Symptoms and treatment of uterine fibroids. Is uterine fibroids dangerous? When is surgery needed and what alternative treatments are available? How dangerous are leiomyomas?

Uterine fibroids (leiomyoma, fibromyoma) is one of the most common forms of cancer in women of a benign nature. Myoma arises as a result of active cell division of the muscular uterine tissue - myometrium. The main development factor this disease is a violation of the hormonal background in the body of a woman, an increased content of estrogens. The most common type of fibroids is nodular uterine fibroids. This is due to the fact that the muscular tissue of the uterus, subject to abnormal growth, forms nodes.

Nodular uterine fibroids can have several forms. The multiple form is characterized by the presence of several nodular formations that are visualized inside the body of the uterus, as well as a single nodular form - the formation of one node. The nodes of uterine fibroids have the appearance of round dense formations of smooth muscle origin, their sizes are estimated by the number of weeks, as in a similar observation of the development of the fetus during pregnancy.

• Cervical fibroids, tumor nodes are located directly in the neck of the organ;
• Myoma of the interligamentous nodes of the uterus or intraligamentary leiomyoma, (the most common form of the tumor);
• Myoma intermuscular, nodes are formed in the muscular layer of the uterine wall;
• Myoma submucosal (submucosal), located closer to the uterine cavity (the rarest form);
• Myoma is subperitoneal (subserous), the nodes are located on the outer surface of the uterus, closer to the abdominal cavity.

Uterine fibroids nodular occurs in 20% of women who have reached the age of thirty, these data are confirmed by medical statistics. Often, the doctor diagnoses the presence of several neoplasms of different sizes at once.

The danger of uterine fibroids lies in the fact that such a disease is asymptomatic, tumor growths can grow over several years, which in turn can lead to loss of reproductive function.

The main reason for the occurrence of this tumor, experts call a violation in the work of the hypothalamic-pituitary system, as a result of which, in the patient's body, increased amount female hormones - estrogen. Also, the factors provoking the development of fibroids include abortion and chronic inflammatory processes of the pelvic organs.

Symptoms of nodular uterine fibroids

The main symptom on the basis of which the doctor may suspect the presence of uterine fibroids in a patient is a violation menstrual cycle. Such dysfunction may take the form of profuse bleeding or prolonged scanty, spotting, discharge.

Women may complain of frequent pulling pains in the lower abdomen, lumbar and sacral region. There are cases when tumor nodes grow towards neighboring organs and thereby lead to a violation of their functions. For example, such disorders may be accompanied by a deterioration in bowel function and Bladder, due to the fact that nodular uterine fibroids constantly press on these organs.

In young girls and women of childbearing age, nodular uterine fibroids cause difficulty in conceiving a child or carrying a pregnancy.

The main risk groups and causes of development of nodular uterine fibroids

Gynecologists cannot say exactly what led to the formation of uterine fibroids, since the development of such a pathological process is strictly individual and may be the result of the action of several factors on the woman's body. However, several main reasons are clearly visible:

• genetic predisposition. Women whose blood relatives have been diagnosed with uterine fibromyoma are more prone to the formation of this type of tumor;
• Frequent abortions. Any surgical intervention in the work of the internal organs of the small pelvis can have negative manifestations, one of which is nodular leiomyoma;
• Chronic gynecological inflammation or disease;
• Sluggish gynecological diseases;
• Menstruation that started late in life;
• Acceptance of incorrectly selected birth control pills or independent, uncontrolled their reception;
• Lack of pregnancy and breastfeeding by the age of 30;
• Lack of physical activity, overweight;
• Constant stress.

All of the above factors are dangerous and can lead to the appearance of uterine tumors.

An experienced specialist can identify nodular formations during a routine gynecological examination and palpation. Therefore, it is so important to undergo preventive examinations once a year, especially for women at risk.

To confirm the diagnosis in medical practice, the method of ultrasound (ultrasound) is used. This method of diagnosing this type of tumor allows not only to establish an accurate diagnosis, but also to determine the number of neoplasms, their location and size.

In rare cases, hysteroscopy (examination with a special optical device that is inserted through the vagina and cervix) or laparoscopy (examination of the uterus through punctures in the abdominal wall) is used to diagnose uterine fibroids.

Based on the data obtained as a result of the study, the doctor prescribes the appropriate treatment.

The hidden danger of fibroids

Nodular fibromyoma of the uterus is a benign type of tumor, but it should be remembered that no type of cancer can occur in a completely healthy body. In order to contact a specialist in time and avoid the unpleasant consequences of such a disease, every woman should know what is dangerous for nodular uterine fibroids.

The main danger of fibroids is a violation of the reproductive system, this can lead to a woman's inability to endure pregnancy - miscarriages, or a woman may lose her ability to bear children completely.

Also, leiomyoma leads to the development of anemia that occurs against the background of unstable bleeding, obesity and disruption of the endocrine functions of the body.

Myoma nodes are prone to inflammatory processes, which, as a result, lead to various kinds of sepsis, peritonitis, or can provoke kidney disease.

Prevention of nodular uterine fibroids

Methods for the prevention of uterine fibroids include regular examination by a gynecologist, ultrasound examination pelvic organs, a healthy lifestyle, the use of contraceptive methods to avoid abortion, timely treatment of gynecological diseases, and excessive insolation should not be allowed.

A good method of prevention is timely pregnancy and breast-feeding, of course, in cases where a woman wants to have a child.

Regular intercourse is also effective as a method of preventing uterine fibroids.

The fight against excess weight. Exercise stress visiting the gym or swimming pool. Experts note that every 10 kg of excess weight increases the risk of fibroids by 20%.

Treatment methods for uterine fibroids

Only a specialist can determine how best to treat benign nodular leiomyoma. Choice suitable treatment depends on the number of formed nodes, their location and size.

There are several main treatments for this type of tumor.

conservative therapy. It implies the use of drugs, which include tranexamic acid - reduces menstrual blood loss and blocks the destruction of blood clots. In medical practice, the gonadotropin releasing hormone (GnRH) agonist is also actively used, its action is aimed at suppressing the production of pituitary hormones, which leads to a decrease in estrogen and a decrease in the size of tumor nodes. This drug is used mainly before surgery.

Surgery. Removing nodes surgical method. Recently, this method is used less and less, since with the development of medicine, new, less traumatic methods for the treatment of nodular fibroids have appeared.

Embolization uterine arteries. The essence of the method is to replace fibroid nodes with connective tissue and stop the blood flow of the fallopian tubes. At the moment, this is the newest and most widely used method of treating fibroids. It does not require the use of general anesthesia, the patient is hospitalized for one day, the manipulation itself is simple and belongs to minimally invasive interventions.

FUS ablation of leiomyoma. A modern, new method of treatment, the main purpose of which is the destruction of the tissues of the node under the influence of temperature - thermal necrosis. This effect is achieved as a result of exposure to a large amount of heat on a strictly localized area of ​​high-intensity focused ultrasound (FUS). This method is very similar in principle to concentrating a sunbeam with a magnifying glass. When using FUS-ablation, adjacent healthy tissues are not damaged. The unequivocal advantages of this method are that it does not require surgical intervention, it is absolutely accurate, all manipulations, up to temperature control, are carried out by a special apparatus.

Other treatments. These methods involve the treatment of nodular fibroids folk remedies and homeopathic preparations.

To folk ways fibroids treatments include:

• Treatment with flax seeds;
• Treatment with potato juice;
• Treatment with motherwort tincture;
• Treatment with propolis;
• Treatment with leeches;
• The use of herbs and decoctions for the treatment of uterine fibroids.

Remember, any of the above means traditional medicine which is used for the purpose of self-treatment of uterine fibromyoma nodules has no medical evidence of effectiveness.

One of the most common benign tumors in women is uterine fibroids. The tumor consists mainly of dense connective tissue fibers and grows inside the wall of the organ or into its lumen.

There may be one or more fibrous nodes, which are often accompanied by painful heavy periods, frequent urination, discomfort in the pelvic area.

What is the difference between fibroids and uterine fibroids?

These are two benign tumors, but they are formed from different types cells. contains smooth muscle cells that form the muscular wall of the uterus. The composition of the fibroma includes connective tissue (it can be imagined by looking, for example, at a skin scar).

Usually the tumor has a mixed composition and is a fibromyoma in its structure. There are no significant features of the clinic, diagnosis and treatment of fibroids and fibroids.

The main characteristics of pathological education

Women often look for the answer to the question - uterine fibroids: what is it? This neoplasm occurs in every second woman and often used to be the reason for the removal of the uterus. Modern gynecology offers patients drugs and minimally invasive surgical interventions that help control the disease.

The tumor in the early stages is located inside the muscle layer. In the future, depending on the location of its main mass, the following types of fibroma are distinguished:

• submucosal, growing into the uterine cavity;
• intramural, or intermuscular;
• subserous, lying on the surface of the uterus and growing towards the abdominal cavity;
• fibroma of the cervix.

The most correct name for fibroids is uterine leiomyoma, which is a type of mesenchymal tumor. It can be very small, without causing any unpleasant manifestations, or grow to a gigantic size. The neoplasm grows slowly.

Causes and provoking factors of development

The exact causes of uterine fibroids are still unknown. As a rule, the tendency to this disease is inherited. The disease occurs 2-3 times more often in women of African descent.

The tumor grows in response to stimulation of the uterus by female sex hormones - estrogens, which are secreted by any healthy woman. Therefore, fibroma can appear even at a young age (about 20 years). However, after, when the ovaries stop producing estrogen, the fibroma often decreases in size.

Factors that increase the risk of developing a tumor:

• excess weight;
• childlessness;
• first menstruation before the age of 10;
• African American origin.

Specialists recognize a certain role and emotional factors. Psychosomatics is a branch of medicine that establishes a connection between the patient's inner world and his illnesses. It is possible that the appearance of uterine fibroids occurs with a long-term effect on the patient of such emotions:

• constant stress;
• resentment;
• decision to have an abortion;
• dissatisfaction with intimacy with a partner;
• anxiety and fears.

