One in two women develops these uterine tumors during their reproductive years.

Fibroids are a very common condition located in the muscular tissue of the uterus. Approximately more than 50% of women develop a fibroid during their reproductive years. Depending on the area of ​​the uterus in which they are located, fibroids can be submucosal, intramural, or subserosal.

“A fibroid is a proliferation of normal and therefore benign muscle cells,” explains Dr. Laura Pineda Domínguez of the Jiménez Díaz Foundation Hospital , about the nature of this condition.

The vast majority of fibroids do not produce symptoms and are often diagnosed by chance during a gynecological check-up, an abdominal ultrasound, or some other imaging test: "The vast majority of fibroids do not produce symptoms. A very high percentage of fibroids have been discovered incidentally or by chance," explains Dr. Manuel Albi, head of the Gynecology and Obstetrics Department at Quironsalud hospitals, part of SERMAS, and head of the Gynecology Service at La Luz University Hospital. However, when symptoms do appear, they often significantly affect a woman's quality of life.

“A very high percentage of fibroids have been discovered incidentally.”

In this regard, Dr. Raquel Senosiain Echarte, from the Gynecology and Obstetrics Department of the Fundación Jiménez Díaz and La Luz University Hospitals, adds that conventional examinations are those that provide the diagnosis and evaluation of fibroids on many occasions and insists on the importance of the location of the fibroid when trying to conceive: "When the fibroid is inside the uterine cavity, it harms the environment in which the embryo will be located."

Difficulties in pregnancy

Although a fibroid is a benign tumor when located in the uterine cavity, it can reduce the chances of pregnancy. In this sense, ultrasound is the gold standard for detecting fibroids, which will guide treatment before attempting to conceive.

However, Dr. Senosiain is reluctant to throw in the towel and encourages patients with this condition, pointing out that a fibroid uterus "should not interfere with, pressure, or condition the pursuit of achieving a gestational goal in a woman who truly wants to become pregnant."

"It should not condition a woman's pursuit of fulfilling her desire to conceive."

Key difference

Although fibroids don't have an oncological component, they can sometimes be confused with a malignant tumor called sarcoma, a more serious and dangerous condition. Dr. Albi warns that "sarcomas are malignant tumors and usually highly malignant," which is why healthcare professionals analyze fibroids in detail to rule out sarcoma: "Whenever we see a fibroid, any gynecologist asks the question: Could this be a sarcoma? And what makes us think of a sarcoma is the abnormal behavior of a fibroid," for example, a fibroid that appears after menopause or a fibroid that suddenly becomes very symptomatic.

Dr. Ana Suárez Gauthier, from the Jiménez Díaz Foundation University Hospital, rules out the danger of leiomyomas due to their very nature and shape: "When we look at them under the microscope, this tumor is composed of smooth muscle cells identical to those of normal muscle. That is already an indication of benignity."

It is an indication of benignity that the smooth muscle cells are identical to those of normal muscle.

For her part, Dr. Pineda insists on the lack of oncological potential of fibroids and the low probability of a fibroid becoming dangerous: "It is absolutely rare to find a sarcoma when the evolution and expectation would be for it to be a normal fibroid."

Possible treatments

For symptomatic fibroids, there are several types of treatment, ranging from the use of certain drugs to destructive and surgical treatments. The goal of fibroid treatment should be solely symptom control. Treatment will primarily depend on the type of symptom. The size, number, and location of the fibroids, as well as the desire for a future pregnancy, should always be taken into consideration when planning treatment.

Surgical treatment is reserved for women with heavy menstrual bleeding and pain or pressure that does not improve with medical treatment. Surgery is also recommended for women with intracavitary fibroids who desire children and those who have symptoms related to the size of the fibroid, such as urinary tract compression.

Myomectomy (removal of the fibroid) or hysterectomy (removal of the uterus) are the standard surgical techniques. Fibroid destruction techniques, such as radiofrequency, focused ultrasound, or microparticle embolization, are other therapeutic options that may be considered in some cases, says Dr. Albi.

"When the surgery is over, the patient goes to the Resuscitation or Recovery Unit, and there, once the patient has recovered, the nursing staff gives them discharge recommendations. These recommendations are very simple, easy to understand, and very easy to implement," says nurse Paula Lupión Miranda, from the Gynecology and Obstetrics Department at La Luz University Hospital.