Fibroma and magnetizer
Uterine fibroma is a benign proliferation of a muscle cell in the uterine wall resulting in a compact tumor-like mass. It is caused by a hormonal imbalance between progesterone and estrogen, this mechanism is still poorly understood.
Very frequently, fibroids are multiple and can trigger pelvic pain by compression of the organ, bladder or rectum.
They are sometimes the cause of infertility by deforming the uterine cavity. They interfere with implantation.
The fibroid involutes, no longer bothers and calcifies at menopause.
The fibroid can proliferate outside the uterus under its outer envelope (subserosum), either in the thickness of the uterine muscle (intramural), or in the uterine cavity, under the mucosa (submucosa).
It is not hereditary and can sometimes be linked to the mutation of genes, often by ethnic origin: Caucasian women have half the number of fibroids than Afro-Caribbean women.
Even if it affects many women from the age of 35, a little more than one in 3 women, it only becomes annoying once in 3.
Their discovery is usually due to: bleeding outside of your period (metrorrhagia) or increased periods (menorrhagia), triggering anemia in 8% of cases.
Diagnosis is made by ultrasound and clinical examination of the pelvis.
The magnetizer stops angiogenesis and it scleroses the blood vessels nourishing the fibroid (s), which are starved of nourishment and dry out.
The medical approach uses an IUD that diffuses for 3 to 5 years or progesterone tablets until menopause:
1) Due to its liver toxicity, the National Medicines Agency is expected to withdraw ulipristal from sale very soon. This drug affects the size of the fibroid which can sometimes be halved. One tablet / day is taken for 3 months, followed by a 2-month break. It is a progesterone modulator that does not induce hot flashes, but requires monthly monitoring of transaminases.
2) Pituitary hormones control the production of ovarian hormones. Gonadotropin agonists (triptorelin, etc.) induce menopause with hot flashes.
3) Surgery takes place in case of failure or poor tolerance of treatments. It must be as conservative as possible. Intramural fibroids are removed by open surgery via a caesarean-type incision in 2/3 of cases or by laparoscopy. Submucosal fibroids by hysteroscopy. The subserosum by laparoscopy. The least invasive technique is performed with a robot (can we sterilize the robot 100%?)
Recurrences are of the order of 30%, but fortunately are not very troublesome, most frequently.
Removal of the uterus is less common than in the past. This radical treatment is contraindicated in case of desire for pregnancy.
4) Embolization is reserved for intramural and performed under radiological control to occlude the uterine arteries or some of their branches to selectively deprive the fibroma of oxygen. The result is a 50% reduction in six months.
In 25% of cases, after 5 years, this first treatment must be completed.
Many women regain a normal quality of life after one or more associated treatments.