Let's talk about uterine fibroids and multiple fibroids

What is uterine myoma?

It is a benign tumor derived from the smooth muscle of the uterus, and is the most common tumor in women.

Uterine myoma occurs a lot at the age of 30 to 40. After menopause, the size usually decreases, and the occurrence of new myoma is rare. If the tumor persists, it can also be found after menopause. If the size increases after menopause, you should suspect secondary degeneration of myoma, especially sarcoma changes, or excessive secretion of female hormones from the postmenopausal ovaries or other organs. A new myoma that occurs after menopause can be considered to have a bad prognosis.

Uterine myoma most often occurs in the body, but rarely in the landscape, uterine ligament, or cervix (less than 5 %). Usually, lesions are multiple and isolated, and their sizes range from microscopic size to very large giant tumors. If you look at the frequency according to the type, it is frequent in the order of intramuscular myoma (80%), submucosal myoma (15%), and submucosal myoma (5%).

What is the type of uterine myoma??

Uterine myoma is classified from the outer layer into 'submucosal myoma → intramuscular myoma → submucosal myoma' depending on the site of occurrence.

(1) submucosal myoma.

As a myoma that occurs in the lower endometrium, the prognosis is the worst. There are the most complications, and even a small size is likely to cause bleeding. There is also a high risk of sarcoma degeneration, and it is prone to infection, suppuration, and necrosis. I'm resistant to radiation

(2) intramuscular myoma

It is located deep within the uterine fascia, and as the size of the uterus itself increases, the area of the endometrium increases, and thus the amount of menstruation increases. Most of them have no subjective symptoms.

(3) submucosal myoma

It occurs just below the peritoneum that covers the uterus. The myoma also stretches to form a stem. Most of them have no subjective symptoms.

What is the cause of uterine myoma?

Uterine myoma comes from a single cell, and the growth of uterine myoma is influenced by female hormones estrogen, progesterone, and growth hormone. Although the exact cause is not known, most uterine myoma is known to occur during childbearing age, growing during pregnancy and decreasing after menopause. The use of estrogen-enhancing agents increases the incidence of uterine myoma and estrogen preparations and growth hormones grow the size of uterine myoma. Conversely, progesterone inhibits the growth of uterine myoma.

The cause of uterine myoma is still unclear, and several factors are known to be involved.

1) a genetic factor

Uterine myoma is a single-celled tumor with chromosomal abnormalities found in about 40%, especially in the reciprocal translocation of chromosomes 12 and 14, defective (deletion) of chromosome 7, and trisomy of chromosome 12.

2) hormones

The theory that estrogen and progesterone are involved in the growth of uterine myoma is that the growth of myoma tends to be dependent on female hormones. Uterine myoma increases in women who show obesity, early onset, and late menopause, and decreases in women who smoke, exercise, and fertility. Also, the sudden growth of myoma in women who took oral contraceptives containing follicular hormones is evidence. However, hormones do not appear to be a single factor in myoma development due to the fact that all women of reproductive age secrete estrogen, and only some women develop myoma.

3) the action of growth factors

The theory is that growth factors are produced by smooth muscle cells and fibroblasts to promote the growth of myoma.

Statistics

About 20% of women over the age of 35 have uterine myoma, and by race, blacks outnumber whites and tend to be more frequent in people of color.

(1) Factors that increase the risk of uterine myoma

˚ Older (40+) ˚ Family history of fibroids ˚ Never been pregnant ˚ Obese ˚ Black

(2) Factors that reduce the risk of uterine myoma

˚ have had five or more pregnancies ˚ are menopausal ˚ have used birth control pills for a long time

What about the pain?

Menstrual abnormalities. The most common symptom of uterine myoma. The amount of menstruation increases, the menstrual period increases, and there may be bleeding even when it is not the menstrual cycle.
As for pain, pelvic pain and pain when pressing the pelvis can also be a symptom of uterine myoma. There is also the pain of sexual intercourse.

Diagnostic tests?

Most patients with uterine myoma are often found accidentally without symptoms, but they may complain of sudden uterine bleeding, excessive menstruation, lower abdominal discomfort, and abdominal bloating. You can estimate uterine myoma when a hard, irregular lump is touched in the lower abdomen.

