Generalmente si manifesta nelle donne in gravidanza ed in coloro che prendono la pillola contraccettiva, e tende a ridursi una volta raggiunta la menopausa, anche se, nel caso si è sottoposte a terapie ormonali, si può assistere ad una ulteriore crescita del fibroma.
E’ un fenomeno comune, si calcola che circa il 40% delle donne ne siano interessate.
Il sintomo più comune è un forte sanguinamento durante il periodo mestruale, che di per se non è preoccupante salvo il fatto che può causare l’anemia.
Il fibroma può essere delle dimensioni di una noce ma può anche diventare molto più grande, fino a raggiungere le dimensioni di un melone, e le dimensioni notevoli possono provocare ulteriori disturbi, come periodi mestruali più lunghi, dolore pelvico, gonfiore, desiderio frequente di urinare ed anche incontinenza urinaria o stipsi.
Il trattamento del fibroma prevede essenzialmente due strade: la miomectomia, cioè l’asportazione del fibroma, oppure l’isterectomia, che rimuove non solo il fibroma ma tutto l’utero. Entrambe sono tecniche molto invasive.
Ma ne esiste una terza, da poco sperimentata, che offre ottimi risultati e risulta essere molto meno invasiva delle altre.
Si chiama embolizzazione del fibroma uterino (UFE), e si tratta di un operazione chirurgica orientata a bloccare il flusso sanguigno che porta linfa al fibroma impedendo ad esso di nutrirsi.
A differenza della isterectomia, l’UFE lascia l’utero intatto e non richiede anestesia generale.
La procedura, che si può anche eseguire in regime di day hospital, prevede che da un piccolo taglio all’altezza dell’inguine una sonda risalga attraverso le arterie fino a raggiungere il punto in cui si trova il fibroma. Una volta individuata la piccola arteria che nutre il fibroma vengono rilasciate delle minuscole palline di materiale plastico che bloccano il flusso sanguigno.
Il fibroma, non più alimentato, comincia a contrarsi già dalla prima settimana dopo l’intervento, e generalmente scompare ad un successivo follow up a distanza di qualche mese.
E’ una tecnica in forte crescita per i buoni risultati che produce, si calcola infatti che circa l’85% dei casi si risolva con la scomparsa del fibroma, mentre nel restante numero dei casi, nonostante il successo dell’operazione dal punto di vista tecnico non si riscontra una riduzione del fibroma.
Sebbene sia una tecnica di notevole efficacia non tutte le donne possono sottoporsi all’embolizzazione del fibroma uterino. E’ sconsigliato infatti per le donne con sospetti tumori, con insufficienza renale o in presenza di fibromi asintomatici, e così pure nelle donne in gravidanza.
E non è ancora ben chiaro quanto e come l’UFE influisca sulla fertilità della donna.
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