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Clinical Gynecology

Clinical Gynecology


Fibroids are benign tumors originating from the smooth muscle of the uterus.


They are also known as leiomyomas or myomas.


These are mesenchymal tumors of the uterus, with size that varies from a few millimeters to tens of centimeters.


A large number of women with fibroids do not have clinical symptoms.


Often they are discovered for the first time during a routine gynecological examination.

In general, fibroids can divided into subserosal, intramural and submucosal. The type is determined by their location in the uterine wall. Subserous fibroids grow on the surface of the uterus, i.e. into the abdominal cavity. They often develop asymptomatically and can become large in size. Intramural nodes form in the muscle layer of the uterine wall. In contrast, submucosal fibroids grow into the uterine cavity. This usually is associated with heavy menstrual cycles.

Fibroids usually begin to develop in women between the age of 30 and 50. These are hormone-dependent tumors which are often demonstrated in cases of obesity, polycystic ovaries, etc. According to some studies, fibroids are less common in women who have given birth rather than in those who have not. Fibroid nodules grow at different rates during the reproductive age, especially during pregnancy. Usually, after menopause, they stop growing and may even slightly decrease in size.


Heavy and painful menstrual cycles (sometimes accompanied by anemic syndrome) represent the most common clinical symptom. Abdominal pain is less common and is usually observed in cases with large fibroids complicated by necrosis. Frequent urination or constipation is rare when compression of the bladder or rectum is present. Leiomyomas, which deform the uterine cavity, can cause difficulty in getting pregnant (infertility).


The diagnosis is most often made by ultrasound scan, during which a rounded solid tumor originating from the uterine wall is visualized. Ultrasound examination (sonography) can also accurately determine the type of the fibroid - intramural, subserous or submucosal. Serial ultrasound measurements and records of the growth rate is mandatory. Less commonly, the diagnosis is made intraoperatively during hysteroscopy, laparoscopy, or laparotomy.


In patients with heavy menstrual cycles, it is possible to use medication to reduce the clinical symptoms. There are also specific drugs that affect to some extent the growth rate of the tumor. Surgical removal is usually performed for when large tumor size and ineffective conservative treatment is observed.


At MC MARKOVS we offer all our patients the full range of tests related to the assessment of a woman's gynecological condition. All examinations are carried out in a comfortable environment with quality medical equipment by highly qualified health specialists.


For more information about performing a prophylactic gynecological examination, you can contact your doctor or call MC MARKOVS.