Myoma Uteri

Among 20% to 50% women may have myoma uteri. This could not be alarming since it is a noncancerous type of tumor growing in the uterus. This mutation of cells in the uterus is benign in nature which means it could not affect the function of the uterus. There are some medical literatures that describe this benign tumor as fibroid or leiomyomata.

Although it is benign in nature, this is the most common indication for women to undergo a surgical procedure called hysterectomy. The larger the body mass of a woman, the higher her tendency to develop such tumors. According to the survey, black American women are more common to have this compared to Asian women. The symptoms usually appear between the age of 30 to 40 years old. When it comes to its etiology, the origin of tumor growth cannot be pointed out yet. Usually, women may have this growing in their uterus during pregnancy. When menopause ensues, it shrink its size, however there are cases that it may cause pain as it degenerates.

Classification of Myoma Uteri:

  1. Intramural – This is the most common(70%) myoma uteri. It can be located in the uterine wall.
  2. Subserosal – Almost 20% of women may have this. It can be located in the sero
  3. Submucosal – It is located beneath the endometrium. Only 10% of women were found to have this case.

Signs and Symptoms:

  1. Asymptomatic in most cases
  2. Fullness sensation in the lower abdomen
  3. Frequent urination
  4. Vaginal bleeding between periods
  5. Dyspareunia
  6. Lower back pain
  7. Abdominal pain or cramps
  8. Change in bowel movement
  9. Infertility
  10. Recurrent miscarriage

Clinical Examination:

  1. Evident abdominal mass
  2. Tender and large size abdomen
  3. Signs of anemia due to menorrhagia

Diagnostic Examination:

  1. A pregnancy test must be done so that pregnancy can be ruled out.
  2. Complete blood count must be taken in order to check for the haemoglobin levels especially for women who experience excessive bleeding.
  3. An accurate examination is through transvaginal ultrasound.
  4. In cases that the myoma cannot be completely diagnosed with transvaginal ultrasound, a magnetic resonance imaging is used in order to help in assessing the depth of the tumor.
  5. Biopsy can be done during hysterectomy in order to study the tissue involved in the mutation.

Medical Management:

  1. Non-steroidal Anti-inflammatory Drugs (NSAIDS) are prescribed in order to reduce the pain sensation as well as minimize the blood loss.
  2. Tranexamic acid is given for patients suffering from excessive blood loss.

Surgical Management:

  1. Oophorectomy is done when ovaries are also included in the damage. Surgical management is indicated when the uterine size is much enlarged. The abnormal bleeding is also another indication for surgical removal since continuous blood loss can result to anemia.
  2. Myomectomy are intended for patients that are included in the reproductive age. Women who wanted to conceive can opt for this after a complete assessment.
  3. Laparoscope-assisted vaginal hysterectomy is the newest method of surgery wherein only a small incision is done in order to minimize bleeding.

Byron Webb Romero, RN, MSN

Finished BSN at Lyceum of the Philippines University, and Master of Science in Nursing Major in Adult Health Nursing at the University of the East Ramon Magsaysay Memorial Medical Center. Currently working at Manila Doctors College of Nursing as a Team Leader for Level I and II, Lecturer for Professional Nursing Subjects, and also a Clinical Instructor.

What Do You Think?