Fibroids

What are fibroids?

Fibroids are benign tumors that appear in the uterus. Fibroids, also known as leiomyomas, are the most common form of benign tumors in the uterus and are usually harmless, since their probability of developing into malignancy is less than 1%.

What are the types of fibroids?

There are several types of fibroids that are separated depending on the location in which they grow:

• Suborogonal Fibroids: They are located on the outer surface of the uterus.
• Intramural Fibroids: They occupy the wall of the uterus (myometrium).
• Submucosal Fibroids: They are located inside the endometrial cavity. For example, a submucosal mischotic fibroid can protrude from the cervix.

When do fibroids appear?

Fibroids appear more often in young women of reproductive age and if they are not diagnosed, they may accompany the woman throughout her life. After menopause it has been observed that they regress, that is, decrease in size.

What is the form of fibroids?

The form of fibroids usually resembles solid formations, the dimensions of which vary. They may be 1-2 cm in size, but they may also occupy the entire peritoneal cavity. A woman may develop either a single tumor or many of them may form outside and inside the uterus. Regardless of their number, they usually do not show symptoms and so are not easily noticed.

What are the causes of fibroids?

The causes of fibroids are unknown. It is believed that one of the most important factors in their appearance is hereditary predisposition. Many studies also demonstrate their hormonal dependence, estrogenic. This is why they first appear in people of reproductive age, increase in size during pregnancy and finally shrink during menopause.

 What are the symptoms of fibroids?

A large percentage of women do not present any symptoms. However, some clinical symptoms that have been observed are:

• Menorrhagia / Uterine Bleeding: It is the main symptom in which vaginal bleeding occurs outside the days of menstruation. If the blood loss is large or the episodes are frequent, anemia can occur.
• Chronic abdominal pain
• Feeling of Heaviness in the Abdomen: This pain can manifest as dysmenorrhea (pain during menstruation), or dyspareunia (pain during sexual intercourse).
• Excruciating Pain: This pain becomes acute when the fibroid becomes inflamed or degenerates.
• Dysuria Complaints: Depending on the location and size of the fibroid, there is a chance that the bladder may be subject to pressure that causes pain when urinating.
• Constipation: In case fibroids cause pressure in the large intestine.
• Vascular problems: In cases where fibroids exert pressure on the pelvic vessels.

Can fibroids affect fertility?

When fibroids press on the fallopian tubes externally or when they protrude into the endometrial cavity, they can cause fertility problems. In about 10%, fibroids, especially when it comes to submucosal fibroids, are responsible for recurrent miscarriages.

 How is their diagnosis carried out?

The diagnosis of fibroids is made on the basis of the clinical symptomatology of the woman combined with physical examination. The physical examination includes palpation of the abdomen and two-handed gynecological examination. In addition, if deemed necessary by the gynecologist, gynecological ultrasound is performed.

How is fibroids treated?

The treatment of fibroids varies depending on the location, type, size of the fibroid, the symptoms and the age of each woman. Based on the above criteria, their removal can be done laparoscopically, laparoscopically or hysteroscopically. There is no medication to completely remove them. However, in many cases, and especially preoperatively, GnRH is administered in order to reduce the fibroids in size.

The Obstetrician – Gynecologist Surgeon Dr. Athanasios Papanikolaou is certified by the European Academy of Gynecological Surgery for endoscopic procedures and is well trained on diseases affecting the uterus. Focusing on the health and safety of every woman, it emphasizes on the diagnostic process and offers personalized solutions for the treatment of gynecological diseases.