Index
It is a typically female problem, and it has been known to many women.
This benign tumor in the uterus affects about 50% of women aged between 30 and 50 years. However, calm, despite the high incidence of the disease, its presence is not always worrisome.
Fibroids: it is not sure what causes the appearance of one or multiple nodules, which can be of different sizes and locations. The event may occur after menarche – the first menstrual period – and lasts until menopause. It is more common in black women, patients with a history of illness in the family (mother or sister), or weight gain because this hormonal dysfunction can occur due to increased fat cells. Other factors related to lifestyle are still under study.
Common symptoms of uterine fibroids
In some patients, the most common symptoms are excessive bleeding during menstruation or irregular periods and pain in the pelvis and abdomen. In other cases, there are no complications. “The benign tumor does not turn into cancer. The problem is when the symptoms of fibroids affect the quality of life. The woman will have constant pain and bleeding profusely, leading to anemia, and, in extreme cases, blood transfusion is necessary. The disease can also cause discomfort during sexual intercourse, irregular bowel function, urinary incontinence, and, in some cases, fertility problems, “explains Dr. Mariano Tamura, obstetrician and gynecologist at the Albert Einstein Hospital (HIAE). Federal University of São Paulo (Unifesp).
Diagnosis and treatment
There are four types of fibroids, named according to their location.
- Submucosa: which appears inside the uterus, can cause heavy hemorrhages and anemia.
- Intramural: is one that develops in the middle of the uterine wall, causing cramps.
- Subserosal: appears on the outside of the uterus, whose main symptom is noted when moving to compress other organs such as the intestine.
- Pedicle: which can be confused with ovarian tumors; It is attached to the uterus only by a tissue called a pedicle.
The diagnosis of the tumors is carried out in consultation with the gynecologist, taking into account the possible symptoms of the patient and the physical examination; in addition, it is evaluated if the uterus is enlarged. The doctor must request an ultrasound or other imaging studies to confirm the disease. If the problem has been found, each patient’s lifestyle and wishes should be considered. “We have to consider the symptoms, age, plans to have children, the desire to preserve the uterus, and whether the patient agrees or not to undergo surgery,” explains Dr. Tamura.
There are numerous paths for treatment:
Hysterectomy: Surgery to remove the uterus. The benefit is definitive; however, it is not recommended for women who still want to have children or maintain the uterus.
Myomectomy: surgical removal of fibroids, preserving the uterus. The anatomy of the body is restored, and the symptoms diminish. It is suitable for women who want to preserve fertility or who have infertility caused by fibroids – which is not very often – with better chances of getting pregnant.
Embolization: a procedure performed through a catheter introduced into the femoral artery and directed to the uterine arteries, responsible for the nutrition of the fibroma. A substance is injected to block the tumor supply. There is a reduction of symptoms and reduction of fibroids, but it is still not considered safe for women who want to maintain or improve the ability to have children.
Ultrasound-guided and centered by magnetic resonance: this new weapon is used against fibroids. The patient lies on a resonance table; the doctor applies the ultrasound waves directed to a specific tumor region where the temperature increases to 90 ° C, destroying the tissue. Studies are underway to evaluate the cases for which this method is effective.
