Fibroids are benign tumors that are located in the muscle tissue of the uterus. Depending on their location, they can be classified as submucosal, intramural, or subserosal. They do not have to cause symptoms and many are identified or located during a routine check-up. Actually, they only appear in the reproductive age and are very common. In fact, one in two women can develop them throughout their lives.
«A fibroid is a cellular proliferation, a tumor without malignant or oncological capacity. A fibroid is to the uterus like a freckle is to the skin. They are very common, they are seen in all women in the world, although there are some conditions that can predispose such as the family component, or race, being more common in black women than in Caucasian women,” emphasizes Dr. Laura Pineda. Domínguez, associate gynecologist at the Fundación Jiménez Díaz University Hospital in Madrid.
Meanwhile, Dr. Manuel Albi González, head of the Department of Gynecology and Obstetrics at the Fundación Jiménez Díaz and La Luz university hospitals (Madrid), maintains that fibroids only appear in the reproductive age, while emphasizing that they do not usually cause symptoms: «A very high percentage have been discovered by chance during gynecological examinations or check-ups. If they produce any symptoms, although it is not usual, fibroids can cause abnormal or heavy menstrual bleeding, as well as pain.
In turn, Dr. Raquel Senosiain Echarte, associate gynecologist at the same hospital centers, points out that ultrasound is the reference test for the detection of fibroids, since it not only allows them to be identified but also delimits their location, a key factor in allowing the evolution of a pregnancy.
Fibroid treatment
Thus, Dr. Albi remembers that there are fundamentally two ways for the medical treatment of fibroids: first, medication, so that the fibroid stops producing symptoms; either the surgical route or ‘invasive‘, as specialists call it, and which can be divided into two equally, on the one hand, destroying the fibroid with techniques that do not involve surgery, or removing the fibroid through conventional surgery.
In this sense, gynecologist Laura Pineda points out that today in a hysteroscopy, a procedure to examine the cervix with a 3-millimeter camera, the fibroid can be removed depending on its size and location. «With this technique you can see the fibroid, which bulges and deforms the uterine cavity, and it can also be trimmed with a millimeter scalpel. “It is an intervention with a rapid recovery,” as he points out.
If you are looking for a pregnancy
But as we mentioned before, one of the problems with fibroids is that they can reproduce frequently and, depending on where they are located, make pregnancy difficult. In this sense, Dr. Senosiain maintains that what matters is the location of the fibroid when deciding whether or not it requires surgical treatment. The presence of a fibroid within the uterine cavity is one of the few indications for treatment before seeking pregnancy, since it can interfere with implantation or hinder the development of the embryo,” he maintains.
Of course, this expert warns that the association between pregnancy and a myomatous uterus is very common, and most pregnancies in these cases proceed normally, with complications being very rare. What’s more, this gynecologist says that complications do not even reach 10%, and this condition should not interfere with a woman’s gestational desire, despite having a myomatous uterus.
Regarding hysterectomy, or removal of the uterus, Dr. Albi maintains that it should not be the first treatment option except in extreme cases. “Treatment must be individualized case by case and today we have enough therapeutic arsenal to be able to make the fibroid compatible with the woman’s desire to be a mother,” highlights this expert from the Jiménez Díaz Foundation and the La Luz Hospital.
When there is a sarcoma behind
Lastly, whenever there is a fibroid in front, it is observed whether it is a sarcoma, a malignant tumor, something that is verified in pathological anatomy, given its high malignancy. “The abnormal behavior of a fibroid makes us think of a sarcoma,” emphasizes Dr. Albi.
However, Dr. Pineda states that these cases are “absolutely rare,” since fibroids do not become malignant.
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