Working Hours
- Monday - Friday
09:00 - 19:00
Contact
Ask the Experts
Myomas
Benign tumors of the uterus, known as myomas, often cause heavy bleeding and abdominal pressure.
In the Gyn-Fertility Clinic Milenković, we provide reliable treatment of myomas, with cutting-edge diagnostic methods and minimally invasive techniques such as hysteroscopy and laparoscopy, in order to achieve the best outcome for our patients.
A myoma is a benign tumor that originates from the muscular layer of the uterine wall. The term fibroid is also often used.
The exact cause of myomas is not known. Genetic factors and the hormone estrogen probably contribute to the development of myomas.
- About 70% of women have myomas.
- 3.5% of women between the ages of 25 and 32 and 8% of women between the ages of 33 and 40 have myomas.
- 15-30% of women with myomas have symptoms.
What are the risk factors for myomas development?
Risk factors for myomas are as follows:
- years of age;
- myomas in the family;
- obesity;
- getting your first period early;
- excessive intake of alcohol and caffeine.
Women of African descent and women who have not given birth have an increased risk of myomas.
Symptoms of myomas
Women with myomas may have the following symptoms:
- heavy menstrual bleeding;
- pain during menstrual bleeding;
- feeling of pressure and pain in the small pelvis;
- frequent urination;
- anemia;
- infertility.
How are myomas diagnosed?
- gynecological examination;
- transvaginal and abdominal ultrasound examination;
- hydrosonography-SIS from saline infusion sonography-when a saline solution is inserted into the uterine cavity before the ultrasound examination;
- hysteroscopy;
- magnetic resonance imaging (MRI);
Classification of myomas
Depending on the location, myomas can be:
- submucosal-in the uterine cavity;
- intramural-in the wall of the uterus;
- subserous-on the uterine wall;
- combination of previously described myomas.
The International Federation of Gynecology classified myomas from 1-7 depending on the location.
Treatment in the Gyn. Fertility Clinic Milenković
In the Gyn-Fertility Clinic Milenković, the treatment of myomas begins with precise diagnosis by means of ultrasound, hysteroscopy or magnetic resonance.
The treatment is adjusted based on the size and position of the myoma - from drugs for milder symptoms to surgical procedures, such as hysteroscopy and laparoscopy. The treatment is adapted to each patient in order to preserve her health and quality of life.
- contraceptive pills, drugs based on artificial progesterone, anti-progesterone, hormonal coil, drugs from the group of agonists and antagonists of gonadotropin - releasing hormone.
Medicines are also used in combination with surgical treatment.
- hysteroscopic myoma surgery;
- laparoscopic myoma surgery;
- classic myoma surgery;
- removal of myomas with radiofrequency and ultrasound energy (vaginal and laparoscopic approach);
- removal of the uterus (hysterectomy) due to myomas;
- fibroid embolization.
When is surgery necessary to remove myomas?
Surgery is necessary:
- in submucosal myomas, that is, myomas located in the uterine cavity;
- in all myomas that give symptoms and cannot be treated with drugs;
- in large myomas;
Read more details about the surgical treatment of myomas on this page.
Can myomas disappear on their own?
Myomas disappear or shrink in menopause. Smaller myomas can disappear spontaneously even before menopause.
How often are myomas controlled?
Myomas are controlled at 6-12 months.
What are the complications if myomas are not treated?
Complications of untreated myomas are anemia, constant feeling of pressure and discomfort in the lower abdomen, frequent urination and pain.
Expert advice: frequently asked questions
Answers by: Milan Milenković MD, PhD
What are the first symptoms of uterine myomas?
15-30% of myomas cause symptoms. Symptoms depend on the location of the myomas and the size of the myomas. Heavy menstrual bleeding, feeling of pressure in the small pelvis and frequent urination are the most common symptoms of myomas.
Do myomas hurt?
Myomas cause pain in cases where necrosis occurs, that is, "extinction" of the fibroid tissue. Necrosis can sometimes be accompanied by an high fever. Large myomas pressing on nerves in the small pelvis can be painful.
Do myomas affect the menstrual cycle and heavy bleeding?
Myomas located in the uterine cavity, that is, submucosal fibroids can be the cause of heavy menstrual bleeding.
Can fibroids burst and what are the symptoms of fibroids bursting?
Fibroids cannot burst, but the fibroid tissue may die, which causes pain.
Can myoma become a malignant tumor?
Myomas can become a malignant tumor in 0.25% of cases.
Can fibroids cause complications in pregnancy?
Fibroids, depending on their location and size, increase the risk of spontaneous abortions, fetal presentation, low-lying placenta, premature placental abruption and pain in the fibroid area.
What is a subserous myoma and when is it operated on?
Subserous myoma is a myoma that is located on the wall of the uterus and is operated on when, due to its size, it puts pressure on the surrounding organs and leads to the feeling of pressure in the small pelvis, pain and frequent urination.
How do myomas affect fertility and chances of pregnancy?
Submucosal myomas (myomas in the uterine cavity) reduce the chance of pregnancy and increase the risk of spontaneous abortions. It cannot be said with certainty that myomas located in the wall of the uterus, i.e. intramural myomas, cause infertility, but the assessment is individual depending on the size and number of myomas. Subserous fibroids, that is, myomas located on the outside of the uterine wall, do not affect fertility.
What is a pedunculated myoma?
A pedunculated fibroid is a subserous myoma that is attached to the uterus by a peduncle containing blood vessels. Most often it does not cause symptoms. Myoma on the peduncle can also be in the uterine cavity. Sometimes the uterus "ejects" into the vagina a fibroid on the peduncle, located in the uterine cavity, so-called "fibroid that is born".
What is myoma necrosis?
Necrosis is the death of tissue and occurs in larger fibroids when the central part of the fibroid does not receive enough blood. It also occurs in fibroids during pregnancy. Necrosis causes pain and sometimes high fever. It is treated with Brufen or Diclofenac and the symptoms usually subside within a few days.
Is it possible for myomas to return after treatment?
The risk of myomas returning is about 50% within 5 years. The risk is even greater if several myomas were removed during the operation.
Can dietary and lifestyle changes help control myomas?
There is no proof that the way to diet or that a particular diet affects myomas.
If you have additional questions, please feel free to contact us.
You can expect an answer during office hours, from Monday to Friday, between 9 a.m. and 7 p.m.