It must be remembered that a woman's health is associated not only with external or hormonal influences, but also with her mental state. Peace of mind is one of the conditions for a healthy lifestyle.

Clinical picture

Even if the neoplasm has reached a large size, symptoms of uterine fibroids are often absent. The tumor is often detected during a routine examination by a gynecologist.

The main signs of the disease:

1. Heavy menstrual bleeding (menorrhagia) with blood clots.
2. Frequent urination or the urge to urinate, caused by the pressure of the tumor on the bladder.
3. Constipation due to compression of the rectum.
4. Feeling of heaviness, fullness in the abdomen.
5. Pain with uterine fibroids usually appears during menstruation, in the later stages it becomes constant, aching, in the lower abdomen or lower back.
6. An increase in the circumference of the abdomen, which sometimes requires a change in clothing size while maintaining the same weight.
7. Infertility or miscarriage.
8. Education in the uterus, detected by a doctor during a two-handed gynecological examination or ultrasound.

With a tumor not big size quite possible normal pregnancy. However, it happens that the disease becomes the cause of infertility or. When the node is located near the mouth of the pipes, a mechanical obstacle appears for germ cells. The cervical node often causes a miscarriage. A large formation can cause a violation of the development of the fetus. Fibroma of the uterus during pregnancy usually does not change its size, but such patients need more careful monitoring.

The issue of delivery is decided in each case individually.

When do you need to urgently see a doctor?

Sometimes situations arise when urgent medical care is indispensable. Is fibroma dangerous? Yes, in addition to problems with pregnancy, it can become a source of bleeding or death (necrosis) of the tumor node.

You should definitely consult a gynecologist if there are such signs:

• irregular menstrual cycle, heavy periods, bleeding between periods;
• increasing pain in the pelvis or abdomen;
• fever or sweating at night;
• an increase in the circumference of the abdomen;
• inability to get pregnant.

call " ambulance is needed in such cases:

• menstrual bleeding that requires more than 3 sanitary pads per hour;
• severe or prolonged pain in the pelvis or abdomen;
• dizziness, chest pain and shortness of breath in combination with vaginal bleeding;
• bleeding from the vagina with a certain or possible pregnancy.

To prevent serious complications from developing, timely diagnosis and treatment of uterine fibroids is necessary.

Diagnostics

An experienced gynecologist knows how to recognize uterine fibroids. He will ask the patient about her complaints and conduct a thorough bimanual examination on the gynecological chair.

Then one or more options for additional diagnostics are assigned. They are necessary not only to confirm the diagnosis, but also to exclude more serious gynecological diseases, as well as to prepare for surgery.

Diagnostic methods:

• organs of the abdominal cavity and small pelvis, helps to determine the presence of a tumor formation. A transvaginal examination is preferable, which allows you to better see the fibromatous nodes.
• Hydrosonography is a method that allows diagnosing submucosal fibroma in 100% of cases, assessing its location relative to the corners of the uterus, dimensions, detecting concomitant diseases of the endometrium, and assessing the thickness of the uterine wall.
• , which is performed using a thin instrument inserted into the uterine cavity through the cervical canal.
• - examination of the uterine cavity from the inside using a fiber-optic camera, carried out on a thin probe through the cervical canal.
• - the introduction of a radiopaque substance into the uterine cavity and tubes, which helps to obtain an image of the internal contours of the organ under study.
• Dopplerography of the uterine arteries is performed before their embolization in order to assess the intensity of blood flow in the fibroma node. The method is also used to control the effectiveness of such an intervention.
• Before embolization, angiography is mandatory - a study of the vessels of the uterus after the introduction of a radiopaque substance into them. The method allows to detect malignant degeneration of the tumor and thus change the treatment tactics in time.
• with or without contrast enhancement, useful for giant masses and for evaluating the effectiveness of embolization.
• is a surgical procedure performed using miniature optical instruments inserted into the abdominal cavity through small openings.

Treatment

To answer the question of how to treat uterine fibroids, you need to know its size and location. Besides, medical tactics depends on the symptoms of the disease, the age of the patient, the desire to have a child in the future and general condition health.

Many women do not need treatment for fibroids. This is possible with a small tumor, no symptoms, or after menopause. If fibroma causes uterine bleeding, it may be required. In addition, such bleeding can be eliminated with the help of medications.

Observation by a gynecologist is necessary to determine the size and growth of the fibroma, and also to make sure that the process is benign. Usually it is enough to be observed annually. If a woman has irregular bleeding or pain, she is prescribed follow-up examinations at least once every 6 months.

The effectiveness of traditional medicine

Non-drug treatment with folk remedies is ineffective and leads to a delay in starting medication or surgery.

Often to avoid hormonal treatment or surgery, women turn to homeopathic remedies. They must be selected by a specially trained specialist, and the effectiveness of such drugs has not been proven.

Enthusiasts of this method believe that homeopathy for fibroids:

• restores the balance of the processes of excitation and inhibition in nervous system which slows down tumor growth;
• reduces the blood supply to the node;
• enhances the production of progestogens, relatively reducing the concentration of estrogens - fibroma growth factors;
• reduces the degree of blood loss and the severity of anemia.

Popular homeopathic remedies:

• Epigallate;
• Mammosan;
• Bupleroom;
• Milona-5;
• Indinol;
• Milife;
• Wild Yams;
• Aurum;
• Calcium;
• Conium;

Remember that taking drugs that have not passed official tests, a woman puts an experiment on her health with unpredictable consequences.

Drug therapy for fibroids

Drug treatment of uterine fibroids without surgery is prescribed for minor bleeding or pain in the abdomen, if the size of the node does not exceed 3 cm in diameter. It may include one or more of the following drugs:

• Non-steroidal anti-inflammatory drugs (Ibuprofen), which have an analgesic effect.
• that reduce the amount of blood lost during menstruation and relieve pain.
• Gonadotropin-releasing hormone agonists are drugs that inhibit the production of estrogen in the pituitary gland. A decrease in estrogen levels leads to a decrease in the size of the fibroma. This type of medication is often used in preparation for surgery to reduce the size of the nodule and reduce blood loss. Within 3 months of taking these drugs, fibroma is reduced by 2 times. However, with a long course of treatment, a woman develops symptoms of estrogen deficiency, reminiscent of menopause: hot flashes, bone fragility, vaginal dryness.
• The antihormonal drug mifepristone is given to shrink fibroids before surgery. It reduces the intensity of pain in the pelvis and lower back, normalizes urination. Side effects are also associated with the suppression of estrogen production. The drug also causes miscarriage, so it should be used with extreme caution in patients planning a pregnancy.
• The drug Danazol causes a complete cessation of uterine bleeding, that is, an artificial menopause. It is a male sex hormone (androgen). He has serious side effects including weight gain, muscle cramps, size reduction mammary glands, acne, unwanted hair growth, oily skin, mood swings and depression, low levels of “good” cholesterol, and signs of liver dysfunction.

When using the last three groups of drugs, menstruation stops. Treatment of uterine fibroids with menopause leads to the fact that menstruation no longer resumes. In young women, combined estrogen-progestogen agents are subsequently used to restore the cycle.

If the patient does not plan to become pregnant in the near future, to restore the hormonal background, she may be offered an installation that provides a contraceptive effect and local release of progestogens. Smoking women, especially those over the age of 35 and at risk of thrombosis, are recommended to prescribe the contraceptive drug Charozetta.

Surgical operations

Surgical removal of uterine fibroids has both risks and benefits. Therefore, the decision to operate is made individually, depending on the characteristics of each patient.

Surgery to remove uterine fibroids is called a myomectomy. It can be performed using hysteroscopy, laparoscopy or open access to the abdominal cavity. The choice of intervention technique depends on the location and size of the formation.

Removal of the uterus (hysterectomy) is the most common surgery for fibroids.

With submucosal options, removal with a hysteroscope from the inside through the uterine cavity is shown. For subserous tumors, laparoscopic removal is performed. With multiple intermuscular nodes, a conservative one is performed: an incision is made in the lower abdomen, and the nodes are carefully peeled out of the muscular wall of the uterus.

To reduce blood loss and reduce the volume of surgery, a course of gonadotropin-releasing hormone agonists is prescribed before the intervention.

Myomectomy is much less likely to cause damage to the rectum or bladder. This operation saves the organ, and pregnancy is possible after it.

The most common operation for fibroma is, or hysterectomy. Depending on the size of the tumor, it may be passed through the vagina or through the abdomen. In some cases, laparoscopy is used.

Laparoscopy is not used in such situations:

• uterus more than 18 weeks;
• low-lying knots along the back wall;
• interconnecting nodes.

Gonadotropin-releasing hormone agonists are often prescribed before surgery. The consequences of the operation to remove the uterus are irreversible infertility and the absence of menstruation.

Hysterectomy is indicated in such cases:

• node growth more than 4 weeks per year;
• suspicion of a malignant tumor - sarcoma;
• fibroma size more than 16 weeks;
• her growth in postmenopause;
• cervical node;
• impossibility of organ-preserving operation.

Hysterectomy is associated with less blood loss than myomectomy. If you suspect uterine cancer or ovarian damage, the appendages are additionally removed.

Even with the preservation of the appendages, half of the patients develop, resembling the signs of menopause. Therefore, hormone replacement therapy is prescribed.

Alternative Methods

A new approach with promising results - . Manipulation involves the cessation of the arterial blood supply to the fibroma. The procedure is performed by inserting a thin tube (catheter) into femoral artery. Under the control of special X-ray equipment, the features of the blood supply to the uterus are determined. The smallest plastic or gelatin particles the size of a grain of sand are injected into the artery that feeds the fibroma. This material blocks the blood supply to the fibrous node, as a result of which the latter decreases in size.

The method is more suitable for women who do not want to be operated on, with the ineffectiveness of other methods or contraindications to surgery. At the same time, the organ is preserved, and pregnancy is possible in the future.

If the nodule is large, embolization may be performed as a preparatory step before myomectomy to reduce the diameter of the fibroma and facilitate its removal.

