Dijagnoza i liječenje mioma maternice

master's thesis

• Title (english): Diagnosis and treatment of uterine fibroids
• Author: Mihaela Barčan
• Mentor: Ivana Maurac (mentor)
• Committee member: Slavko Orešković (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Ivana Maurac (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2020-09-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Miomi maternice najčešći su benigni ginekološki tumori. Histološki su građeni od snopića glatkih mišićnih stanica i oskudnog veziva, nalik normalnom miometriju. Monoklonalnog su porijekla, a rast im je ovisan o estrogenu i progesteronu. Epidemiološki podaci dobiveni dosadašnjim istraživanjima pokazuju kako kumulativna incidencija ovih tumora tijekom fertilne dobi iznosi 70% do 80%. Rizik razvoja mioma maternice raste s dobi sve do menopauze, a daleko je viši u žena afričkog porijekla. U postmenopauzi uglavnom involuiraju i simptomi se povuku. Iako je većina žena s miomima asimptomatska, u onih s manifestnom kliničkom slikom kvaliteta života ozbiljno je narušena. Najčešći simptomi mioma maternice su menoragija s posljedičnom anemijom, bol u zdjelici, dismenoreja, dispareunija, kompresivni simptomi porijeklom iz mokraćnog ili probavnog sustava te neplodnost. Dijagnoza počiva na kliničkom i ultrazvučnom nalazu, a u nejasnim slučajevima potrebna je i magnetna rezonancija. Klasificiraju se na temelju položaja u stijenci maternice pa se razlikuju submukozni, intramuralni te subserozni miomi, a rjeđe se susreću i cervikalni, parazitski i intraligamentarni miomi. Submukozne i intramuralne miome povezuje se sa smanjenom reproduktivnom sposobnošću. Iako postoje farmakološke metode, one nude samo privremeno olakšanje simptoma i korisne su za preoperativnu pripremu. Osnova liječenja je odstranjenje tumora miomektomijom ili histerektomijom. Novije, manje invazivne metode liječenja su embolizacija arterije uterine te ciljana ultrazvučna kirurgija vođena magnetnom rezonancijom.

Abstract (english)

Uterine fibroids are the most common benign gynaecological tumours. They are histologically composed of smooth muscle cells and sparse connective tissue, resembling normal myometrium. They are of monoclonal origin and their growth depends on estrogens and progesterone. Epidemiological data based on present studies reveal that cumulative incidence of uterine fibroids during childbearing age is 70% to 80%. Risk of developing fibroids increases with age up until menopause, with women of African descent having greater risk of developing fibroids. They usually regress in postmenopause and the symptoms abate. Although most women with fibroids are asymptomatic, those with clinically apparent myomas have significantly reduced quality of life. The most common presentations of uterine fibroids are
menorraghia, pelvic pain, dysmenorrhea, dyspareunia, compressive symptoms originating from urinary or digestive tract and infertility. Diagnosis is based on clinical and ultrasound examination, although if findings are inconclusive, magnetic
resonance imaging should be performed. Fibroids are classified based on their location in the uterine wall, into submucous, intramural and subserosal myomas, but cervical, intraligamentary and parasitic fibroids can be found as well. Submucous and intramural fibroids are associated with infertility. Even though there are pharmacological options, they provide temporary symptom alleviation and are useful as preoperative treatment. Therapy is based on tumour removal by myomectomy or hysterectomy. Newer, less invasive treatment methods are uterine artery embolization and magnetic resonance-guided focused ultrasound.

• Keywords: miomi; menoragija; bol u zdjelici; dismenoreja; miomektomija; histerektomija
• Keywords (english): uterine fibroids; menorrhagia; pelvic pain; dysmenorrhea; myomectomy; hysterectomy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:955541
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-03-19 13:46:18