What is Myoma? What is its removal and what is its risks?

Question

What is Myoma? What is its removal and what is its risks?

Answer 1

    What is uterine myoma and its symptoms

    Uterine myoma – benign tumor formed from muscular and connective tissues, which is one of the most common tumors found in women's reproductive organs.

    Depending on the prevailing type of tissues- parenchyma or interstitial, this tumor was used to be called differently: myoma, fibroma, fibromyoma. However, since the myoma nodules are developed mainly from muscle cells, the most correct terminology is considered to be myoma (leiomyoma).

    Uterine myoma is the most common pelvic tumor and they are diagnosed in upto15 to 20% of women in pubertal period [1].

    Although myoma (uterine fibroids) is generally considered to be a slowly growing tumor, in 20-40% of women at the age of 35 and more have uterine fibroids of significant sizes with severe clinical symptoms [2]. Moreover, myoma can be relapsed in 7-28% of patients after surgical treatments and in certain cases it may even turn into malignant tumor.

    The researchers have remarked that women who gave birth to at least two children have 2 times less risk of developing myoma than the childless women. Though, the scientists are not sure at this point whether the child delivery actually protects them from myoma, or if the myoma itself is the causative factor of infertility in those childless women.

    For the growth of thus formed tumors, they need to be further supported by negative factors: abortions, long term use of inadequate contraceptive pills, chronic, sub acute and acute inflammations of uterus or its appendices, stresses, ultra-violet irradiation, cystic formation of ovary etc. For example, the women who had 10 abortions by the age of 30 have double the risk to develop uterine myoma at 40 years of age.

    The growth of uterine myoma is featured as a benign, hormone sensitive diffuse or nodulous hyperplasia of myometrium and characterized by having multiple factors of pathogenesis, systemic changes, though the exact etiology of myoma is not known yet.

    Uterine myoma is developed on the background of hyper estrogens, progesterone deficits and hyper gonadotropins. The majority of the researchers consider, that the growth of myoma depends on concentration of cytosolic receptors to the sexual hormones, and their interactions with the endogen or exogen hormones. In accordance to clinical observations, it can be admitted that both growth and regression of myoma are estrogen-dependant; the tumor size gets increased during pregnancy and is regressed after menopause [3]. The only moment that needs to clear is to find out whether it is the decrease in receptor numbers or estrogen, progesterone and androgen hormone quantities which lead to regression in myoma size (regarding androgen – there is an hypothesis that myoma is sensitive to androgen).

    The chromosomal anomaly (12q13-15) is quite common in myomatous cells [4]. In fact, in 30-40% cases, the predisposition to uterine myoma is passed down from mothers to daughters on hereditary line. A form of myoma so called 'family type' is present where uterine myoma are seen in all the family line – in grandmother, mother, aunts and sisters.

    Uterine myomas are often identified during routine gynecological examinations. In such examinations, the gynecologists may only assert the fact – presence of uterine myoma. In other cases the primary symptoms of myoma may appear as: hypo gastric pains, low backaches, bleedings, impairments of close up organs –example, tachyuresis (frequent urination).

    We need special examinations to determine the number of nodules, sizes and their exact localizations. Mostly ultrasound examinations are enough for this, but in certain cases CT scans, MRI could be necessary.

    Myoma may be located in the external, middle or inner layers of uterus (subserous, interstitial and submucous). Nodules can be located in the isthmus (5%) or in the uterine body (95%) [5]. The most 'unpleasant' ones are those, which are located in the inner layer.

    Such types of myoma deform the uterus cavity, and thus cause severe bleedings during menses resulting into low hemoglobin levels (this is why during iron deficit anemia in women, they should have gynecological examinations).  

    up

The conventional treatment options

    The uterine myoma by itself is not an indication for operative method of treatment. Mainly it depends upon the patients' overall health condition, severities of the clinical symptoms and the sizes of the tumor.

    The major indications for the operative methods of treatment are severe pains, fast growth rate of the nodules, arising suspicions about the malignancy of myoma, inflammatory changes in the tumor nodules and dysfunction of closely lying organs (urinary bladder, intestines etc.), infertility (when all other reasons are already excluded). If an experienced gynecologist recommends you an operative method of treatments, you should go for it as early as possible.

    

Answer 2

Myoma is usually a benign muscle tumour it is better to consult with your doctor and follow closely with your doctor.