Hysteroscopy pp 337-356 | Cite as

Physiology and Importance of the Myoma’s Pseudocapsule

  • Andrea Tinelli
  • Ospan A. Mynbaev
  • Radmila Sparić
  • Saša Kadija
  • Aleksandar Stefanović
  • Raffaele Tinelli
  • Antonio Malvasi


Many researches addressed the role of uterine myomas in physiology and their negative impact on the women well-being. In the new century, there have been many discoveries in genetics, molecular biology, and pharmacology as part of the understanding of the biological behavior and treatment of myomas. Nevertheless, it is still not entirely clear on the impact of uterine myoma uterus physiology and reproduction. It is not clear, for example, why some myomas grow so fast, why others remain unchanged in size for years, because some negative impacts in women’s health and other patients rather not complain symptoms, even with myomas in the uterus. In the anatomical evaluation of the myoma, there is a structure that is occasionally mentioned in the macro- and microscopic description. In fact, during its growth, myoma induces the progressive formation of a sort of pseudocapsule, due to compression on the surrounding structures and which separates myomas from the healthy uterine tissue. The pseudocapsule cells have the features of smooth muscle cells similar to the myometrium, indicating that the pseudocapsules are part of the myometrium compressed by the myoma. Pseudocapsule is rich of collagen fibers, neurofibers, and blood vessels, as a sort of neurovascular bundle, with a proper angiogenic profile. Pseudocapsule sparing during myomectomy preserves myometrium integrity peripheral to myoma site, enhancing myometrial healing after myomectomy, with a positive impact on successive uterine anatomy restoring patient’s fertility. In this chapter, we discuss the latest scientific evidence relating to the myoma pseudocapsule, demonstrating its importance in the uterine physiology and in surgical technique applied during the myoma enucleating.


Uterine myoma Fibroids Pseudocapsule Fertility Myomectomy Healing Cesarean section Uterine scar 


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Andrea Tinelli
    • 1
    • 2
  • Ospan A. Mynbaev
    • 2
    • 3
    • 4
  • Radmila Sparić
    • 5
    • 6
  • Saša Kadija
    • 5
    • 6
  • Aleksandar Stefanović
    • 5
    • 6
  • Raffaele Tinelli
    • 7
  • Antonio Malvasi
    • 2
    • 8
  1. 1.Department of Gynecology and Obstetrics, Division of Experimental Endoscopic Surgery, Imaging, Minimally Invasive Therapy and TechnologyVito Fazzi HospitalLecceItaly
  2. 2.Laboratory of Human Physiology, Department of Applied MathematicsMoscow Institute of Physics and Technology (State University)DolgoprudnyRussia
  3. 3.The Department of Obstetrics, Gynecology and Reproductive MedicinePeoples’ Friendship University of RussiaMoscowRussia
  4. 4.Laboratory of Pilot ProjectsMoscow State University of Medicine and DentistryMoscowRussia
  5. 5.Clinic for Gynecology and ObstetricsClinical Centre of SerbiaBelgradeSerbia
  6. 6.School of MedicineUniversity of BelgradeBelgradeSerbia
  7. 7.Department of Gynecology and ObstetricsPerrino HospitalBrindisiItaly
  8. 8.Department of Gynecology and ObstetricsSanta Maria Hospital, GVM Care and ResearchBariItaly

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