position, shape and also the volume of the fibroids. A complete blood count, iron and ferritin can also find them. When there are multiple fibroids or is technically difficult to see them by ultrasound, a CT or MRI could give us very good results. Some small fibroids that are hypovlenogonia are some cases that cannot be found by ultrasound. For these cases when we suspect their existence, a diagnostic hysteroscopy with the introduction of a camera is the best way to make a diagnosis.
Their treatment is either medical or surgical. We could use medicines such as oral contraceptives, GNRH agonists, which are substances that can not be used for longer than 6 months because potentially could create growth of ovarian cancer in the future and also have many side effects such as symptoms similar to those of menopause. Essentially, these substances cause a chemical menopause the patient. The use of strong analgesics is also helpful, especially when the solution starts two to three days before menstrual. Some of them, such as tranexamic acid, could reduce blood flow during that time.
The use of GNRH agonists or GNRH analogues, could help when used 2 months prior to surgery so that treatment can reduce the volume of the fibroids and that makes the surgery technically easier.
In case of failure of pharmaceutical solutions or in cases of infertility due to the existence of main hypovlenogonion fibroids, the treatment should be surgical and there are two basic techniques that can be implemented.
One is to remove only the fibroids, which can be done laparoscopically with the introduction of a camera from the navel and the patient has to stay in the hospital for two days. The second option is open surgery in which fibroids are removed and the patient should remain in the hospital for five days. Using either technique can remove fibroids that exist or if they are mostly hypovlenogon fibroids into the uterine cavity, in this case a very good surgical technique, which is very much better for the patient, is Hysteroscopic removal of fibroids through invasive hysteroscopy.
Using these high technology techniques, along with experienced and qualified personnel can significantly reduce the hospital stay and potential complications. Furthermore, in cases where other reasons exist that have to do with problems in the fallopian tubes or ovaries the uterus must removed. That means not removing only the fibroids but the patient will have to have a total hysterectomy. Modern techniques nowadays allow women suffering only from minomitrorragy not directly related to the presence of fibroids, handle data through hysteroscopy for endometrial destruction and reduction of symptoms.
It is true that modern obstetrics enables patients suffering from fibroids to improve their quality of life either pharmaceutically or by surgery, and especially surgery gives a temporary but not permanent solution to the problem.
It should also be stressed that in case of fertility problems because of fibroids, modern techniques especially those of invasive hysteroscopy can help in achieving the goal of having children.
|
|
|
