What is Myoma?Myoma uteri are the most common benign tumors of uterus. It is estimated that this tumor is found in 20-50% of women over 30. It is considered that genetic disposition plays role on development of myomas. Incidence of myoma uteri is 3-9 times higher in black women when compared to white women. Although they are asymptomatic, the main symptoms are: pressure of uterus on surrounding organs with mass effect, abnormal uterine bleeding, infertility and pubic pain. Severity of symptoms varies according to the number, size and position of myomas.
How myoma is diagnosed?Myoma uteri can be diagnosed with examination, transvaginal ultrasonography and/or hydrosonography (applying liquid into the uterus and making control) and hysteroscopy (intrauterine examination with camera). Myomas are classified according to their locations in uterus:submucous (uterine cavity), intramural (intra-uterus wall), subserous (outer side of uterus), intraligamentary (ties holding the uterus) and cervical (cervix).
The most frequent reasons for operation in myomas are: anemia due to severe bleeding, severe pubic pains due to pressure on intra-abdominal organs and constipation and fertility. These complaints are observed more frequently in case of myomas growing towards intrauterine or on the uterine wall. The reasons for decreasing rates of pregnancy due to myomas are: distortion in embryo movement, irregularity of intrauterine layer and deterioration of blood flow.
How myoma is treated?Surgical treatments of myomas vary according to the findings, number and location of myoma, age of patient and whether the patient wants to have baby or not. A myoma growing towards intrauterine can easily be extracted with hysteroscopy (intrauterine imaging with camera). The myomas growing on uterine wall or towards out of uterus should be extracted using laparoscopy (close method) or laparatomy (open method). Until recently, open operation was being performed for myomectomy with a wide skin incision. Duration of stay in hospital and time of return to normal physical activity was very longer. However, 95% of myomas are being extracted by experienced surgeons with Laparoscopy today.
Advantages of extracting myomas with laparoscopy
- No need for wide skin incisions
- Better imaging
- Lesser blood loss
- Lesser pain and drug therapy
- Lesser intra-operative and post-operative complication
- Minimal scars
- Shorter duration of stay in hospital
- Shorter time to return work