Uterine Fibroid

Uterine fibroids (also called fibroma or leiomyoma) are benign tumors that originate from the smooth muscle of the uterus.
This is one of the most common gynecological conditions, especially in women of reproductive age. The size of fibroids can range from microscopic to very large, which can enlarge the uterus to the size of a pregnancy. Their development is hormone-dependent – they grow under the influence of estrogen and often shrink after menopause.

Types and Manifestations

Fibroids are classified according to their location in the uterus:

• Subserosal: Located on the outer surface of the uterus, causing symptoms by pressing on adjacent organs.
• Intramural: Located within the uterine wall, the most common type associated with heavy bleeding.
• Submucosal: Located under the uterine lining (endometrium), even small submucosal fibroids often lead to the most severe bleeding symptoms.

Symptoms and Consequences

Many women with fibroids have no complaints. When symptoms occur, they often include:

• Heavy and prolonged menstrual bleeding (menorrhagia): This is the most common symptom and may lead to anemia.
• Pelvic pain and pressure: A feeling of heaviness or fullness in the lower abdomen.
• Pressure symptoms: Frequent urination or difficulty defecating due to pressure on the bladder or rectum.
• Fertility problems: Fibroids, especially submucosal ones, can make it difficult to conceive or may lead to miscarriage.

Diagnosis and Treatment

The diagnosis is made through a gynecological examination and confirmed with ultrasound, which is the primary method for assessing the number, size, and location of fibroids.

Treatment depends on the severity of symptoms, the size of the fibroids, and the woman’s reproductive plans:

• Observation: For small, asymptomatic fibroids, simple monitoring is recommended.
• Medical treatment: Used to relieve heavy bleeding (e.g., hormonal contraceptives) or to temporarily reduce the size of fibroids before surgery (e.g., GnRH agonists).

Surgical treatment:

• Myomectomy: Surgical removal of only the fibroid nodules, preserving the uterus – preferred for women who wish to have children.
• Hysterectomy: Removal of the entire uterus – applied in cases of severe symptoms or in women who have completed their childbearing desire.

Non-invasive procedures: In some cases, uterine artery embolization may be applied, wherein the blood supply to the fibroids is blocked.

 Synonyms: Leiomyoma, Myoma, Fibroid