Uterine Myoma: Definition, Clinical Characteristics, and Treatment Approaches
Özet
Uterine myomas, also known as leiomyomas or fibroids, are the most prevalent benign tumors of the female reproductive system, affecting approximately 20–40% of women of reproductive age. These neoplasms originate from the smooth muscle cells of the uterus and, while often asymptomatic, may present with menorrhagia, pelvic pain, and infertility in certain individuals. Hormonal influences—particularly estrogen and progesterone—alongside genetic predisposition, environmental exposures, and metabolic factors, significantly contribute to their pathogenesis. Transvaginal ultrasonography remains the first-line diagnostic modality, whereas MRI and hysteroscopy serve as adjunctive tools for detailed assessment. Management strategies are tailored based on patient age, symptom severity, and reproductive goals, encompassing medical therapy, surgical interventions, and minimally invasive techniques. Emerging treatment modalities, including gene therapy, vitamin D supplementation, and phytochemicals such as EGCG, offer novel therapeutic avenues. Ultimately, an individualized, multimodal approach is essential to optimize clinical outcomes in patients with uterine fibroids.
Uterin myomlar, diğer adıyla leiomyom ya da fibroidler, kadın üreme sisteminin en yaygın iyi huylu tümörleri olup, üreme çağındaki kadınların yaklaşık %20–40’ını etkiler. Bu neoplazmlar, rahim düz kas hücrelerinden köken alır ve çoğu zaman asemptomatik olsa da, bazı olgularda menoraji (ağır adet kanaması), pelvik ağrı ve infertilite gibi şikâyetlerle ortaya çıkabilir. Özellikle östrojen ve progesteron gibi hormonların etkisi, genetik yatkınlık, çevresel maruziyetler ve metabolik faktörler, bu tümörlerin oluşumunda önemli rol oynar. Tanıda transvajinal ultrasonografi birinci basamak yöntemdir; manyetik rezonans görüntüleme (MRI) ve histeroskopi ise detaylı değerlendirme için yardımcı araçlardır. Tedavi seçenekleri, hastanın yaşı, semptomların şiddeti ve doğurganlık hedeflerine göre bireyselleştirilir; medikal tedavi, cerrahi müdahale ve minimal invaziv teknikleri içerir. Gen tedavisi, D vitamini takviyesi ve EGCG gibi bitkisel bileşenleri içeren yeni tedavi yöntemleri, yenilikçi tedavi yaklaşımları arasında yer almaktadır. Sonuç olarak, uterin fibroidli hastalarda klinik başarıyı artırmak için bireyselleştirilmiş ve çok yönlü bir tedavi yaklaşımı esastır.
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