Fibroids (myoma)

Fibroids are common, usually harmless growths that form in the uterus, but for some women they can cause unpleasant symptoms and health problems. The need for treatment may vary depending on the severity of symptoms, the size of the fibroids and the woman's general health status. Fibroid treatment options include drug therapies, surgical interventions and minimally invasive procedures.

What is fibroids?

Fibroids are benign (non-cancerous) tumours that usually develop in the uterus. Fibroids, also called uterine fibroids or leiomyomas, can be located in the uterine wall or on the outer surface of the uterus. Fibroids are usually round or oval in shape and can be of different sizes. Some are as small as the size of a pea, while others can form large masses and significantly increase the size of the uterus.

How and why does fibroids occur?

Fibroids are benign tumours that develop in the muscle layer of the uterus (myometrium) and the exact cause of their formation is not known exactly. Fibroids are formed by abnormal growth and proliferation of a single cell that starts in the muscle layer of the uterus. This cell begins to multiply uncontrollably as a result of genetic and hormonal changes and forms a tumour mass over time. Some fibroids grow rapidly, while others may grow very slowly or remain stable.

The development of fibroids may show a genetic predisposition. The hormones oestrogen and progesterone have a significant effect on the growth of fibroids. These hormones stimulate the growth and proliferation of uterine muscle cells. Fibroids usually occur in women of childbearing age and tend to shrink after menopause as hormone levels fall. Growth factors and cytokines in the uterus are proteins that influence cell growth and differentiation. The extracellular matrix is a structure of proteins and other molecules that fill the intercellular space. In fibroids, ECM is more abundant than normal and this promotes tumour growth.

How is fibroids (myoma) treated?

Fibroids (fibroids) treatment varies depending on the size, number, location, symptoms and general health status of the patient. Treatment options may include monitoring and observation, medication, minimally invasive procedures and surgical interventions.

Follow-up: In some cases, treatment may not be necessary, especially if the fibroids are small and do not cause any obvious symptoms. In this case, doctors may monitor fibroids at regular intervals and use imaging tests such as ultrasound to check for any changes.

Medication: Various medications can be used to reduce the size of fibroids, relieve symptoms and control them without the need for surgical intervention.

Minimal Radiological Procedures: These less invasive methods can be used as an alternative to surgery and usually offer shorter recovery times. With uterine artery embolisation, the blood vessels supplying the fibroids are blocked, thus shrinking the fibroids. Myolysis, performed laparoscopically or hysteroscopically, uses laser, electric current or freezing (cryoablation) techniques to shrink the fibroid tissue.

Myomectomy: Surgical removal of fibroids. This method is preferred for women who want to preserve their fertility. Myomectomy can be performed laparoscopically, hysteroscopically or through open surgery.

Hysterectomy: It is the complete removal of the uterus and is the most definitive treatment for fibroids. This method is recommended for women who do not respond to other treatments, have large fibroids or have no plans to have children. Hysterectomy can be performed through the abdomen, vagina or laparoscopy.

Recovery Process After Fibroid Surgery

Laparoscopic myomectomy is performed by making small incisions in the abdomen. The recovery period after laparoscopic myomectomy is usually shorter and less painful. Patients can usually stay in hospital for 1-2 days and return to their daily activities within 2-3 weeks after surgery. In this method, the recovery period usually varies between 2-4 weeks.

Hysteroscopy is the removal of fibroids in the uterus with a camera (hysteroscope) inserted through the cervix. Complete recovery usually takes 1-2 weeks.

Open surgery can be performed for larger or deeply located fibroids. Recovery time after open myomectomy is longer. Patients usually stay in hospital for 2-3 days and full recovery can take up to 4-6 weeks.

Rest is important during the healing process, but light movements and walks can increase blood circulation and accelerate healing. Painkillers prescribed by the doctor can be used. It is important to follow the doctor's recommendations about returning to sexual activity after fibroid surgery. It is generally recommended to avoid sexual intercourse in the first 4-6 weeks of the healing process.