Although tumours are popularly thought of as cancer, the likelihood of fibroids turning into cancer is quite low; even so, it should be kept in mind that they may, however rarely, change in a malignant direction, and follow-up must not be neglected. When they are found in a woman of reproductive age they may lead to major problems, and sometimes they are detected incidentally during a gynaecological examination. However, they are most often seen in the 35-40 age group. The likelihood of seeing them in adolescence is quite low, but the frequency may increase in parallel with advancing age. On the other hand, since fibroids tend to grow with the hormone oestrogen, this growth may also continue during pregnancy. In pregnancy, as a result of a deterioration we call degeneration, pain may be seen clinically and different images on ultrasound, and this may also cause difficulties in pregnancy. But these situations are not always seen. In the menopausal period they may also shrink as the hormone oestrogen decreases. Fibroids, which appear with different symptoms, may give no symptoms in various situations. In order to detect fibroids, which can sometimes be found at routine check-ups, a comprehensive gynaecological examination must be performed.
Symptoms of Fibroids
- Excessive bleeding during menstrual periods,
- Anaemia,
- Enlargement in the abdomen and the uterine region,
- Severe pain during sexual intercourse,
- Pain in the lower back and the tailbone,
- Frequent urge to urinate,
- Blockage of the tubes (in some cases fibroids may lead to blockage of the tubes),
- Constipation
In every woman these symptoms may occur with different severity and as different complaints. Fibroids may invite different problems according to their size, number and rate of growth. Fibroids can be removed from the body by surgery, but after the operation the risk of recurrence also increases. After surgery micro-sized fibroids may remain, and by growing over time they may bring various problems with them. However, if the fibroids are small they can be kept under control without being operated on. When the symptoms are severe and reach a level that disrupts daily life, surgery may be necessary. For fibroids that do not lead to major problems, clinical follow-up may be sufficient. If we consider that fibroids grow steadily, early diagnosis is of great importance in this situation. When fibroids are noticed late or cause serious clinical complaints, they may make a surgical operation necessary.
Must Open Surgery Always Be Performed in Surgical Treatment
Today, closed operations in particular are widely used in the surgical treatment of fibroids. If the fibroid is close to the inner layer of the uterus, hysteroscopy is performed; if it is deeper and larger, the operation is performed laparoscopically. In recent years fibroid surgery has been performed successfully with robotic surgery in particular.
Must the Uterus Always Be Removed in Fibroid Operations?
The answer is very clear: no. The uterus can be preserved in many cases. One of the important points here is the experience of the surgeon who applies these surgical techniques. Follow-up after surgery is important, especially in patients whose uterus has been preserved.