Recently, most obstetrics and gynecology clinics are equipped with ultrasound devices, which are often accidentally found by ultrasound when performing uterine cancer tests. Ultrasonography of the vagina is the first diagnostic method used in that it is less sensitive or specific, but has advantages in terms of cost-effectiveness and is easy to perform.

How do you treat it??

The fundamental treatment is, of course, surgical removal of the lesion. Other organs due to the rapid growth of myoma or the large size of myoma. Especially if you press the bladder. Bleeding due to myoma. It's associated with infertility.

There's also medication. Hormone therapy is generally a temporary treatment to prevent bleeding. It's a delay method until you solve a medical problem to prepare for surgery. The size of myoma can be reduced, but it is not completely cured. Usually, the size decreases while taking drugs, but it grows again about three months after quitting the drug. Therefore, hormone therapy is used before surgery to facilitate surgery and to reduce bleeding before and after surgery.

As a non-drug treatment, patients with small myoma without any special symptoms in the examination are monitored while identifying the condition of myoma through regular diagnosis. This is called observational therapy. In particular, uterine myoma without symptoms before and after menopause usually tends to decrease in size, so you can also watch while observing the progress.

If myoma suddenly grows or symptoms such as pain occur while observing the progress, surgery (open surgery or laparoscopic surgery) is performed because sarcoma changes or other secondary degeneration of uterine myoma are suspected.

other than this

1. Endometriosis (D&C)

Patients with non-pregnant uterine myoma accompanied by abnormal bleeding should perform cytosolic tests and segmentation sofas to see if they are accompanied by other diseases, especially cancer.

2. Myomectomy

Myoma resection is a procedure for young women who need to maintain reproductive ability, and should be performed before the procedure by checking their husband's pregnancy ability, uterine ovarian imaging, endometrial and cytological examinations. About 40% of people become pregnant after surgery, and there is also a disadvantage that the uterine wall becomes weak after removal or myoma can be reshaped.

3. A hysterectomy

It's done if you don't want to get pregnant or if your myoma is multiple. It depends on the age and condition of the ovary, but it is a trend these days to leave the ovary unless there is anything unusual.

When the size of the uterus is larger than 12 weeks pregnant, when there is a large submucosal myoma accompanied by excessive menstruation, and when there are symptoms of bladder and rectal compression, hysterectomy is considered. In addition, hysterectomy is considered when other pelvic diseases (pelitis, endometriosis) are accompanied or myoma is growing rapidly, intra-ligament myoma or hexagonal myoma, or when there is a fear of cancer.

4. Uterine arterial embolization

Uterine arterial embolization is one of the most recently developed treatments. Uterine arterial embolization is performed under intravenous anesthesia. The microcatheter is inserted through the femoral artery into the uterine artery. It is a method of causing infarction of uterine myoma by putting an embolized solvent through this microcatheter.

5. Myolysis

Myoma dissolution is a treatment that necrosis myoma by applying high-frequency energy to the myoma.

In the end, if the uterine myoma is not small and large, the most fundamental treatment is to remove the lesion by surgery.

You can get pregnant. Even if you have a myoma, there are many cases of pregnancyIn my friend's case, he knew that he had myoma in the ultrasound during pregnancy, so he cut out the myoma during a cesarean section when he gave birth to a child. Also, if you get a myoma while planning your child and suddenly get bigger, you can plan your pregnancy after surgery! Six months after myoma surgery, I also saw cases of pregnancy in the media. (In fact, I have been suffering from adenomyosis for eight years and have been collecting data for eight years of uterine disease. My family and friends who know I'm sick heard, saw, and told me somewhere.) A few years ago, a woman in her 20s, who was the manager of comedian Park Sung-kwang, had multiple myoma and had surgery. 

Suddenly, Park Sungkwang's manager was doing well.. She had to quit as a manager, and she was very sorry to be in the media, how hard must it have been for her to have menstrual painI know that menstrual painIt's scary to have a recurrence again, right? Reoccurrence... They say it happens a lotIf you lift the uterus completely, it will not recur.

So, if you are married and already have a child, you choose hysterectomy, but it is said that it is so happy to be free of pain ^^ It is said that it is a choice without regret 🙂 I know how much you've been struggling with your periods.