Laparoscopic occlusion of the uterine arteries is performed with the introduction of small instruments into the abdominal cavity and the cessation of blood flow through the vessels. However, the blood supply to the fibrous node does not stop completely. This intervention reduces blood loss during subsequent myomectomy. In addition, after it, the thickness of the myometrium decreases, and the nodes stand out well into the uterine cavity, which facilitates their removal.

FUS ablation

The latest treatment method is the action of focused ultrasound under the control of magnetic resonance. In this case, MRI is used to direct a beam of ultrasonic rays that heat and destroy the focus of the fibroma.

There are other modern technologies that allow the destruction of submucosal nodes without surgery, such as cryomyolysis (freezing) or electromyolysis (destruction of the node using electric current). They are used for small single formations.

The duration of disability depends on the volume and method of performing the operation:

After surgical treatment, it is recommended to wear compression stockings for 1 month and take Dipyridamole, Pentoxifylline or Aspirin to prevent thrombosis. Iron preparations are prescribed to restore the level of hemoglobin in the blood. If necessary, hormone replacement therapy is added.

Over the next years, it is better for the patient to avoid prolonged exposure to the sun, visits to baths and saunas, massage of the lower back and buttocks.

Prevention and prognosis

Measures to prevent uterine fibroids:

• avoid excess weight after 18 years;
• to give up smoking;
• regular medical checkups.

The success of treatment largely depends on the severity of the disease and the method of therapy.

Can you get pregnant with uterine fibroids?

Yes, it is quite possible. This increases the risk of miscarriage. However, many women with small tumors carry children safely.

If a fibroma is found over the age of 35, ovulation is already worsening at the same time, which increases the likelihood of problems with conception.

Fibroma rarely turns into a cancerous tumor. It occurs more often in postmenopausal women. The main sign of malignancy in this case is a rapidly growing tumor that requires surgical intervention.

It is possible to block the cervical canal. Violated physiological processes occurring in the reproductive system. The general health of a woman is deteriorating. When choosing a method of treatment, various factors are taken into account, the most reliable and sparing method is selected. An assessment of the size of the fibroid is important, since there must be good reasons for the operation.

Types of fibroids

The neoplasm originates in the muscle tissue of the uterus, gradually increases in size due to abnormal cell division. Unlike a malignant tumor, fibroids do not spread to other organs, they grow much more slowly. Initially, cells develop abnormally only in muscle tissue, and then the tumor goes beyond it. Depending on the direction in which it grows, the following types of fibroids are distinguished:

1. Submucosal - it is formed in the depth of the muscle layer (myometrium), grows towards the mucous membrane of the uterine cavity, therefore it is called "submucous".
2. Subserous (subperitoneal) originates in the outer muscle layer, grows towards the serous membrane that separates the uterus from the abdominal cavity. Knots can have a wide base or a thin stem.
3. Interstitial (intramuscular) - develops in the middle of the muscle layer, without going beyond it.

When assessing the degree of danger of a tumor and choosing a method of treatment, specialists take into account its location. In most cases, myomatous nodes are located in the body of the uterus (corporal view), but sometimes they are also in the cervix (cervical fibroids).

The tumor is single or multiple, in the form of several nodes. For a specialist choosing a method of treatment, the size of uterine fibroids is of great importance.

How dimensions are determined

The growing tumor stretches the uterus, which leads to a gradual increase in the abdomen (similar to its growth during pregnancy). According to which week of pregnancy the size of the abdomen corresponds, the size of the fibroids is estimated.

The exact size of the tumor in centimeters can be determined using ultrasound. In this way, even fibroids smaller than 1 cm are detected. Ultrasound is performed either through the anterior wall of the abdominal cavity or through the vagina. This allows you to identify and measure fibroids of any localization and size.

In difficult cases, when a small tumor is located, for example, between the ligaments, the hysterography method is used (X-ray of the cavity with the introduction of a contrast fluid). To study fibroids and assess its size, hysteroscopy (examination with an endoscope inserted into the uterine cavity through the vagina), diagnostic laparoscopy (an optical device is inserted into the uterine cavity through a puncture on the anterior wall of the peritoneum) and MRI are also used.

All myomatous nodes, depending on their size, are divided into three categories:

Compliance with the size of the abdomen during pregnancy

12-15 weeks or more

Sometimes uterine fibroids reach a size at which the abdomen is, as at 37 weeks of gestation.

In addition to size, the rate of tumor growth is also taken into account. A tumor is considered to grow rapidly if its size increases by 2-2.5 cm (or 5-6 weeks) per year. Thus, the growth of small and medium-sized fibroids is assessed. If they are small and grow slowly, then conservative treatment is possible. At sizes greater than 8 cm (or 15 weeks), the nodes are removed.

In addition to the size of the tumor and the rate of development, when prescribing treatment, the severity of the symptoms, the age of the woman, and her intention to have children are taken into account.

The danger of large fibroids

There are uncomplicated and complicated forms of the disease. Possible complications are:

• necrosis of the myomatous node - an acute painful condition in which there is a torsion of the legs, a violation of the blood supply to the fibroids;
• the formation of cystic cavities (the threat of purulent inflammatory processes);
• compression of blood vessels and nearby organs;
• malignant degeneration (into sarcoma).

Fibroids can reach a diameter of 25 cm. A large tumor located outside, on the front wall of the uterus, compresses the bladder, which leads to difficulty urinating or, conversely, can cause urinary incontinence. In addition, the appearance of fistulas connecting the cavities of the uterus and the bladder is possible.

If a large fibroid is located on the posterior surface of the uterus, then bowel movement is difficult, and constipation occurs.

A large knot can compress the inferior vena cava, making it difficult for blood to move from the lower body to the heart. In this case, the woman has shortness of breath and palpitations even at rest. In the presence of many medium and large nodes (myomatosis), there are constant uterine bleeding that is not associated with menstruation. This leads to anemia.

Video: Complications with large nodes. When and how is surgical removal performed?

When is surgical treatment used?

Surgery for uterine fibroids is mandatory in cases where it grows rapidly - up to 2 cm (4 weeks) in diameter during the year, and also if the tumor has a stalk and there is a risk of its twisting.

An unconditional indication for surgical removal of fibroids is the appearance of uterine bleeding and severe anemia in a woman. This is possible due to a violation of muscle elasticity during the development of large myomatous nodes in it, deterioration of contractility.

Myoma must be removed surgically if it is the cause of infertility or miscarriage. An operation is also prescribed if a woman has severe pain in the abdomen, rectum, bladder, as they are squeezed, blood circulation is disturbed.

Video: Treatment of fibroids with hysterectomy and uterine artery embolization

What types of operations exist

When choosing a method for the operation, the size of the uterine fibroids and its localization are of primary importance. In each case, the doctor decides on the method of removing the tumor, the possibility of preserving organs and menstrual function.

Myomectomy

This is an operation in which only the tumor is removed, the uterus is preserved. Most often, this method is used to treat women under 40 who would like to maintain the ability to give birth to a child.

Removal of the tumor is carried out in this case in various ways.

Laparotomy is the removal of fibroids located deep in the muscle tissue or under the outer shell of the uterus by making an incision in the abdomen above the pubis. The tumor is excised. The risk of infection and complications is minimal. This method is especially effective when there are many nodes, there is an increased likelihood of damage to large vessels. Prevent bleeding during surgery open way much easier. In addition, the removal of fibroids can be done quickly.

Laparoscopy - removal of fibroids through 3 small openings in the abdomen using optical instruments. Carbon dioxide is first introduced into the uterus to create conditions for more free manipulation of instruments and avoid cuts. The image is displayed on the screen, which allows you to control the process.

The advantage of the method is that the wound heals quickly, the operation is less traumatic, and there is no suture left after it. It is carried out under general anesthesia. The disadvantage is that there is still a minimal chance of internal cuts, so the woman is under the supervision of doctors for 3-4 days. Sometimes, if the myomatous node is located on the posterior or lateral outer surface of the uterus, it is removed through a puncture in the posterior wall of the vagina.

Addition: If necessary, this method can remove large myomatous nodes in pregnant women. In this case, the fetus is not injured, the pregnancy proceeds normally.

Hysteroscopic myomectomy. A method that is used to remove fibroids in the cavity itself. It is carried out using an optical instrument (resectoscope) through the vagina. The method is not used if a woman has inflammatory diseases of the genital organs or cervical defects.

Hysterectomy

Removal of the uterus completely or with preservation of the cervix. Such an operation is performed in the most severe cases, when there are many large nodes, the fibroids occupy the entire cavity, there is severe bleeding. At the same time, the level of hemoglobin is critically low, the probability of tumor degeneration into sarcoma is high. Most often, such operations are performed on women after 45 years.

Removal of the uterus is performed in several ways: through an incision in the lower abdomen, through punctures in the abdominal wall (laparoscopic method), through the vagina. After the operation, a woman cannot have a period. But if the ovaries are not removed, then the rest of the symptoms of menopause may be absent. The possibility of sexual activity after the operation is preserved.

Video: Methods for removing fibroids while preserving the uterus

Minimally invasive methods for treating fibroids

When treating fibroids with these methods, no incisions or punctures are required.

Embolization of the uterine arteries. The method consists in the fact that through the inguinal artery with the help of a catheter, "plugs" made of plastic or gelatin are brought to the vessels of the fibroids, which block the flow of blood. Due to lack of nutrition, the tumor gradually decreases. The procedure is performed under local anesthesia.

FUS-ablation (focused ultrasound). Removal of fibroid nodes is carried out using a directed ultrasonic flow, which causes heating and evaporation of the nodes located in the muscle. The process is controlled using a magnetic resonance tomograph. In this case, anesthesia is not required, the functions of the uterus are fully preserved. The method is effective even in the presence of large nodes.

Video: Evaporation of fibroids by FUS ablation

The possibility of pregnancy with myoma

Large fibroids (greater than 15 weeks) are the cause of infertility if they block the tubes or cervix, creating obstacles to the movement of sperm. In the presence of nodes no larger than 3 cm in diameter (that is, less than 8 weeks), pregnancy is possible. If the nodes do not increase, then their existence does not affect the course of pregnancy and the development of the fetus. Complications arise when the tumor grows in the uterine cavity, fills it, making it difficult for the fetus to develop. Often this ends in a miscarriage.

