Hello... Today, I would like to talk to you a bit about fibroids. Fibroids are generally benign tumors originating from the uterine muscle tissue in women. They can present with different complaints in various age groups. As obstetricians and gynecologists, we don't recommend surgery for every fibroid. Depending on the patient's history, current condition, desire for fertility continuation, age, previous pregnancies, and whether the patient desires to have children, we can offer alternative treatment options for managing the fibroids.

Fibroids can be treated differently based on their location, number, size, growth pattern, whether they cause rapid growth, if the patient experiences pain, abnormal bleeding, or if there is excessive bleeding leading to anemia. Some fibroids grow towards the inside of the uterus, affecting the area where pregnancy would implant. In such cases, they are significant due to an excessive increase in bleeding, intermenstrual bleeding, or potentially obstructing pregnancy. Other fibroids grow outward from the uterine muscle wall, towards the abdominal organs, potentially pressing on surrounding tissues such as the intestines or bladder, causing rapid growth, pain, constipation, or a decrease in bladder capacity, leading to symptoms such as difficulty urinating.

Some fibroids grow within the uterine muscle wall, varying in degree of growth towards the inside or outside of the uterus, generally enlarging the uterus and being completely localized within the muscle tissue. For these fibroids, we determine the treatment option for patients by considering parameters such as the number and size of the fibroids, the symptoms they cause, whether they induce pain, contribute to increased or prolonged menstrual bleeding, or lead to abnormal bleeding and intermenstrual bleeding, as well as whether they cause a decrease in the patient's blood count.

Of course, we don't perform surgery for every fibroid, but when we decide on surgery, we consider factors such as the patient's age, whether we will preserve or remove the uterus, the patient's desire for fertility continuation, the presence or absence of living children, and whether the patient desires a new pregnancy.

For younger patients who have not yet had a pregnancy or those with a desire for a new pregnancy, especially if they have fibroids growing towards the inside of the uterus, we can recommend the option of surgery through hysteroscopy, a minimally invasive procedure, to remove the fibroids from within the uterus and send them for pathological examination.

If a patient has multiple fibroids causing excessive bleeding and pain, and if the fibroids are not leaving a healthy area of the uterine muscle wall, or if the patient is of advanced age, approaching menopause, or has completed her fertility, we may suggest surgical options, either open or minimally invasive, depending on the potential to preserve the uterus based on the number, location, and size of the fibroids.

If a patient has numerous fibroids, causing excessive bleeding and pain, and if the fibroids are not leaving a healthy area of the uterine muscle wall, or if the patient is of advanced age, approaching menopause, or has completed her fertility, we may recommend surgeries other than fibroid removal, such as hysterectomy.

I wish you all a good day.