Myoma Uteri

Abstract

Uterine fibroids, also known as leiomyomas or myoma uteri, are benign smooth muscle tumors that arise primarily in women of reproductive age. These tumors are hormonally responsive, with their growth strongly influenced by estrogen and progesterone. Myomas can be asymptomatic or cause a wide range of clinical manifestations including menorrhagia, anemia, pelvic pressure, urinary disturbances, and infertility. The etiology involves genetic mutations, notably in the mediator complex subunit 12 and high mobility group AT-hook 2 genes, and environmental factors such as exposure to endocrine-disrupting chemicals. Epidemiological studies reveal higher prevalence in African descent and familial aggregation. Diagnosis is often achieved through pelvic examination and ultrasonography, whereas magnetic resonance ımaging remains the gold standard for complex cases. Fibroids are classified using the Federation of Gynecology and Obstetrics system based on their location relative to the endometrial and serosal surfaces. Medical management includes non-steroidal anti-inflammatory drugs, antifibrinolytics, and hormonal therapies, though they primarily target symptoms rather than tumor size. Surgical options such as hysterectomy, myomectomy, and minimally invasive techniques such as magnetic resonance-guided focused ultrasound are indicated for refractory cases. Future directions emphasize early diagnosis, individualized treatment, and the use of fibroids as a model to explore novel therapeutic strategies, particularly those aiming to interrupt fibroid pathogenesis at the molecular level. Given their accessibility and relatively benign nature, fibroids also provide a valuable platform for testing emerging technologies in gynecologic care. As research advances, the paradigm is shifting from radical surgical intervention toward personalized, fertility-preserving treatments.