Myomas are persistent tumors that appear in the female genital tract, the uterus. This disorder most often affects women of childbearing age and is not commonly cancerous, and its origin is unknown. It is estimated that 30% of women between 30 and 45 years of age suffer from uterine fibroids. However, very few have information about this disorder, so many are often more scared than they should.
These fibroids are also known as fibromyomas, fibromas, or leiomyomas, and the treatment will depend on the symptoms that the woman presents. For this reason, if you wonder when to operate on a uterine myoma, we invite you to read the following FastlyHealarticle with all the information about this condition.
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Types of Uterine Fibroids
Although all fibroids have their origin in the myometrium, they are classified into three types of fibroids depending on the exact location of the disorder and its growth, that is, towards which area it will grow:
- Subserous myoma: fibroids that increase towards the abdominal cavity are located below the serosa, that is, the layer in charge of covering the outer part of the uterus. They are the most frequent since they occur in 55% of women with uterine fibroids and are generally asymptomatic. However, they can compress various adjacent organs if left to develop much more uncontrolled.
- Intramural myoma: This type of tumor grows in the muscular walls of the uterus and expands in the central area of the myometrium. For this reason, if they become substantial, they can increase the size of the uterus and distort the outer wall. Intramural fibroids are the next most frequent type of this alteration because of the women diagnosed with fibroids, 40% of the cases suffer from it.
- Submucosal myoma: the main characteristic of submucosal myomas that arise just below the myometrium, the layer that covers the inner wall of the uterus, and its growth occur towards the inside of the uterine cavity, so it can occupy a large part of the same if it is allowed to develop to a considerable size. Although they are the least common, since only 5% of women with this disorder suffer from it, they are the type of tumor that causes the most symptoms because it considerably increases menstrual flow and can cause iron-deficiency anemia. They are also the ones most likely to become malignant tumors.
Common symptoms of uterine fibroids
The symptoms that women with fibroids present will depend exclusively on the type of fibroid; however, there are specific common symptoms in most cases. For instance:
- Hypermenorrhea is heavy menstruation that may be accompanied by clots and could last more than ten days. This symptom is suffered by 70% of diagnosed women.
- Metrorrhagia: women who show this symptom have vaginal bleeding between one period. Generally, this blood loss appears when you have submucosal fibroids, although it is not an exclusive symptom.
- Pain: although discomfort and various pains are not typical symptoms in fibroids, this can occur when the fibroid is enormous. Women with this condition can primarily identify pain as discomfort, weight, or discomfort.
- Compression: this is an uncommon symptom when a fibroid is present in the minor pelvis.
- Infertility: In some cases, women suffering from uterine fibroids may lose pregnancies because fibroids make it impossible for the embryo to implant in the endometrium.
- Anemia in women with fibroids is often a secondary symptom of excessive blood-shedding.
What measures does a fibroid have to have to be operated on
It is expected that when diagnosing this type of tumor in the uterus, many women are scared and immediately think that the fibroid should be operated on, but this is not always necessary. Generally, treatment is not required when there are no symptoms, and the tumors are smaller, as is often the case in subserous fibroids, which are also the most common. In these cases, it is enough to periodically go to the doctor to monitor the fibroid and carry out medical studies to determine its status.
Treatment for uterine fibroids is indicated when it causes symptoms, is more significant than 6 cm in diameter and has accelerated growth. The use of hormonal drugs is usually the first recommendation to reduce the symptoms and the size of the benign tumor by 30% to 60%; however, when its consumption is interrupted, the fibroid tends to grow again, which is why it becomes a temporary measure or a treatment before surgical care.
Suppose you are in doubt as to when to operate on a fibroid. In that case, the doctor will opt for it when said tumor is enormous if the symptoms are intense and do not respond to drugs, if menstruation is very abundant, if the size of cancer compromises other areas, for example, if it compresses the ureters or if it is the possible cause of fertility problems when seeking pregnancy.
How is a uterine fibroid operation performed?
Several surgeries can operate on a uterine fibroid, and the doctor will determine the most appropriate depending on its size, symptoms, location, and the patient’s desire to preserve reproductive function.
In general terms, these surgeries are classified as hysterectomy and myomectomy, the latter procedure being the most chosen due to its low invasiveness and preservation of the uterus. Also, myomectomy is divided into:
- Hysteroscopic: it is the technique of choice to operate a submucosal myoma, in which if there is abundant uterine bleeding, fertility problems, or recurrent abortions, it is when the myoma must be worked on. It introduces the endoscope vaginally, a small tube integrated with a camera. When viewing the tumor, a surgical instrument is used through the internal line of the endoscope to make the incision. It is minimally invasive that you could even resume your activities the next day.
- Operate myoma by laparoscopy: it is performed by making minor cuts less than 1 cm in the abdomen through which surgical instruments and the laparoscope are introduced, which is a fiber-optic camera to observe where the myoma is located and remove it. Due to the difficulty of finding a submucosal myoma. The invasion is minimal and can be discharged the same day.
- Traditional: in this procedure, it is also entered through the abdomen, but unlike the previous one, a single, larger incision is made to remove the fibroid, which is why it is considered one of the last options because it is more invasive. Likewise, it requires 2 to 3 days of hospitalization and a 4 to 6 weeks recovery time.
On the other hand, although a hysterectomy requires the removal of the uterus, it is essential to know when to operate on a fibroid with this technique, which is usually when there is very abundant bleeding that does not stop with other procedures, there is a predisposition to developing fibroids or suffer from other gynecological diseases such as endometriosis. The extraction route can be through the vagina, an abdominal incision, or laparoscopy.
This article is merely informative. At FastlyHeal .com, we do not have the power to prescribe medical treatments or make any diagnosis. We invite you to see a doctor in the case of presenting any condition or discomfort.
If you want to read more articles similar to When to operate on a uterine fibroid, we recommend that you enter our category of Female reproductive system.
I am a Surgeon with a diploma in comprehensive ultrasound and surgical care residency, an area I am specializing in. During the exercise of my profession, I have realized the need for patients to know the diseases they suffer, and I can tell you that a large part of their complications is due to a lack of information. Being a health web writer allows me to transmit my experience, without borders, to all those readers eager for knowledge, educate them in the prevention of diseases and promote a healthy lifestyle.