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Subserous myoma is a type of benign tumor composed of muscle cells that develops on the outer surface of the uterus, called the serosa. This type of fibroid does not usually lead to the development of symptoms, however when it is very large it can cause compression in Organs nearby organs and lead to pelvic pain and bleeding, for example.
Treatment for subserous fibroids is usually indicated when symptoms arise or when they are related to complications, and the use of medication or surgery to remove the fibroid or uterus may be indicated by the doctor.
Symptoms of subserous fibroids
Subserosal fibroids do not usually show symptoms, except when they reach large volumes, which can cause compression of Organs adjacent organs and lead to more serious problems. The manifestation of symptoms can be gynecological, such as abnormal uterine bleeding, pelvic pain, dysmenorrhea or infertility and as a consequence of bleeding, iron deficiency anemia may occur.
In addition, urinary retention, urge to urinate frequently, swelling of the kidneys, intestinal dysfunction, venous stasis, hemorrhoids may also occur, and although it is rare, fever associated with fibroid necrosis may also occur.
Although rare, the presence of uterine fibroids can impair fertility because they can cause:
- Deviation of the cervix, making access of sperm difficult;
- Increase or deformity of the uterine cavity, which can interfere with the migration or transport of sperm;
- Proximal obstruction of the tubes;
- Alteration of the tube-ovarian anatomy, interfering with the capture of eggs;
- Changes in uterine contractility, which can prevent the displacement of sperm, the embryo, or even nesting;
- Abnormal uterine bleeding;
- Inflammation of the endometrium.
If symptoms do not manifest, removal of the fibroid is not indicated, as the surgical procedure can contribute to the development of other infertility factors.
Although there is a possibility of causing infertility, even in the presence of uterine fibroids, it is possible to become pregnant, but the presence of fibroids can harm pregnancy. Some uterine fibroids can increase the chances of miscarriage, premature birth, low birth weight, fetal abnormalities, or even having to have a cesarean section.
Possible causes
The appearance of fibroids may be related to genetic and hormonal factors, since estrogen and progesterone promote their development and growth factors, produced by smooth muscle cells and fibroblasts.
In addition, there are several risk factors that can contribute to the development of uterine fibroids, such as age, early onset of the first menstruation, family history, being black, obesity, high blood pressure, eating a lot of red meat , alcohol or caffeine and never having children.
How the treatment is done
In the case of fibroids that do not lead to the appearance of signs or symptoms, specific treatment is not necessary, but it is important that an ultrasound examination is performed regularly. If symptoms are present, the doctor can indicate the start of treatment, which can be:
1. Drug treatment
This treatment aims to reduce or eliminate symptoms by reducing the size of the fibroid or bleeding, in addition to being useful before performing a surgical procedure, since it allows for a reduction in size which makes the surgery less invasive .
2. Surgical treatment
Surgical treatment must be individualized, adapted to each case. A hysterectomy, which consists of the removal of the uterus, can be performed, or a myomectomy, in which only the fibroid is removed. See how surgery is done to remove the fibroid.
Created by: Tua Saúde Editorial Team
Bibliography>
- INFORMED HEALTH. Uterine fibroids: Overview. 2014. Available at:. Accessed on 14 Aug 2020
- NEWTON WELLESLEY HOSPITAL. Fibroids. Available in: . Accessed on 14 Aug 2020
- PORTUGUESE SOCIETY OF GYNECOLOGY. National Consensus on Uterine Fibroids. 2017. Available at:. Accessed on 10 Aug 2020
- MINISTRY OF HEALTH. Clinical Protocol and Therapeutic Guidelines Leiomyoma of the Uterus. 2017. Available at:. Accessed on 10 Aug 2020