Sometimes, if the fetus is already large enough and begins to lack nutrition due to the pressure of the fibroids on the vessels, a caesarean section is performed and the subsequent removal of the uterus. C-section you have to do it even if the fibroid occurs in the neck or overlaps it.

• This article is usually read

With the onset of menopause in the body of a woman, the content of sex hormones gradually decreases. In menopause, it becomes impossible.

The cause of unusual uterine bleeding, infertility and other pathologies in women is often abnormal thickening and changes.

If a woman's menstrual cycle fails, menstruation is too plentiful or, conversely, scanty, has an unusual color, this is c.

During a gynecological examination in women, cysts are often found on the cervix. Naturally, patients begin at the same time.

Real erosion of the cervix and pseudo-erosion are completely different conditions. Most often, false erosion is faced by women mo.

Inflammatory processes that occur in the female genital organs are dangerous because they can quickly spread to the entire system, calls.

The cervix is ​​a narrow canal with a mucous plug to protect against infection from entering the cavity, tubes and testicles.

The consequence of inflammatory diseases of the uterine appendages, as well as hormonal disorders in the body, can be irreversible betrayal.

• Most read

Copyright ©17 Magazine for women "Prosto-Maria.ru"

Any use of site materials is possible only if there is a direct, active link to the source

Diagnosis and treatment of uterine fibroids

Tumor manifestations are a fairly common occurrence in women of different ages. There is no reason to worry if the disease is detected in a timely manner, and high-quality measures are taken to eliminate it. What is fibromyoma and how is it different from other tumor formations? Uterine fibromyoma has in its nature muscle and connective fibers, and there are more of the latter. The pathology is benign and affects every fifth woman. In 95% of cases, the body of the uterus is affected, and only 5% is in the cervix. As a rule, women are the ones to fear the most. Menopause can cause the disappearance of the tumor. But it may be the other way around, the tumor on the uterus will grow even more.

The reasons

As medical practice shows, small tumors can live in the patient's body for a long time without manifesting themselves. And as soon as any provoking factors appear, uterine fibroids begin to grow at a high speed. These factors are:

Diabetes, obesity, heredity, and metabolic disorders also negatively affect the body and provoke the growth of fibroids.

Symptoms

In the early stages, only a doctor can detect pathology during a routine examination. The patient herself is unlikely to be able to determine that she has a fibromyoma by the symptoms, since they are very weak. They become clearly expressed only when the tumor on the uterus already reaches a large size. And yet, if, after listening to the body, a woman noticed the following signs of fibroids, you need to urgently consult a doctor and tell all your complaints:

• Too painful periods;
• Bloody discharge from the vagina, not associated with menstruation;
• Feeling of heaviness;
• Pain during sex;
• When reflected pain in the lower back;
• Bloating
• If a woman cannot get pregnant for a long time.

With uterine fibromyoma of small size, the doctor chooses an observational tactic. Observation of the symptoms of uterine fibromyoma also occurs in the premenopausal period, when the level of estrogens responsible for a woman's healthy sex life decreases in the body.

Differences from fibroids

What is uterine fibromyoma and how is it different from fibroids? Both are benign tumors, the reasons for their formation are the same, and the signs of uterine fibroids are similar to fibroids. Both forms differ only in the composition of the tissues that form their basis.

Muscle tissue predominates in myoma, while connective tissue predominates in fibromyoma. In a normal fibroid tumor, the same amount of muscle and connective tissue. Its formation occurs as follows: first, a muscle tissue nucleus is formed, which then grows into a connective tissue.

Differences in species

Depending on the place of origin and nature of growth, several types of uterine fibroids are distinguished:

• Submucosal - differs in that it is formed under the mucous layer of the uterus (such tumors are also called submucosal);
• Diffuse - extends to most of the entire body of the uterus;
• Interconnective - a rather complex formation that originates in the interligamentous space. Such fibromyomas are difficult to remove, as they choose their locations close to the blood vessels;
• Subserous - a tumor that can be found under the upper, outer layer of the uterus;
• Nodular fibromyoma of the uterus - characterized by the formation of several nodules;
• Interstitial - formed on the uterine walls. A characteristic feature is the rapid growth rate, such a fibromyoma is the most common.

In addition to this distribution, there is also a division of fibromas into simple (developing slowly, easily treatable), proliferating (they are characterized by increased growth, but do not contain atypical cells) and presarcomas.

The most dangerous fibromas are presarcomas. They can be recognized by a large number of atypical cells, and therefore are subject to prompt removal. Most often, along with such a fibroma, the entire uterus is also removed.

Leiomyoma

Leiomyoma of the uterus with an equal share can be attributed to fibroids, since it contains muscle tissue, and fibromyomas, since they also have fibrous tissue.

The formation is not a real tumor, but has the same benign character. Decay does not occur. Leiomyofibroma also depends on the hormonal state of the body, growth occurs with a decrease in estrogen.

The characteristic form of development is nodal. Education can be one, but more often you can find a plural form. Nodes can appear simultaneously in several places, or they can appear one after another with different time intervals.

The signs and causes of fibroleiomyoma are the same as in other forms of pathology. However, most of these formations can be diagnosed at an early stage by contacting a doctor in time. An area of ​​increased density can be seen even before the formation of a node, and therefore, measures can be taken for prompt treatment. Fibromyomas on the uterus tend to disappear on their own without resorting to treatment.

Complications

Treatment of uterine fibroids is a prerequisite for maintaining health. If the body does not receive timely and high-quality treatment, the following complications may occur:

• Tumor necrosis. Such a process may occur due to malnutrition of fibroids. The situation is complicated by the appearance of severe pain, vomiting, hyperthermia. This can only be corrected by an operation on the uterus;
• Purulent processes. They occur quite rarely, and may occur against the background of tumor necrosis. This situation is accompanied by severe sepsis. Surgical treatment is an integral part of the treatment;
• Node origin. They can form in the vagina or even outside of it. The nodes grow on a long stalk, their formation is accompanied by severe pain. The danger is that an inversion of the uterus may form, which will require urgent surgical intervention;
• Leg twist. This situation is the most common and is accompanied by severe pain, hyperthermia, disruption of the intestines and bladder.

All this should not frighten a woman who cares about her health and visits a doctor twice a year.

Diagnostics

To diagnose the disease, diagnostic procedures are used that are standard for determining all types of uterine fibroids:

• Gynecological examination;
• Hysteroscopy;
• Diagnostic curettage;
• metrography;
• Cytological and histological studies.

Blood biochemistry, smears and cultures for flora, as well as hormonal examination are also performed.

Modern diagnostic methods are very large, so each doctor chooses the option that is most suitable for this patient.

Treatment

How to treat uterine fibroids? Any treatment, both conservative and surgical, is aimed at preserving the reproductive organ as much as possible.

Among the operations, the most common is myomectomy. Its action is aimed at removing uterine fibroids. The organ is preserved, however, if a woman has cured the pathology with this method, there is no certainty that relapses will not recur. Partial removal of the uterus is possible.

Relatively recently, a method of treatment appeared - arterial embolization. It involves blockage of the arteries that feed the tumor, artificially. The tumor regresses.

Treatment of uterine fibroids without surgery is carried out mainly with hormonal drugs. The choice of drugs is determined by the individuality of the organism, the presence of concomitant pathologies, the stage of tumor development. Treatment with hormones is carried out for at least six months and includes:

• The use of drugs of the progestogen group, if women do not have interruptions in the menstrual cycle;
• Patients under 45 years of age who have acyclic bleeding are prescribed estrogen - progestin preparations;
• Antigonadotropic drugs;
• Women over 45 are prescribed androgen-containing drugs.

It must be remembered that hormonal drugs are contraindicated in patients who have developed diabetes, varicose veins, and hypertension.

Treatment is not limited to hormones. At the same time, painkillers, antianemic, hemostatic agents and vitamins are also prescribed.

If the fibromyoma has grown to a large size, resembling a pregnancy of about 12 weeks, is submucosal in nature, and also has a pronounced clinical picture only surgical treatment is indicated.

The use of traditional medicine methods, which most women like to use, should only complement the main treatment, but in no way replace it. In addition, the choice of such funds should not be independent, but with the participation of the attending physician.

Prevention

So that a woman never encounters such a diagnosis as fibromyoma, she must adhere to simple rules throughout her life:

• Use of contraceptives to avoid abortions;
• It is advisable to plan the first birth before the age of 22, and breastfeeding after them is simply necessary;
• The first pregnancy must end in childbirth and the birth of a child;
• All inflammatory processes should be cured without dragging on;
• Do not abuse sunbathing;
• Annual gynecological examination.

A disease that is not dangerous at first glance can lead to complications that are difficult to treat, so timely diagnosis will help save not only health, but in some cases the life of a woman.

Indications and contraindications for surgery for fibroids

For women over 30 years of age, the most common indication for uterine surgery is fibromyoma, which is diagnosed in 15–17% of patients in this age group. At the same time, single nodes do not make the operation mandatory. Conservative treatment may be quite sufficient in the absence of malignant tumor growth and precancerous diseases in the cervical region and in the endometrial layer. The operation is also not required if submucosal nodes are found, if they do not exceed the size of the uterus at the 12th week of pregnancy in women under 45 years of age and if the formation in patients older than 45 years is less than 15-16 weeks of pregnancy.

In some cases, the effect of therapeutic methods may be low, which requires the introduction of restrictions on the conservative treatment of the patient, regardless of the size of the fibromyoma. In 25% of women who seek help, the disease develops asymptomatically and requires constant monitoring at least three to four times a year. Such patients need to take a blood test for hormones and, if necessary, correct the hormonal background. It should be remembered that dyshormonal disruptions are more common in women over 40 years of age, therefore, the latent course of the disease in such patients requires more attention from doctors.

