Uterine fibroids are the most common tumor in women. 70% of women over 50 have at least one fibroid, and these are caused by growth of uterine smooth muscle cells.
The reason why fibroids occur is unknown, although there is evidence that estrogen and progesterone are related to tumor growth. It is rare to find them before menarche, and the fibroids usually diminish after menopause.
Most fibroids are asymptomatic, and should treat those who interfere with the normal quality of life. Clinical symptoms depend on the size, location and number. Accordingly, it can lead to symptoms by understanding alterations or breakthrough menstrual bleeding, or affect fertility.
Treatment of fibroids
Treatment may be medical or surgical. Physicians are mainly based on the decrease in estrogen. Usually, patients show a transient improvement in symptoms, although, they usually return after treatment, can sometimes solve problems and avoid surgical treatment.
Radiological techniques, embolization of fibroids and destruction ultrasound-guided radiofrequency are other options available.
Furthermore, when a surgical treatment must, have different techniques, which depend on the characteristics of the fibroid, the patient and the surgeon's experience. Whenever possible minimally invasive surgery (laparoscopy, hysteroscopy) will be held. When required or desired to preserve the uterus to perform myomectomy (which is only the extraction or myomas), and in other cases hysterectomy (removal of the uterus) is required.
Qurúrgica as appropriate technique and experience of the surgeon
1. Hysteroscopy: Indicated in submucosal lesions and intracavitary
2. Laparoscopy or laparotomy: subserosal and intramural fibroids, myomectomy or hysterectomy (total or subtotal)
3. Vaginally: Total hysterectomy and myomectomy any case
La via laparoscopic and vaginal allow a shorter hospital stay and early recovery.
We must not forget that despite the majority of fibroids are benign, a small percentage can be malignant (leiomyosarcoma), it should be assessed at the time of indicating the surgical technique.