Best Myoma Diagnosis and Treatment in Thailand

Myomas are benign, monoclonal tumors of the smooth muscle cells of the myometrium. It seldom develops in the cervix, the lower part of the uterus. When it does, it is usually accompanied by myomas in the larger upper part of the uterus. 

Large cervical myomas may partially block the urinary tract or may protrude into the vagina. Sores develop on prolapsed myomas, which can become infected, bleed or both. In rare cases, prolapsed myomas can also block the flow of urine.

The presence of myomas is associated with fertility. The presence of submucous myomas decreases fertility, and their removal increases fertility to baseline rates.

Myomas in pregnancy can affect myoma growth, dependent on the individual differences in genetic, circulating growth factors, and myoma-localized receptors. 

Types of Myoma

  • Inside the cavity of the uterus – can cause bleeding and severe cramps
  • Underneath the uterine lining – can crowd into the uterus cavity and lead to heavy bleeding and other more serious problems 
  • On the outer wall of the uterus – can cause pain due to their size or pressure put on nearby organs

Women who have myoma uteri might or might not have symptoms. A woman may have only one fibroid or many varying sizes and types.

Symptoms of Myoma

  • Pelvic Mass
  • Abnormal or heavy menstrual bleeding
  • Difficult to urinate, frequent urination
  • Constipation , pressure on the rectum
  • Menstrual pain, cramp-like period pain
  • Acute pelvic pain with fever and nausea if there is a torsion of the tumor

Possible Causes of Myoma

  • Hormones – estrogen and progesterone, two hormones that stimulate the development of the uterine lining during menstrual cycle in preparation for pregnancy. Appear to promote the growth of fibroids. 
  • Genetic changes – many fibroids contain changes in genes that differ from those in normal uterine muscle cells.
  • Extracellular Matrix (ECM) – it is the material that makes cells stick together, like mortar between bricks. ECM is increased in fibroids and makes them fibrous. ECM also stores growth factors and causes biologic changes in the cells themselves.

The treatment for myoma uteri depends on the symptoms, size and location of the tumor, age (how close the person is to menopause), the patient’s desire to have children, and the general health of the patient.

  • Hysterectomy – removal of the uterus
    • Can be done by
      • Vaginal hysterectomy
      • Abdominal hysterectomy
      • Laparoscopic hysterectomy
  • Myomectomy 
    • Can be done by
      • Laparoscopic myomectomy 
      • Abdominal myomectomy

Finding the best treatment for myomectomy requires a capable doctor to ensure a high success rate.

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