Found a mistake in the text? Select it and a few more words, press Ctrl + Enter

Indications for surgery for uterine fibromyoma

Surgery to remove fibroids is necessary if there are obvious symptoms, such as menorrhagia and metrorrhagia, accompanied by secondary anemia. Indications for surgical intervention include pain caused by node necrosis, twisting of the subserous fibromyoma stem, as well as pain syndrome that accompanies compression of nerve fibers and stretching of the ligamentous apparatus when the formation is localized in the pelvic area between the ligaments.

Removal of fibroids is also required if subserous and submucosal tumors have a thin stalk that can twist and become necrotic. In some cases, the formation can disrupt the act of urination or defecation, putting pressure on the bladder or rectum.

If the fibromyoma is of considerable size and develops rapidly, especially during menopause and menopause, then surgery can also be recommended as the only effective treatment. Tumors that are larger than the size of the pregnant uterus for a period of 12 weeks in women under 45 years of age and 15–16 weeks in size in patients over 45 years of age are subject to removal.

If you suspect malignant tumor growth or the development of cervical fibromyoma of the uterus, surgery is also necessary.

In addition, the indication for surgery is infertility or repeated miscarriages, if it is established that the cause of the pathology is fibromyoma. As part of this operation, the uterus is not removed.

Contraindications for surgery for uterine fibromyoma

Surgery for uterine fibromyoma is not performed if there is a history of diseases of the cardiovascular system, upper respiratory tract, kidney. Removal of the formation is also contraindicated in violation of metabolic processes, the presence of an acute or subacute infectious process in the peritoneum and pelvic organs.

Acute infectious diseases cause the transfer of surgical intervention until the patient is completely recovered.

Taking into account the fact that the diagnosis of "uterine fibromyoma" is often made to a woman simultaneously with the diagnosis of "mastopathy", the main goal of the treatment of fibromyoma folk methods the normalization of the hormonal background of the patient is considered.

Uterine fibromyoma is one of the most common benign tumors that develop in women of childbearing age. For most patients, the question often arises about the possibility of conceiving, bearing and giving birth to a child.

Multiple uterine fibromyoma is one of the most common benign tumors among patients. The frequency of such a diagnosis is frighteningly high: every fourth woman over the age of 30 years has the pathology.

The subserous nodes are dissected from the uterus so that the incision line runs slightly above the base of the pedicle in a circular direction with a slight bend resembling a curly brace. This helps to avoid excessive tension of the tumor during further overtoning and suturing of the fibromyoma bed.

The information on the site is intended for familiarization and does not call for self-treatment, a doctor's consultation is required!

Nodular fibromyoma of the uterus: what women need to know?

Under the definition of nodular uterine fibroids understand benign tumor formed from the connective tissue of the muscles of the organ. A neglected fibroid can develop into a malignant neoplasm, which is why it is so important to diagnose and treat this disease in time, especially for nulliparous women.

Nodular fibromyoma of the uterus: causes

Nodular myoma is one of the most common gynecological diseases. In the thickness of the uterus, nodes of different diameters are formed and begin to grow outward or inward. They cause disturbances in the menstrual cycle and other vital internal organs.

The tumor is divided into three types:

The theory of the occurrence of a tumor is based on a violation of the hormonal background. The following factors can provoke a malfunction in the work of hormones:

• malfunction of the ovaries
• inflammatory process in the genitals
• promiscuous sex life
• prolonged sexual abstinence
• constant stress
• previous abortion or other uterine surgery

More often than others, fibroids are diagnosed in women whose relatives have been found to have uterine nodes.

The risk group includes infertility due to non-ovulation, as well as the absence of children after 30 years.

Women taking estrogen-containing contraceptives or those undergoing menopause treatment are also at risk.

Favorable background for the development of fibroids can be overweight, diabetes, sedentary lifestyle, diseases thyroid gland.

The growth of an existing fibromyoma increases during pregnancy, since its origin is hormone-dependent. After childbirth, the nodes have the ability to decrease to their original size or disappear altogether.

In our country, the size of uterine fibroids is measured by weeks of pregnancy, that is, how many weeks of pregnancy corresponds to an enlarged uterus.

We invite you to learn about the types of uterine fibroids from the proposed video.

Symptoms and Diagnosis

Complaints in the presence of fibroids depend on its size, the features of its localization and growth, the timing of the disease. Most patients do not feel any manifestations of the tumor. Approximately 20% of women experience various symptoms, such as:

• increased blood flow during menstruation
• heavy periods are accompanied by pain in the lower abdomen, clots, acute spasms
• often notice pain in the lower back or in the perineum
• fibromyoma is one of the causes of infertility
• spotting between cycles
• sudden weakness, drowsiness
• frequent urge to urinate
• worsening of the defecation process due to the pressure of the tumor on the pelvis

If nodules have formed on the uterus, then often intimacy brings a woman severe discomfort. Systematic blood loss leads to the development of anemia.

First of all, it is possible to determine fibromyoma on a standard gynecological examination. The doctor can manually install a bumpy and enlarged uterus. In the future, for a more detailed analysis, the following studies are prescribed:

• transvaginal ultrasound of the small pelvis - evaluates the location of the fibromyoma, its diameter, the density of the tissue structure, its pressure on the surrounding organs
• hysterosalpingoscopy - clarifies the presence of submucosal fibroids in endometrial tissues
• endometrial biopsy - helps to exclude the malignant nature of the tumor, the material taken is sent for histological analysis
• diagnostic laparoscopy is an additional method for evaluating fibromyomas to distinguish them from ovarian neoplasms.

Based on the results of analyzes of previous examinations, a further treatment strategy is being developed.

Nodular fibromyoma of the uterus: treatment

For successful treatment without surgery, it is important to consult a doctor in a timely manner and establish a diagnosis of nodular fibromyoma of the uterus on early stage development. Avoiding surgery is possible with the following indicators:

• specific arrangement of nodes
• uterine volumes do not exceed 12 weeks of gestation
• mild symptoms of the disease in the absence of complications

Complex treatment is based on inhibition of the growth of the focus or its complete stop. Patients are prescribed hormonal therapy, designed to reduce the production of estrogen. Doctors successfully use androgen derivatives (Gestrinon, Danazol) or GnRH (Zoladex).

Androgens are drunk in a course in a period of about eight months, as a result of which the fibroid nodes are reduced in diameter.

The effect of drugs based on GnRH is usually used in the preoperative period, since small nodes are easier to remove. However, patients observe many side effects from therapy - a flush of heat, a feeling of menopause, dryness of the vaginal mucosa, an unstable emotional state, and the development of osteoporosis.

With nodes less than 2 cm, it is advisable to use hormonal contraceptives Janine or Yarina. To achieve the desired result, drink them for at least 3 months.

Mirena intrauterine hormonal system demonstrates excellent results in the treatment of fibroids. By regularly releasing a certain type of hormone into the uterine cavity, it prevents the growth of nodes and has a contraceptive effect.

General strengthening multivitamin complexes, drugs with a high concentration of iron are added to specific therapy.

There are chances not to remove a fibroma that is asymptomatic during pregnancy. But overly enlarged uterine nodes can interfere with the full development of the embryo. In this case, nodular uterine fibroids can provoke an abortion in the later stages. Given the possible complications, a pregnant woman with fibroids requires double attention from doctors.

Nodular fibromyoma of the uterus: operation

Surgical intervention for fibroids is necessary for large sizes, pronounced symptoms, or tumor necrosis.

There are the following types of operations:

• Conservative myomectomy. This is an organ-preserving procedure, used for women of childbearing age who are planning a pregnancy and have a single fibrous node. This technique is the least traumatic, avoids the formation of adhesions in the postoperative period, as well as excessive blood loss during the operation. In addition, the procedure for removing fibroids takes a short time, and recovery proceeds with minimal side effects.
• Hysterectomy. A radical method of node surgery, which consists in the complete removal of the uterus. Until recently, hysterectomy was the only treatment for fibroids, as the most common gynecological disease. However, recent studies have forced doctors to reconsider their views on such "therapy". The uterus performs not only a reproductive function, but also works as an important endocrine organ. Her liquidation hits the rest internal organs not to mention the psychological problems after the operation.
• Now doctors are trying to preserve the reproductive system in patients with various stages of fibroids, so they have developed a new method of treatment - embolization. Embolization of the uterine arteries. The method consists in blocking the flow of blood to the fibroids with a special object. I stopped drinking fibrous tissue begins to regress, which leads to a complete cessation of fibroid growth.

This method has many advantages:

• performed under local anesthesia
• minimum recovery time
• low-traumatic intervention without incisions and sutures
• no recurrence
• impact on 100% nodes with multiple propagation

Do not forget about the postoperative period. It is advisable to conduct several courses of mesotherapy, undergo general strengthening procedures.

Among possible complications after the operation, infectious inflammatory processes, the formation of adhesions or synechia on the uterus, internal bleeding can be noted.

Pregnancy is possible in half of the operated patients, but this does not exclude the subsequent formation of new fibromyoma nodes.

There is no specific prevention of nodular fibroids. Regular gynecological examination with ultrasound diagnostics, taking contraceptives only as directed by a doctor, a full-fledged sex life and timely treated diseases of the genital area are the best prevention of nodular uterine fibromyoma.

• To post comments, please login or register

Receive news by email

Receive the secrets of longevity and health in the mail.

The information is provided for review, any treatment should be carried out by visitors with their doctor!

Copying materials is prohibited. Contacts | About the site

A gynecologist and distinguish 2 forms of uterine fibroids - diffuse and nodular.

The cause of occurrence can be both primary changes in the muscle wall against the background of hormonal disorders, and secondary changes due to abortion, postpartum complications, chronic inflammatory diseases of the genital organs.

The main signs of fibromyoma. pain, discomfort, bleeding, dysuric disorders, impaired defecation, infertility, sexual dysfunction - reduce the quality of life of a woman.

A gynecologist will be able to diagnose the disease during a gynecological examination. The full picture will be an ultrasound. smear for bacterial culture, laboratory tests.

TREATMENT OF UTERINE FIBROMIOMA

Treatment of uterine fibroids should be long-term, but gentle, herbal medicine and homeopathy. In the presence of a knotty form of the uterus - consultation of a gynecologist - oncologist or surgeon.

