5. Introduction

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 estrogendependent, 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.