The subserous myoma is a type of benign tumour that is due to the development of muscle cells called serosa, on the outer surface of the uterus. This type of myoma is not usually accompanied by any symptoms. However, when it becomes too large it can compress the nearby organs and result to pelvic pain and bleeding.
Treatment of subserous myoma is usually prescribed once the symptoms appear or when they are related to other disease complications. The doctor may use various medications or perform surgery so as to remove the myoma or the uterus.
Symptoms of subserum myoma
The subserous myoma is not usually accompanied by any symptoms except when it grows and becomes very large, causing compression of the adjacent organs and leading to more serious problems. The symptoms may manifest themselves as gynaecological, such as abdominal uterine bleeding, pelvic pain, dysmenorrhea or infertility. Anaemia may also occur as a consequence of bleeding.
Other symptoms that may also be present include urinary retention, urge to urinate frequently, swelling of the kidneys, intestinal dysfunctions, venous sepsis and haemorrhoids. Although rare, fever that is associated with necrosis of fibroids may also be experienced.
Although rare, the presence of uterine fibroids can impair fertility because they can cause:
- Deviation of the cervix, hindering the access of sperm
- Increase or deformity of the uterine cavity, which may interfere with the migration or transport of spermatozoa
- Proximal obstruction of the tubes
- Alteration of the tubo-ovarian anatomy, interfering in the capture of eggs
- Alteration in uterine contractility, which can prevent the displacement of sperm, embryo, or even cause nidation
- Abnormal uterine bleeding
- Inflammation of the endometrium
If the symptoms do not manifest themselves, the removal of myoma is not recommended. This is because the surgical procedure may contribute to the emergence of other infertility problems.
Even though there is a possibility of infertility with the presence of uterine fibroids, it still possible to become pregnant. But still, the presence of fibroids may impair the pregnancy. This happens when some of these fibroids increase the chances of having a miscarriage, premature delivery, low birth weight, fatal abnormalities or even resorting to caesarean section when the time of giving birth comes.
The development of fibroids may be related to genetic and hormonal factors. This is because the hormones oestrogen and progesterone promote their development and growth, as they will be produced by smooth muscle cells and fibroblasts.
In addition, there are also several risk factors that may contribute to the development of uterine fibroids such as age, early onset of the first menstruation, family history, being black, obesity, hypertension, eating large amounts of red meats, alcohol or caffeine and never having any children.
How treatment is done
When the fibroids to not lead to the appearance of any signs and symptoms, there is no specific treatment required. However, it is important that an ultra sound examination is performed on a regular basis. If the symptoms are present, the doctor may recommend initiation of treatment, which may be:
1. Drug treatment
This type of treatment aims to reduce or eliminate the symptoms such as reduction of the size of the myoma and also reduction of bleeding. It is also used during the surgical procedure as it reduces the size of the myoma, making the procedure less invasive.
2. Surgical treatment
Surgical treatment depends on each case if the subserous myoma. A hysterectomy may be performed. This is a procedure that involves removal of the uterus, or a myomectomy, which involves only removal of the myoma itself.