Will myomectomy cause recurrence? Factors that increase the risk of uterine fibroids

Myomectomy, as the name implies, refers to the surgical removal of uterine fibroids. According to the current situation, due to the possibility of cervical cancer after total hysterectomy, the treatment of residual cancer is very difficult. Therefore, total hysterectomy is recommended for most patients, that is, direct removal of the uterus. So, will myomectomy be repeated? So far, the cause and pathogenesis of uterine fibroids are still unclear, and may be related to the following aspects.

Factors that increase the risk of uterine fibroids: estrogen used in maternal pregnancy, obesity, African Americans, moxifen, etc. Factors that reduce the risk of uterine fibroids include: exercise, multiple births, menopause, oral contraceptives, etc. Sex hormones and their receptors Modern medicine believes that uterine fibroids are a hormone-dependent tumor. Uterine fibroids occur during the reproductive years, are rare before puberty, and shrink or disappear after menopause. Studies have shown that estrogen and progesterone synergistically promote the growth of fibroids. The main mechanism may be that estrogen in the follicular phase increases estrogen receptors on uterine smooth muscle, and then progesterone in the luteal phase promotes the mitotic activity of fibroids, thereby stimulating the growth of fibroids.

Uterine fibroids have increased expression levels of growth factors and their receptors. They are considered to be mediators or effectors of increased ovarian hormones during uterine fibroid formation, but the possibility of abnormal primary regulation of one or more growth factors cannot be ruled out. Uterine fibroids usually contain an excess of extracellular mediators, mainly containing fibroblasts and their collagen types I and III, and the interaction of fibroid cells with fibroblasts and various growth factors provides a suitable microenvironment for the formation and growth of fibroids.

Uterine fibroids are related to hormone levels in the body. If recurrence is possible after surgery, generally speaking, the recurrence rate of uterine fibroids after surgery is about 20-30%. The reasons for recurrence may be: small fibroids that were not discovered after surgery gradually increase under the action of sex hormones; or the patient has fibroid pathogenic factors, and new fibroids continue to occur.