I.

INTRODUCTION

Uterine myoma is the most common tumors of the female genitalia tract. Myoma
commonly called fibroid. It is the benign tumor of the smooth muscle in the wall of the
uterus. Hysterectomy has been a common therapy in patients who have completed
reproduction. Total hysterectomy plus bilateral salphingo oophorectomy TAHBSO- this
procedure removes the utereus, cervix, both ovary and both fallopian tube, ovary and one.
Fibroids can be present and be apparent. However they are clinically apparent in up to 25
% of the women. Although, myoma is generally considered to be slowly growing tumor
in 20-40% of women at the age of 35 and more have uterine fibroids of significant sizes
with severe clinical symptoms. Moreover, myoma can be relapse in 7-28% of patient
after surgical treatment and in certain case it may even turn to malignant tumor, this
could cause significant morbidity including prolonged or heavy menstrual bleeding,
pelvic pleasure and pain and in rare cases reproductive dysfunction. Myoma affects one
of every four women ¾ of woman with this condition,however, experience no
symptoms.
Uterine myoma is developing on the background of hyper estrogen, progesterone,
deficits in hyper gonodotrophine. The majority of the researches say that the growth of
myoma depends on concentration of cystosolic receptors to the sex hormones and their
interactions, with the endrogen or extrogen hormones. In accordance to clinical
observations, it can be admitted that both growth and regressions of myoma are estrogen-
dependent, is the tumor size gets increased during pregnancy and is regressed after
menopause. The only that needs to clear is to find out whether it is decreased in receptors
numbers of estrogen, progesterone and androgen- hormones quantities which lead to
regression in myoma size ( regarding androgen there is an hypothesis that myoma is
sensitive to androgen ) for growth that formed tumors, the need to be further supported by
negative factors. Abortions, long term used of inadequate contraceptive pills, chronic
sub-acute and acute inflammation of uterus or its appendices, stress, ultraviolet radiation,
cystic formation of ovary etc. for example, the woman who had ten abortions by the age
of thirty have double to developed uterine myoma at fourty years old. In fact, uterine
myoma = account for 20% of 650,000 hysterectomies performed annually in the U.S
interest in the uterine preservation and organ preserving surgery through techniques
minimally invasive surgery has increased the first reports of laparoscopic myomectomy.