In the presence of uterine fibroids, a woman should be registered with a gynecologist and undergo a control examination 2 times a year.

Causes, symptoms and treatments for nodular fibroids and fibroids

Nodular uterine fibroids is a benign neoplasm. Fibroids are localized in muscle tissues, respectively, and this node consists of muscle fibers, and fibroids are located in connective tissues. That is, this is a disease in which nodes form in the thickness of the uterus, and in the process of their growth, their localization may change.

Myomatous nodes appear in women aged 25 to 55 years. Although medical practice suggests that the disease is getting younger and manifests itself at an earlier age.

• Intramural myomas. When the nodes are located in the thickness of the uterus and grow there.
• Submucosal fibroids. When the nodes are localized under the inner shell of the organ, which means that these nodes grow into the uterine cavity.
• subserous fibroids. When the nodes are localized under the outer shell of the uterus, and in the process of growth they go out, that is, into the abdominal cavity.

Nodular fibroids of the uterus: signs and symptoms

Signs of nodular uterine fibromyoma

Manifestations of fibroids will depend on the size of the nodes, the characteristics of their localization, the duration of the course of the disease, and other factors. The most common symptoms of the disease are pain, bleeding, anemia caused by prolonged blood loss, pain symptom, symptoms of compression of neighboring organs, an increase in the size of the abdomen, pain during intercourse, a feeling of fullness in the stomach, flatulence. Menstruation with fibromyoma is abundant and prolonged, bleeding is not uncommon, not associated with menstruation.

Pain in fibroids is usually caused by tension of the ligamentous apparatus of the uterus, stretching of the abdominal wall, pressure of a growing tumor on other organs. Violations of the work of nearby organs often occur when fibroids are localized close to the cervix. The growing tumor presses on the bladder and causes urination disorders. Posterior cervical fibromyoma puts pressure on the rectum and provokes intestinal disorders. With the onset of menopause, the neoplasm decreases in size. However, according to medical statistics, in 2% of cases, uterine fibromyoma degenerates into a malignant tumor.

Types of fibromyomas, the reasons for their appearance

There are several types of fibroids. The submucosa appears inside the uterine cavity, under its membrane. It causes severe pain and spasms. Subserous fibromyoma develops on the outer lining of the uterus. Interstitial is formed on the walls of the uterus and rapidly increases in size. Interligamentous fibromyoma is localized in the environment of the ligaments that support the uterus in the abdominal cavity. The stalked one develops from the subserous form when a leg grows in it. Such formations can twist and cause severe pain. Making a diagnosis with an increase in the size of the uterus does not cause difficulties during a routine gynecological examination. In order to clarify the number and location of nodes, additional studies are used: ultrasound, hysteroscopy, laparoscopy.

Factors contributing to the development of fibroids include progesterone deficiency, increased levels of estrogen hormones, disruption of the synthesis and conversion of sex hormones, and changes in the sensitivity of the myometrium to them. The hereditary factor also plays a role. The cause of the development of fibromyoma can be an abortion, chronic inflammatory diseases of the genital organs. The likelihood of developing this disease increases in women who postpone pregnancy to a later age.

Uterine fibroids is one of the most urgent and burning issues of women's health. At the moment, fibroids are detected in 3.2% of all women over 30 years of age. In those who have gynecological pathology, fibroids are much more common - in 12-20% of cases. The predominant occurrence is in women over 40 years of age.

Malignant degeneration of fibroids occurs in 1.5-5% of cases, in 2% - there is a combination of fibroids and endometrial cancer.

Infertility occurs in 40% of cases in patients with fibroids due to a previous disorder of the ovaries with the formation of the menstrual cycle of the anovulatory type.

Myoma is a benign hormone-dependent tumor that develops from the muscular and connective tissue elements of the uterus.

The term "hormone-dependent" reflects the modern view on the nature of the occurrence of fibroids. It is believed that the tumor occurs as a result of excessive stimulation of the tissues of the uterus to grow. This stimulation is carried out by hormones called estrogens. These hormones are normally produced by the ovaries during the first phase of the menstrual cycle. However, their ability to cause the growth of hormone-dependent tissue is significantly limited by progesterone, another ovarian hormone.

AT menopause when the role of the ovaries decreases, the main source of estrogens are the male sex hormones androgens. In menopausal women, the primary supplier of androgens are the adrenal glands.

A benign tumor is uterine fibromyoma. Basic principles of its treatment

Uterine fibromyoma is a benign tumor that is localized in the myometrium. A single cause of this disease has not yet been established. Studies have shown that one of these reasons may be hormonal dysfunction. An important role in the development of the disease is played by the hereditary factor, as well as chronic inflammation genital organs and aborted abortion. In women who postpone pregnancy to a later age, this pathology is recorded more often. Therefore, many experts call this disease "the disease of female careerism."

Nodular fibromyoma of the uterus is characterized by the formation of nodes in the myometrium, which eventually grow in different directions. As a rule, multiple neoplasms are recorded, less often - submucosal and subserous. Sometimes there are cases when myopathic nodes also affect the cervix.

Symptoms of fibromyoma can manifest themselves in different ways. First of all, this is due to the growth and size of the tumor, its localization and other factors. Very often, the signs of the disease are manifested in the form of pain in the lower abdomen, lower back and pelvis, frequent urination and constipation, heavy bleeding during the menstrual period. All this can cause infertility and miscarriages. Uterine fibroids can grow to the size of a soccer ball. Many patients complain of heavy and prolonged menstruation. Very often, the submucosal form of fibroids is accompanied by bleeding that is not associated with menstruation. According to statistics, about 2% of fibromyomas degenerate into sarcomas.

Nodular uterine fibroids - treatment depends on the tumor

One of the most common diseases in women is nodular uterine fibroids. Nodular uterine fibroids is the most common form of the disease. The treatment of this disease is carried out in different ways. In some cases, only drug treatment is used, sometimes the tumor is removed by surgery, and in some cases it is necessary to remove not only the fibroids, but also the uterus.

Basic principles of treatment of nodular uterine fibroids

Treatment of nodular uterine fibroids is selected for each woman individually and depends on the size, location of the nodes, the age and general condition of the woman, and the presence of concomitant diseases.

However, there are also general principles treatment of nodular myomas. A healthy lifestyle and proper nutrition are also of great importance. Proper nutrition is the main commandment of healthy food. alternation of work and rest, a good night's sleep Dreams: how to understand our dreams. lack of stress and inadequate loads - this affects the state of metabolism and immunity - the main factors that contribute to the restoration of hormonal levels and suppression of tumor growth.

Depending on various reasons, hormonal therapy, surgical treatment, as well as new low-traumatic methods of treatment in the form of embolization of the uterine arteries and the destruction of fibroid cells with various energy sources are used to treat nodular fibroids.

Nodular uterine fibroids: treatment and causes

Nodular uterine fibroids is a benign tumor formed in the muscle tissue of the organ.

A nodular form of uterine fibroids develops from muscle and connective fibers and is a rounded dense knot, the dimensions of which are calculated by doctors in weeks.

What threatens this disease and how can you determine its presence?

Note that over time, a neglected nodular fibroid can turn into a malignant tumor. For this reason, the disease requires timely detection and correct diagnosis.

There is also multiple nodular uterine fibroids. As the name implies, the disease is characterized by not one, but several nodules. Removing them is a real problem.

Causes of nodular uterine fibroids

The main cause of the disease is hormonal disbalance provoked by:

• improper diet;
• frequent change of sexual partners;
• stress;
• sexual abstinence;
• gynecological diseases and complications.

Genetics plays a prominent role in the formation of nodes, so women whose relatives had fibroids are recommended to have frequent examinations by a gynecologist.

Symptoms of nodular uterine fibroids

• a sharp increase in temperature during ruptures or twisting of the fibroids;
• infertility;
• sudden drowsiness and weakness;
• deterioration of the bowels and bladder;
• lower back pain;
• pain in the lower abdomen;
• spotting;
• profuse bleeding.

Treatment of nodular uterine fibroids

At the initial stages of development, this disease can be treated with hormonal drugs. With the restoration of hormonal balance, nodular uterine fibroids themselves may also disappear.

In the case of continued growth of fibroids, mandatory surgical treatment is prescribed.

With surgery, uterine fibroids can be removed with or without the uterus. Patients with childbearing function can count on the preservation of their reproductive organ.

However, despite the results of treatment, the risk of hormonal disruptions, coronary heart disease, and cancer is increasing. mammary gland and other similar diseases.

In general, you need to pay special attention to your own health and undergo examinations by gynecologists, mammologists and others.

Nodular uterine fibroids: causes, symptoms, treatment and prevention

Pathology is more typical for women over 30 years of age. According to statistics, this pathology is detected in almost 17% of patients of this age. In most cases, a myomatous tumor of the nodular structure is diagnosed, i.e. nodular uterine myoma.

More about the disease

A nodular neoplasm consists of one or more nuclei, it occurs gradually, often develops latently, therefore it is difficult to detect, especially at the initial stages.

Nodular myoma formation, like other benign tumors, grows between healthy tissues, pushing them apart. But if there is a confluence of pathological factors, then malignancy can occur, which will lead to malignancy.

Since the main causes of such formations are hormonal disruptions, hormonally active women, whose age is approaching menopausal and menopausal, are at risk. In other words, myomatous nodes are found mainly in flying ladies, and in every sixth of them.

More recently, such formations were mistakenly perceived by specialists as precancerous tumors, however, today most doctors tend to classify them as exclusively benign neoplasms.

The reasons

The underlying provoking factor of such nodes is an imbalance in the hormonal status, which consists in the excess content of progesterone and estrogen hormones.

Under the influence of such an imbalance, the cellular structures of the myometrium undergo hyperplastic changes.

According to many gynecologists, childbearing unfulfillment can provoke the appearance of myomatous nodes. The uterine body prepares for conception every month, but if it does not occur for a long time, then a cellular failure occurs, which provokes the formation of a myomatous node.

