Uterine fibroid pseudocapsule

Abstract

Uterine myomas or fibroids are the most common benign tumors of the genital organs of women, with a frequent negative impact on reproductive system. They can be single or multiple, and frequently cause of significant female morbidity for interference on the of quality of life [1]. Literature data show that 5.4-77 % of women have myomas, depending either on the study population or by diagnostic techniques applied to myoma detecting [2]. The myoma prevalence is somewhat lower in Europe than in the United States, which are more influenced by racial differences [3]. They are detected in 70 % of uteri after hysterectomy (more than 80 % of cases in the form of multiple myomas) [4]. On 100 total hysterectomy, specimens performed at a distance of 2 mm demonstrated myomas in 73 % of samples of the uterus in premenopausal women and 84 % of the uterus in postmenopausal women. The average number of myomas in this study was 7.6 % among premenopausal women and 4.2 % in postmenopausal women [4]. Previous epidemiological studies, focusing mostly on symptomatic women, largely underestimated myoma prevalence. Fibroids consist mainly of smooth muscle cells (Fig. 6.1) with different amounts of fibrous tissue so, generally, they are benign with few symptoms, but when they disrupt the uterine functions, they cause: excessive uterine bleeding, anemia, defective implantation of an embryo, recurrent pregnancy loss, preterm labor, obstruction of labor, pelvic discomfort, and urinary incontinence and may mimic or mask malignant tumors [5]. Larger fibroids (Fig. 6.2) can even compress any of the surrounding organs, leading to urinary, digestive or sexual symptoms [6].