2012 11 16

Uterine myoma. When is surgery required?

Gynaecological Diseases, Women’s Health

Gimdos mioma kada reikia operuoti

Uterine myoma is a benign growth of the uterus. Statistics show that it is most prevalent in 30-50 year-old women. However, sometimes large myomas can also be diagnosed in younger women aged between 25 and 30. They are linked to the activity of sex hormones.

When is surgery needed?

Myoma is a tumour which does not necessarily require surgical treatment.

As many as 50% of myoma cases are asymptomatic. They rarely lead to malignant cancer and are therefore considered  a benevolent formation (tumour).

Surgery is performed when myomas produce symptoms causing discomfort or health problems.

As has already been said, myomas rarely develop into malignant tumours, and during menopause they reduce in size and become calcified. Myomas that are larger than 6 cm can cause pressure in the pelvis minor region and compression of the veins, resulting in venous stasis and deep vein thrombosis in the pelvis minor and the legs. Fortunately, such cases are uncommon.

It is important to locate the site where the myoma has formed. If located within the uterine cavity, even a small lesion can lead to heavy menstrual bleeding and infertility.

Generally, myomas are not painful. However, heavy periods should be a cause for concern as they may lead to iron deficiency anaemia. If bleeding is attributed to myoma, surgery is the only efficient treatment option.

 Uterine myoma symptoms:

  • Heavy menstrual bleeding
  • Bleeding between periods
  • Infertility
  • Abdominal swelling
  • Urination problems (especially frequent urination)
  • Pelvic pain, pain in the small of the back (these symptoms are rarely caused by myomas).

Not so long ago, one of the most popular and frequently used options was surgical removal of the tumour together with the uterus (hysterectomy). Today the situation has completely changed. Dr Gediminas Mečėjus, an obstetric-gynaecologist at the Medical Diagnostic and Treatment Centre says that “if myoma has become a health problem, it needs to be removed ALONE! The main thing is that WE CAN ALWAYS REMOVE THE MYOMA AND SAVE THE UTERUS!!!”.

If the myoma does not present any problems and has no impact on the quality of life, monitoring via regular tests and yearly visits to the obstetric-gynaecologist is sufficient in the long run. Surgery is required when symptoms become severe or when the myoma becomes very large.

Advancements in obstetrics and gynaecology have brought spectacular results, especially when it comes to preservation and safeguarding of the female body. These days surgery is performed via the vaginal route or through a minimal incision. Patients can go back to work very quickly following the operation, and most importantly – it has now become possible to preserve the uterus and femininity.

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