In addition, provoke the formation of nodular fibroids and other factors:

• Traumatic impact caused by abortions, gynecological surgical manipulations, curettage for diagnostic purposes, etc.;
• Heredity;
• Material exchange pathologies;
• Hypodynamic factor;
• Irregularity of sexual relations;
• Sexual dissatisfaction, etc.

Symptoms of nodular uterine fibroids

Myoma begins, as a rule, latently, i.e. asymptomatically, so it is difficult to differentiate them into initial stages. However, it is precisely the beginning myomatous nodes that lend themselves to conservative therapy, in other cases, surgical intervention is necessary.

1. Abundant menstrual flow and lengthening of menstruation, the appearance of uterine bleeding of an intermenstrual nature;
2. Painful manifestations during menstruation, before them. The pain is localized in the uterus, however, often radiates to the lower back;
3. Iron deficiency anemia develops due to profuse blood loss;
4. If the tumor grows to a large size, then there is a noticeable increase in the volume of the abdomen.

When growing to a significant size, myomatous nodes affect the rectal and vesical structures, which leads to constipation and other problems with the intestines, and also causes urinary disorders.

Forms

Nodular uterine fibroids can be proliferating or simple.

A simple tumor is characterized by the growth of cellular structures, and a proliferating one is accompanied by active myocyte reproduction and rapid growth of the node.

By the nature of myoma formations are single and multiple.

Effects

It is impossible to predict the clinical scenario for the development of a particular fibroid. Some nodes for a long time asymptomatically develop practically without increasing in size. Others can quickly begin to grow, characterized by the appearance of new nodes, which is fraught with loss of the uterus.

With pressure on the rectum or bladder structures, the tumor can lead to dysfunction of these organs and even provoke serious pathological problems in their activity.

If the tumor blocks the exit to the cervix, then menstrual flow accumulates in the uterus, which further leads to the formation of a hematometer - a closed uterus filled with blood. Such a consequence requires immediate surgical elimination.

Diagnostics

Myomatous nodes can be detected during a two-handed examination by a gynecologist, during which deformation and structural changes in the uterine body, its enlargement and a bumpy surface are revealed.

A highly informative method for diagnosing such a pathology is ultrasound procedure, dopplerography, MRI and CT.

To differentiate the myomatous formation, determine the location of the nodal pedicle and other necessary data, hydrosonography is performed, which is an ultrasound examination of the uterine body filled with fluid.

Features of the treatment of nodular and multinodular uterine fibroids

The basis of the treatment of myoma formations is surgical therapy, but if the tumor is on initial stage development, then conservative treatment with drugs of hormonal origin is carried out.

If in the process of such therapy it is possible to stabilize the hormonal status of the patient, then the myomatous nodes resolve on their own. When useless hormonal drugs surgical intervention is scheduled.

Indications for surgical procedures are the following factors:

1. Abundant menstrual blood loss;
2. Large sizes of myoma formation;
3. Accelerated tumor growth;
4. The probability of myomatous malignancy is high;
5. The presence of other tumor formations;
6. Violation of intratumoral activity.

Advanced forms of nodular myomatous formation require mandatory radical removal of the uterine body, therefore it is categorically unacceptable to ignore the pathology.

But most often, organ-preserving operations are used, such as myomectomy, which is performed intravaginally or laparoscopically. Sparing is also considered an operation using a hysteroscope.

Treatment with folk remedies

Many patients prefer drug treatment of nodular uterine fibroids folk methods. There may be several reasons for this preference: someone is afraid of surgery, and someone does not recognize modern medicine at all.

In any case, most gynecologists do not interfere with such treatment, however, they recommend that it be carried out as an auxiliary therapy, and not the main one.

Traditional medicine has many recipes in its arsenal. Since myomatous nodes, as a rule, are accompanied by heavy bleeding. To eliminate them, it is recommended to use medicinal herbs like yarrow, shepherd's purse or nettle. Decoctions and infusions are prepared from these plants.

To reduce the tumor or slow down and stop its growth, folk remedies based on fly agaric, tartar, celandine or hog uterus are used.

Alternative treatment of nodular myomatous formations can give positive results, however, before using such recipes, it is recommended to consult a gynecologist and combine basic drug therapy with alternative treatment.

Forecast

After surgical removal of myomatous nodes, the prognosis is positive for life, and most often the patients retain the ability to conceive and give birth to healthy offspring.

If the treatment was conservative and carried out through hormone therapy, then the likelihood of a relapse is high.

If the nodes differ in pathologically rapid growth, quickly spread through the uterine body, then a radical hysterectomy may be prescribed, which involves the surgical removal of the uterus, its appendages and myomatous nodes. Even a single node, the treatment of which was not started in a timely manner, can lead to such consequences.

Prevention

It is possible to prevent the occurrence of nodular uterine fibroids by responsibly approaching the issue of pregnancy planning.

Systematic visit antenatal clinic and gynecological examinations will help to detect the tumor in a timely manner and prevent the development of its more dangerous forms.

Some experts recommend that premenopausal patients who have an unstable hormonal background take special drugs that normalize estrogen levels. In addition to myoma prevention, such treatment will help the female body more gently prepare for menopause.

Video showing hysteroscopic surgery for multiple nodular uterine fibroids:

Symptoms and treatment of uterine fibroids

In modern gynecology, there is an increase in the incidence of benign tumors among women of reproductive age. Uterine fibromyoma, which occurs in the myometrium, is one of the most common tumor-like formations of a benign nature.

Uterine fibromyoma is a hormone-dependent pathological process, which often needs to be treated with surgery. The neoplasm is formed from the fibers of the muscle layer and the connective tissues prevailing in the composition. The size of the formation is measured by the attending physicians in weeks, as in pregnancy.

Fibromyoma is also called myoma or leiomyoma. The difference between terms such as fibromyoma and leiomyoma is the prevalence of different tumor tissues.

Symptoms of fibroids are found in almost every second woman who comes to see a gynecologist. Most of the nodes are located in the body of the uterus, however, cervical localization is not excluded.

Fibromyoma of the uterus can be:

With nodular uterine fibromyoma, treatment is more effective. This is due to the fact that the nodular form implies the formation of separate tumors. While with a diffuse variety, an extensive spread of the pathological process is observed.

Knotty fibromyoma of the uterus is:

• single;
• multiple.

Most often, nodular fibromyoma of the uterus or leiomyoma is represented by multiple neoplasms.

Before treating fibromyoma, including by the method of surgery, it is necessary to diagnose its variety in accordance with localization.

• Submucous or submucosal. Such a nodular formation is diagnosed by the attending physician under the endometrium.
• Interconnective. This is a complex tumor growing between the sheets of the broad ligament of the uterus. Treatment of interligamentous fibroids or leiomyomas is a challenge due to possible damage vessels.
• Subserous. The uterine tumor grows under the outer layer of the muscular organ.
• Interstitial. This is the most common type of nodular fibromyoma, meaning the appearance of a neoplasm in the thickness of the myometrium.

Uterine fibromyoma also includes three main forms.

• Simple. This formation is characterized by slow progression and good treatment efficacy.
• Proliferating. With such a pathology, there is a rapid growth of a node of a benign nature.
• Presarcoma. Fibromyoma is distinguished by the content of a significant amount of atypical cellular elements, which necessitates its early treatment. Doctors note that presarcoma is often the cause of amputation of the uterus.

Accordingly, fibromyoma and leiomyoma have a single morphology code M889 (international classification of diseases code 10 revision D25 - uterine leiomyoma).

Causes of occurrence and progression

Nodular fibromyoma is a poorly understood pathology. It has been noted that often the growth of a benign tumor occurs in the reproductive age, and after the onset of menopause, the formations regress.

Uterine fibroids are characterized by slow progression. The growth of a neoplasm to a diagnosable size takes an average of five years. However, under the influence of adverse factors, symptoms of the rapid growth of nodular fibromyoma or leiomyoma may be observed, which necessitates the operation. In this connection, the disease should be detected and treated in time.

The reasons for the progression of uterine fibroids include:

• absence of pregnancies and childbirth in women under 30;
• frequent surgical interventions and abortions;
• stress;
• prolonged insolation;
• inflammatory diseases of the reproductive organs;
• uncontrolled intake of COCs;
• hormonal imbalance;
• metabolic disorders;
• burdened by fibromyoma family history;
• early (from 9 years) onset of menstruation.

Symptoms and complications

Symptoms of the disease in more than half of clinical cases are absent. This is due to the slow growth of the nodular tumor. When a nodular fibromyoma reaches a significant size, symptoms of pathology appear:

• pelvic pain of varying intensity, aggravated by menstruation;
• acyclic bleeding;
• increase in the number spotting and duration of critical days;
• soreness with intimacy;
• squeezing of the intestines and bladder, manifested by constipation and frequent urination;
• an increase in the volume of the abdomen;
• infertility, as well as miscarriage in the absence of timely treatment.

The severity of symptoms is essential for the choice of treatment tactics, which means the use of surgery or conservative therapy. Treatment of uterine fibroids without surgery is possible only in the absence of severe symptoms.

The nodular form of the disease often leads to symptoms of serious complications that require surgery.

• Necrosis of a nodular neoplasm. This phenomenon occurs due to the twisting of the leg of the node and the disruption of its power supply. Among the symptoms, one can single out severe pain, nausea, vomiting, and the development of an infectious process is not excluded. Treatment of pedicle torsion and necrosis of nodular fibroids is exclusively surgical. If the pathology is not treated in a timely manner, sepsis may develop, and the uterus will have to be removed.

• The birth of a node. Often nodular submucosal fibroids are born in the vagina. Symptoms of this complication are pulling or cramping pains in the lower abdomen. If you do not carry out immediate surgical treatment, an eversion of the body of the uterus may occur.

As a rule, the appearance of symptoms of complications is associated with the lack of adequate treatment, which leads to the need for surgery.

An increase in a nodular tumor often prevents the onset of pregnancy - this applies to submucosal localization, as well as large intramural fibroids, which deform the uterine cavity. Without surgery or conservative treatment, implantation does not occur. In addition, pregnant women with a history of benign neoplasms are at risk of miscarriage, preterm birth, and various postpartum complications.

