Most fibroids do not cause any symptoms or complaints in patients. However, some symptoms such as abnormal bleeding, disturbingly painful and bleeding menstrual periods, back pain and painful sexual intercourse may be encountered.
In addition, some fibroids can prevent the expansion of the bladder by putting pressure on the bladder due to the mass effect and may cause the patient to go to the toilet frequently. In the same way, as a result of the pressure on the anus, it can lead to the feeling of needing a toilet all the time.
One of the biggest problems in fibroids is that they prevent pregnancy by exhibiting behaviors like a mass in the uterus. Fibroids, especially close to the inner surface of the uterus, can disrupt the appropriate area for the embryo, which consists of the combination of sperm and egg, to attach.
In addition to these, a palpable mass in the lower part of the abdomen may also be a sign of fibroids due to the growth of some fibroids that are not noticed due to skipping periodic health checks.
Diagnostic Methods
Fibroids usually occur as a result of routine gynecological examinations, but for the definitive diagnosis, the patient’s history is taken and examined by the physician. The mass can be detected by using high resolution ultrasounds together with physical examination.
If the mass is large or if the uterine tissue cannot be clearly distinguished, MRI can also be performed to avoid any confusion. Detailed information on soft tissues can be obtained by MR imaging.
Treatment Methods
Most fibroids are detected incidentally, without causing any symptoms or complaints. In such fibroids, fibroids are followed periodically without any treatment. Apart from this, if the detected fibroids cause some symptoms, treatment should be planned. In treatment, surgical methods are generally applied. The decision for surgery is made according to the patient’s age, complaints, number and location of fibroids, and whether the patient has children, and the scope of the surgery is determined. Myoma surgeries can be done in two ways, the first option is to remove the fibroid. If the patient does not have a child and is planning to have a child in the future, the removal of the uterine fibroid is performed in order to continue the uterine function in order to have a child until another fibroid occurs. The second option is the complete removal of the uterus. Since fibroids are tumors produced very frequently by the uterus, if the patient has a child and there is no question of giving birth to another child, it may be recommended to remove the uterus after the age of 40 so that it does not produce fibroids again.
These surgeries can be performed with several different methods:
Hysteroscopy
In this method, small fibroids that cause pain and cause frequent or severe bleeding are removed by vaginal entry. Fibroids located under the uterus or in its inner layer are removed with a special imaging system.
Closed Surgeries
Closed surgeries are performed with laparoscopic or robotic surgery methods. The fibroids that are not very large are removed from the uterine bed and the remaining uterine tissue is sutured to prevent both bleeding and heal the uterine wall.
Open Surgery
This method involves the removal of very large tumors that have advanced to the upper part of the navel. Due to the large size of the fibroids, there is no area to work in the laparoscopic or robotic method, and the fibroids are cleaned by incision with the open surgical method.
In some suitable patients who do not prefer surgery, drug treatment can be applied. Although drug treatments do not eliminate fibroids, they may help reduce excessive bleeding caused by fibroids and partially shrink the fibroid.
In addition, in some suitable patients, fibroids can be reduced by closing the vessels feeding the fibroid with a catheter advanced through the inguinal vein with interventional radiological techniques.