Uterine myoma, myomectomy and minimally invasive treatments

Abstract

Uterine fibroids or myomas are the most common pelvic uterine tumors in women of childbearing age. They are benign monoclonal tumors arising from the smooth muscle cells of the myometrium. They could have negative impact on the reproductive system and can be single, but are more often multiple, causing significant morbidity and impairment of the quality of life. They are the leading indication for hysterectomies in the USA; nevertheless, epidemiological data on fibroid prevalence and incidence are limited and reliable population- based research is lacking. They arise in reproductive age women; estrogens and progestogens proliferate tumor growth as the fibroids rarely appear before menarche and regress after menopause. The majority of women with uterine fibroids are asymptomatic; consequently they get less clinical attention, and fibroid tumors often remain undiagnosed. Large numbers of patients with symptomatic fibroids typically present with symptoms of heavy or prolonged menstrual bleeding or pelvic pain and/or pressure. Additionally, women with uterine fibroids may suffer more often from dyspareunia, abnormal uterine bleeding and non-cyclic pelvic pain. Therapeutic options to treat these symptoms include medical therapy, surgical interventions and uterine artery embolization.