Uterine Myomas


The uterine leiomyomas or myomas are the more frequent benign tumors of the female genital system (Figure 1 & 2). Almost 40% of the female population is diagnosed with uterine myomas, while 2/3 of those are presented during the reproductive age. It is also interesting that 20% of the hysterectomies worldwide are performed because of uterine leiomyomas.
Εικόνα 1
Figure 1
Figure 2

Almost the half of the women with uterine leiomyomas is presented with pelvic pain, and tenderness. However, some of them are diagnosed with anemia because of pathologic hemorrhage from the genital tract. The rest of the cases are asymptomatic and the diagnosis becomes after transvaginal or transabdominal ultrasound (TVUS & TAUS) of the pelvis and of the genital tract. In some cases the diagnosis of myomas introduces during the exploration of sub-fertility couple. Symptoms and signs of the woman are depended mainly from the size, the number and the position and the myomas.
Figure 3
Figure 4

Total hysterectomy with/without adnexectomy (fallopian tubes and ovaries) is a radical approach for patients with gross uterine myomas, heavy bleeding and for women who not desire fertility preservation (Figure 3). The enucleation is the most common conservative surgical therapeutic approach of leiomyomas. The enucleation is fertility sparing operation and it is the therapeutic option for younger aged patients (Figure 4). The former treatments (hysterectomy or enucleation) can be done via laparotomy or laparoscopy (Figure 5).
Figure 5
Figure 6
Conservative medical approach is also offered of patients with uterine myomas. Medication which is used for the treatment of myomas is mainly the GnRH-analog and the aromatase inhibitors. Both of them down-regulate the production of the estrogen, which is the critical hormone of the myomas’ development. However, the use of the medical treatment for uterine myomas is temporary, especially for patient in reproductive age. The medication is used to postpone the surgical treatment because of patient’s medical pathology or severe anemia (heavy uterine bleeding because of myomas), which must be improved before the surgical approach.


Η αντιμετώπιση των λειομυωμάτων της μήτρας σήμερα είναι πολύπλευρη και απαιτεί εξατομίκευση της θεραπείας, η οποία είναι ανάλογη του αριθμού και του μεγέθους των λειομυωμάτων, καθώς και της ηλικίας και των απαιτήσεων της ίδιας της γυναίκας.


Kalogiannidis doctor


Associate Professor
Obstetrics Gynecology -
Gynecologic Oncology



Test PAP

PAP smear or test PAP is the collection of cell population from the cervix and the endocervical canal to identify cervical pathology, actually premalignant and malignant diseases.

HPV-DNA testing

Human Papilloma Virus (HPV) is related to cervical cancer in 99% of cases. Most often high risk subtypes concerning the malignant diseases of the female genital tract are the types 16 and 18.


Colposcopy is the method for the further diagnostic approach of patients with cervical pathology, which was diagnosed using PAP smear or HPV-DNA testing.