Doç. Dr. Cengiz ANDAN Online
×Myoma refers to benign (non-cancerous) tumors that develop in the muscle layer of the uterus (myometrium). These formations, medically named uterine leiomyoma or fibroid, are the most common pelvic masses in women. They generally appear during the reproductive years and can grow under the influence of the estrogen hormone. Myomas can occur as a single focus or develop in multiple numbers in the uterus. Their sizes can vary from a few millimeters to 20 cm.
Myoma Types Myomas are classified according to their location in the uterine wall:
Submucosal myoma: Grows toward the uterine cavity, generally increases menstrual bleeding, and can cause infertility.
Intramural myoma: Located within the uterine muscle layer, can lead to menstrual pain and increased bleeding.
Subserosal myoma: Grows toward the outer surface of the uterus, generally causes pressure symptoms.
Pedunculated myoma: Attached to the uterus by a thin stalk; carries a risk of torsion (twisting).
Myoma Symptoms While some myomas cause no symptoms, others may present complaints that reduce the quality of life:
Excessive and prolonged menstrual bleeding (menorrhagia)
Spotting between menstrual periods
Severe menstrual pain (dysmenorrhea)
A feeling of fullness/pressure in the groin or lower back area
Pain during sexual intercourse (dyspareunia)
Frequent urination or constipation (due to pressure on adjacent organs)
Infertility or recurrent miscarriages
What Causes Myoma? Although the exact cause is unknown, the following factors play a role in myoma development:
Hormonal effect: Estrogen and progesterone support myoma growth.
Genetic predisposition: A family history of myoma increases the risk.
Age: More common between the ages of 30–50.
Other factors: Excess weight, early onset of menstruation (menarche), having never given birth (nulliparity).
How is Myoma Diagnosed?
Gynecological examination: Uterine enlargement or irregularity may be detected.
Ultrasonography (USG): The most commonly used diagnostic method.
Magnetic Resonance Imaging (MRI): Shows the location, number, and size of the myoma in detail.
Hysteroscopy: Allows direct visualization of the uterine cavity, especially for submucosal myomas.
Myoma and Pregnancy During pregnancy, myomas can:
Increase the risk of miscarriage.
Lead to preterm birth.
Change the baby’s position (presentation).
Increase the need for a Cesarean section.
However, not every myoma negatively affects pregnancy; follow-up and evaluation are important.
Myoma Treatment Options Treatment is determined according to the size, location, symptoms of the myoma, and the patient’s desire for children.
1. Medical Treatment
Myoma growth can be slowed with hormonal medications.
Symptoms can be alleviated with medications that reduce bleeding.
Treatment does not eliminate the myoma.
2. Surgical Treatment
Myomectomy: Removal of the myoma while preserving the uterus. Preferred for patients who desire children.
Hysterectomy: Removal of the uterus. Provides a permanent solution for patients who do not desire children and have severe symptoms.
Hysteroscopic Myoma Surgery: A closed method for submucosal myomas.
3. Minimally Invasive Methods
Myoma removal via laparoscopic or robotic surgery.
Uterine artery embolization (shrinking the myoma by cutting off its blood flow).
Does Myoma Recur? Myomas can develop again after surgery.
The risk of recurrence is higher, especially in patients who are young and have multiple myomas.
Myoma and Infertility Myomas, especially types that distort the uterine cavity, can make it difficult for the embryo to implant. The chance of pregnancy may increase after myomectomy.
Do myomas become cancerous?
Very rarely (0.1–0.5%), they can transform into a malignant tumor called “leiomyosarcoma.”
Does every myoma need surgery?
No, small myomas that do not cause symptoms can be regularly monitored.
Can myoma be completely eliminated with medication?
No, medications can stop growth or shrink them, but they do not eliminate them completely.
Myoma Treatment in Istanbul
As Assoc. Prof. Dr. Cengiz Andan, I offer patient-specific approaches compliant with scientific guidelines for myoma treatment. The goal is both to improve the quality of life and to preserve fertility.
Fill out the form to request a free consultation to get preliminary information about your treatment process or learn about treatment methods tailored to your specific needs.