What is Leiomyomata?
Leiomyomata which is also known by various other names like Uterine Fibroids, Uterine Myoma, Leiomyoma, and Fibromyoma is a pathological condition in which there is growth of benign lesions in the muscle tissue of the uterus of a female. Leiomyomata is quite a common condition and about 50% of females of a reproductive age have this condition. In many cases, this condition does not interfere with the functioning of the organs but in some cases the patient can experience some severe symptoms which may require a visit to the gynecologist for treatment. These lesions which develop in the muscle tissue of the uterus are medically termed as fibroids and they tend to be variable in size ranging from as small as a coin sized to as big as a watermelon. Sometimes, the size of the tumor or lesion may be so large that the female may look as if she is seven or eight months pregnant. There may be a single lesion in Leiomyomata or there may be a cluster of many lesions or fibroids
What are the Classifications of Leiomyomata?
Leiomyomata is primarily of four types which have been described below. They are classified based on their location in the uterus.
- Subserosal Leiomyomata: The lesion or fibroid in this type of Leiomyomata is found in the outer portion of uterus and their growth is also in that direction.
- Intramural Leiomyomata: This is by far the most common form of fibroid found in Leiomyomata. The fibroids in this type develop within the uterine wall and expand thus expanding the uterus as well making it look larger than normal.
- Submucosal Leiomyomata: Fibroids in this type develop immediately under the lining of uterine cavity. These fibroids are the ones that can result in heavy menstrual periods and also may lead to frequent miscarriages and infertility in females.
- Pedunculated Leiomyomata: These types of fibroids grow on a stalk which connects them to the wall of the uterus.
What are the Symptoms of Leiomyomata?
As stated, many cases of Leiomyomata may not cause any problems but in some cases certain symptoms can be experienced especially if a female has submucosal type of Leiomyomata. These symptoms are:
- Heavy and prolonged menstrual periods
- Severe pain behind the legs
- Experiencing pressure or pain in the pelvic region
- Increased urinary frequency
- Altered bowel habits
- Enlargement of the abdomen which can be mistaken for pregnancy.
How is Leiomyomata Diagnosed?
If a female experiences these above mentioned symptoms, the gynecologist will first inspect the uterus checking for its size to see if there is any enlargement. If the physician feels there is an enlargement then an ultrasound or MRI of the uterus will be ordered which will confirm the presence of Leiomyomata and it will also give the size and location of the fibroid which then confirms the type of Leiomyomata. Once Leiomyomata has been diagnosed the gynecologist will then formulate a treatment plan which may range from watchful waiting to observe the fibroids to a range of invasive treatments which have been discussed below in detail.
How is Leiomyomata Treated?
In the times gone by, the most preferred treatment for Leiomyomata was performing a hysterectomy and removing the entire uterus but that killed any hopes of the patient having any baby in the future but with the advancement that medical science has made over the years there are more new treatments available which the patient can choose for treatment of Leiomyomata. Before considering the best treatment for the patient the physician looks at the following specifications:
- Age of the patient
- Overall health of the patient
- How severe the symptoms are
- Past history of the patient
- The type of Leiomyomata.
Some of the treatment options for Leiomyomata are:
Magnetic Resonance Guided Focused Ultrasound Surgery for Leiomyomata: This is a noninvasive procedure in which the fibroids are removed without harming the uterus in anyway. This is usually done in an outpatient setting and the recovery time is usually three days.
Hysterectomy for Leiomyomata: This is a procedure in which the entire uterus is removed from the body. This is done in an inpatient setting and needs at least six weeks of recovery time. After this procedure, there is absolutely no chance for the patient to get pregnant again.
Abdominal Myomectomy to Treat Leiomyomata: In this procedure, an incision is made in the abdomen and the uterus is reached and depending on the location of the fibroids the area is explored and the fibroids removed without harming the uterus in any way. Post procedure, it usually takes about a month for the patient to fully recover from the surgery.
Laparoscopic Myomectomy: This procedure is done for removing small fibroids. It uses a laparoscope for removal of the fibroids and is done in an outpatient setting and the patient requires at least a couple of weeks to fully recover from the procedure.
Hysteroscopic Myomectomy: In this procedure, fibroids are removed using an instrument called as Hysteroscope which is inserted through the vagina through the cervix into uterus. There is no harm done to the uterus. The patient can return to normal functioning within two days of the procedure.
Apart from these above mentioned procedure, there are other noninvasive treatment options like hormone therapy, herbal medications and the like which may sometimes be used to treat the condition.
What are the Chances of Recurrence of Leiomyomata Post Surgical Removal?
Myomectomy is the procedure which is done for treatment of Leiomyomata but post treatment by this method there is also a chance of recurrence of Leiomyomata. It is a bit difficult to judge the exact percentage of recurrence, studies have suggested a recurrence rate of 10% in a five year time frame when myomectomy is done using laparotomy. There is a greater chance of recurrence after a laparoscopic myomectomy. This means that if a female has frequent or recurrent Leiomyomata then the chances of that female getting pregnant or carrying her pregnancy to term is quite bleak post myomectomy for treatment of Leiomyomata.