Myoma uterino

Uterine fibroids are very common gynecological tumors.
Its frequency is high and is expected to 1 of each 4 O 5 Women have a fibroid. It usually occurs in women between 30 Y 50 years.

They are usually benign. Solo 1/10000 cases are malignant and are called leiomyosarcoma. In these cases a rapid tumor growth was observed.

They originate from the middle layer of the uterus (or matrix).
They are hormone dependent tumors, and growing by the hormonal action. On the other hand, menopause, decreases in size.

They can be single or multiple. Sometimes they can reach considerable size.
Its cause is unknown. It relates to female hormones and has also been observed an inherited tendency.(genetics).

Fibroids can build different locations:

Subseroso: It is the most common type. It appears on the outer lining of the uterus.
Intramural: It is the second most common. It grows in the thickness of the muscle layer of the uterus.
Submucosos: It is growing in the lining of the uterine cavity. It is the least common .


Spotting between periods
Heavy menstrual bleeding.
Longer duration of menstrual period
Need to urinate more often
Pelvic pain
Feeling of abdominal compression in the lower abdomen.
Pain with sexual intercourse
It may be associated with infertility.
Often fibroids are asymptomatic. In addition, after menopause, fibroids become smaller and symptoms may stop play.


Exploring the doctor can detect a large uterus and irregular morphology.
Ultrasonography, especially, proportional transvaginal ultrasound can diagnose
Magnetic resonance imaging is the imaging test that provides a better diagnosis of fibroids.
Histerosonografia. Use serum instillation inside the uterine cavity to study the morphology of the uterine cavity and evaluate caracteristaicas myoma
Hysteroscopy allows direct visualization of the uterine cavity by introducing a lens that is inside a metal sheath small caliber through vaginal.
-Endometrial biopsy. It is done by introducing a small cannula inside the uterine cavity to take a small sample of endometrial tissue. The sample is sent to pathological analysis, to rule that it is a malignant tumor.

Treatment of uterine fibroids

Treatment of fibroids can be medical or surgical.
The choice of treatment depends on the symptoms that occur, age, desire gestation, or if the woman is pregnant then.

There are a variety of treatments:

  • Oral contraceptives
  • Of levonorgestrel IUD
  • Injecting GnRH analogues
  • Analgesia and iron supplements
  • De ulipristal acetate (Esmya)

Surgical treatment includes:

  • Operative hysteroscopy allowing resection of submucosal fibroids
  • Miomectomia, that can be performed laparoscopically or by open surgery or laparotomy Robotic Surgery. Will preserve the fertility of women
  • Hysterectomy, which it involves removal of the entire uterus and fibroids. that can be performed laparoscopically or by open surgery or laparotomy Robotic Surgery

Other treatments are:

  • Uterine artery embolization. It is a technique that, by catheterization of the pelvic vessels, and injection of small particles that clog the vessels feeding the fibroid, producing a significant decrease in size. The technique is performed by an interventional radiologist.
  • High intensity focused Utrasonidos (HIFU). No interventional technique, which destroys mioas by applying ultasonidos.