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The most common benign neoplasm of the uterus in the uterine body is leiomyoma. How common this problem is is shown by the fact that as many as 1/3 of women suffering from reproductive system ailments are women with uterine fibroids.
Uterine fibroids – classification
Uterine fibroids is a disease that occurs in almost 20% of all women. They are most often diagnosed in women between 35 and 45 years of age. Estrogens are of great importance in their formation.
Depending on their location, the muscles are divided into:
• submucosa – causing distortion of the uterine cavity,
• intramural,
• subserial – can lead to distortion of the uterine body.
Uterine fibroids – symptoms
Some uterine fibroids may have a pedunculate and polypoid shape. These types of lesions can stretch the cervix and enter the vaginal canal and sometimes even out through the vulva. These types of fibroids are called “giving birth”. However, usually fibroids are benign changes that should be consulted with a doctor who will assess the possibility of their malignancy. However, the transformation of fibroids into malignant changes is a relatively rare situation and does not exceed 3%.
Uterine fibroids may be asymptomatic and are often diagnosed during a routine gynecological examination. Women usually see a gynecologist because of bleeding like prolonged periods or intermenstrual spotting. Often women complain of bloody vaginal discharge, usually accompanied by a foul odor. In addition, with larger size myomas, the following may appear:
- difficulty passing stools
- trouble urinating
- difficult getting pregnant and reporting it.
Diagnosis of uterine fibroids
Most often, uterine fibroids are diagnosed during a routine gynecological examination, preceded by an interview. The identification of uterine fibroids often depends on their location within the uterus, size and, importantly, the structure (degree of obesity) of the examined woman. The most visible in the examination are subserial fibroids, which, even if they are small, can change the structure of the uterus first. Identifying other small intramural or submucosal myomatous lesions can be confusing. In this case, a transvaginal ultrasound examination is helpful. An important role is also played by laparoscopy and hysteroscopy, which is important in the diagnosis of fibroids.
Treatment of uterine fibroids
Leiomyomas (benign lesions) are usually treated by surgery. The type of surgery depends on their location, number, age of the patient and the will to have children in the future. The most frequently used surgical procedures are:
- removal of the uterus together with the cervix (myoma),
- supracervical excision of the affected uterus (much less frequently).
In women who would like to have children in the future, enucleation of uterine fibroids is performed. However, patients should be informed that there is a risk of relapse.