
Fibroids are benign uterine formations created by the uterine muscle cells. They are diagnosed in 25% of the women we examine. Their appearance relates to mom-to-daughter inheritance. However, estrogens are responsible for the increase in their size.
Most of the times, we detect them at random in a routine gynecological ultrasound or in hydrosonography. However, there are times when fibroids lead a woman to a gynecologist, because of hemorrhages, infertility, sensation of increased abdominal weight, great blood loss during periods, even first-trimester miscarriages. In pregnancy, fibroids grow in size, due to increased levels of estrogen. The rate of fibroids hiding cancer is just 0.1%. The size of fibroids varies from millimeters to tens of centimeters. However, the position of fibroids in the uterus is mainly responsible for whether the woman shall have any of the above symptoms or not. We may detect a large fibroid on the outer surface of the uterus of an asymptomatic woman, or a small fibroid of a few millimeters in the endometrium, which causes major bleeding or infertility. Therefore, we understand that not only size, but also position plays an important role. At present, fibroids are mainly removed endoscopically (i.e., laparoscopically, robotically and hysteroscopically) and rarely with the classic open laparotomy.