Diagnosis and treatment

The absence of symptoms, including nodular pathology, often causes its accidental detection during a preventive examination. You can identify the disease using the following diagnostic methods:

• examination by the attending physician by palpation;
• gynecological ultrasound;
• hysteroscopy;
• Blood tests to determine the level of sex hormones.

Treatment of uterine fibroids is selected individually for each patient. Before treating the disease, the doctor takes into account the symptoms, size and type of nodular formation. The implementation of the childbearing function and the age of the woman are essential.

Many women are interested in how to treat uterine fibroids. You can treat the disease:

It is possible to treat the disease conservatively without surgery in the absence of severe symptoms and fibroids with a volume of up to 12 weeks. Conservative treatment without surgery is based on the use of hormonal drugs:

• gestagens;
• estrogen-gestagens;
• antigonadotropic drugs;
• androgen-containing drugs.

Medical treatment without surgery can slow down the progression of the disease, reduce leiomyoma and eliminate unpleasant symptoms. It is necessary to treat with hormonal drugs for a long time, following the prescription of the attending doctor. This is due to the fact that drug treatment can cause serious side effects, as it sometimes involves the introduction into an artificial menopause.

With fibroids for more than 12 weeks and severe symptoms, surgical treatment is indicated, which involves an operation.

Organ-preserving operations include myomectomy by laparoscopic or laparotomy technique. Such operations can eliminate leiomyoma, while maintaining reproductive function. Submucosal fibroids can be removed without open surgery, but with hysteroscopy or FUS ablation. MRI-guided FUS ablation involves direct removal by evaporation.

Radical operations involve amputation of the body of the uterus by hysterectomy or extirpation. Treatment with radical surgery is recommended for women after menopause.

• refuse abortion;
• avoid surgical interventions;
• plan a first pregnancy before the age of 30;
• timely treat diseases of the reproductive sphere;
• avoid prolonged insolation;
• regularly examined by a gynecologist.

Surgery for uterine fibromyoma can be avoided if the symptoms of the disease are not ignored, but adequate treatment is carried out at the initial stage of the pathological process. If a gynecologist recommends surgery as a treatment for nodular leiomyoma and to relieve symptoms, alternative methods may be considered, such as FUS ablation and uterine artery embolization.

Nodular fibromyoma of the uterus: what women need to know?

The definition of nodular uterine fibroids is understood as a benign tumor formed from the connective tissue of the muscles of the organ. A neglected fibroid can develop into a malignant neoplasm, which is why it is so important to diagnose and treat this disease in time, especially for nulliparous women.

Nodular fibromyoma of the uterus: causes

Nodular myoma is one of the most common gynecological diseases. In the thickness of the uterus, nodes of different diameters are formed and begin to grow outward or inward. They cause disturbances in the menstrual cycle and other vital internal organs.

The tumor is divided into three types:

The theory of the occurrence of a tumor is based on a violation of the hormonal background. The following factors can provoke a malfunction in the work of hormones:

• malfunction of the ovaries
• inflammatory process in the genitals
• promiscuous sex life
• prolonged sexual abstinence
• constant stress
• previous abortion or other uterine surgery

More often than others, fibroids are diagnosed in women whose relatives have been found to have uterine nodes.

The risk group includes infertility due to non-ovulation, as well as the absence of children after 30 years.

Women taking estrogen-containing contraceptives or those undergoing menopause treatment are also at risk.

Favorable background for the development of fibroids can be overweight, diabetes, sedentary lifestyle, thyroid disease.

The growth of an existing fibromyoma increases during pregnancy, since its origin is hormone-dependent. After childbirth, the nodes have the ability to decrease to their original size or disappear altogether.

In our country, the size of uterine fibroids is measured by weeks of pregnancy, that is, how many weeks of pregnancy corresponds to an enlarged uterus.

We invite you to learn about the types of uterine fibroids from the proposed video.

Symptoms and Diagnosis

Complaints in the presence of fibroids depend on its size, the features of its localization and growth, the timing of the disease. Most patients do not feel any manifestations of the tumor. Approximately 20% of women experience various symptoms, such as:

• increased blood flow during menstruation
• heavy periods are accompanied by pain in the lower abdomen, clots, acute spasms
• often notice pain in the lower back or in the perineum
• fibromyoma is one of the causes of infertility
• spotting between cycles
• sudden weakness, drowsiness
• frequent urge to urinate
• worsening of the defecation process due to the pressure of the tumor on the pelvis

If nodules have formed on the uterus, then often intimacy brings a woman severe discomfort. Systematic blood loss leads to the development of anemia.

First of all, it is possible to determine fibromyoma on a standard gynecological examination. The doctor can manually install a bumpy and enlarged uterus. In the future, for a more detailed analysis, the following studies are prescribed:

• transvaginal ultrasound of the small pelvis - evaluates the location of the fibromyoma, its diameter, the density of the tissue structure, its pressure on the surrounding organs
• hysterosalpingoscopy - clarifies the presence of submucosal fibroids in endometrial tissues
• endometrial biopsy - helps to exclude the malignant nature of the tumor, the material taken is sent for histological analysis
• diagnostic laparoscopy is an additional method for evaluating fibromyomas to distinguish them from ovarian neoplasms.

Based on the results of analyzes of previous examinations, a further treatment strategy is being developed.

Nodular fibromyoma of the uterus: treatment

For successful treatment without surgery, it is important to consult a doctor in a timely manner and establish a diagnosis of nodular uterine fibromyoma at an early stage of development. Avoiding surgery is possible with the following indicators:

• specific arrangement of nodes
• uterine volumes do not exceed 12 weeks of gestation
• mild symptoms of the disease in the absence of complications

Complex treatment is based on inhibition of the growth of the focus or its complete stop. Patients are prescribed hormonal therapy, designed to reduce the production of estrogen. Doctors successfully use androgen derivatives (Gestrinon, Danazol) or GnRH (Zoladex).

Androgens are drunk in a course in a period of about eight months, as a result of which the fibroid nodes are reduced in diameter.

The effect of drugs based on GnRH is usually used in the preoperative period, since small nodes are easier to remove. However, patients observe many side effects from therapy - a flush of heat, a feeling of menopause, dryness of the vaginal mucosa, an unstable emotional state, and the development of osteoporosis.

With nodes less than 2 cm, it is advisable to use hormonal contraceptives Janine or Yarina. To achieve the desired result, drink them for at least 3 months.

Mirena intrauterine hormonal system demonstrates excellent results in the treatment of fibroids. By regularly releasing a certain type of hormone into the uterine cavity, it prevents the growth of nodes and has a contraceptive effect.

General strengthening multivitamin complexes, drugs with a high concentration of iron are added to specific therapy.

There are chances not to remove a fibroma that is asymptomatic during pregnancy. But overly enlarged uterine nodes can interfere with the full development of the embryo. In this case, nodular uterine fibroids can provoke an abortion in the later stages. Given the possible complications, a pregnant woman with fibroids requires double attention from doctors.

Nodular fibromyoma of the uterus: operation

Surgical intervention for fibroids is necessary for large sizes, pronounced symptoms, or tumor necrosis.

There are the following types of operations:

• Conservative myomectomy. This is an organ-preserving procedure, used for women of childbearing age who are planning a pregnancy and have a single fibrous node. This technique is the least traumatic, avoids the formation of adhesions in the postoperative period, as well as excessive blood loss during the operation. In addition, the procedure for removing fibroids takes a short time, and recovery proceeds with minimal side effects.
• Hysterectomy. A radical method of node surgery, which consists in the complete removal of the uterus. Until recently, hysterectomy was the only treatment for fibroids, as the most common gynecological disease. However, recent studies have forced doctors to reconsider their views on such "therapy". The uterus performs not only a reproductive function, but also works as an important endocrine organ. Its elimination affects the rest of the internal organs, not to mention the psychological problems after the operation.
• Now doctors are trying to preserve the reproductive system in patients with various stages of fibroids, so they have developed a new method of treatment - embolization. Embolization of the uterine arteries. The method consists in blocking the flow of blood to the fibroids with a special object. Having ceased to be nourished, the fibrous tissue begins to regress, which leads to a complete cessation of fibroid growth.

This method has many advantages:

• performed under local anesthesia
• minimum recovery time
• low-traumatic intervention without incisions and sutures
• no recurrence
• impact on 100% nodes with multiple propagation

Do not forget about the postoperative period. It is advisable to conduct several courses of mesotherapy, undergo general strengthening procedures.

Among the possible complications after the operation, infectious inflammatory processes, the formation of adhesions or synechia on the uterus, and internal bleeding can be noted.

Pregnancy is possible in half of the operated patients, but this does not exclude the subsequent formation of new fibromyoma nodes.

There is no specific prevention of nodular fibroids. Regular gynecological examination with ultrasound diagnostics, taking contraceptives only as directed by a doctor, a full-fledged sex life and timely treated diseases of the genital area are the best prevention of nodular uterine fibromyoma.

• To post comments, please login or register

Receive news by email

Receive the secrets of longevity and health in the mail.

The information is provided for review, any treatment should be carried out by visitors with their doctor!

Copying materials is prohibited. Contacts | About the site

Article last updated 07.12.2019

Fibromyoma is a type of benign neoplasm that forms in the smooth muscle layers of the uterus. The name of this disease has various options: leiomyoma, leiofibroma, myoma. Pathology develops both in the form of a single node, and in the form of an accumulation of multiple formations. Nodular fibromyoma of the uterus is diagnosed much more often than other gynecological diseases.

What is uterine fibroids? Basically, fibroma is diagnosed after 35 years. At this age, most women already have various somatic disorders, diseases of the female genital area, endocrine disorders. Small nodes do not manifest themselves in any way for quite a long time, however, in the presence of adverse factors, their rapid growth may begin.

These factors include:

• Lack of childbirth and lactation by the age of 30;
• Prolonged uncontrolled use of contraceptives;
• A large number of abortions;
• Overweight;
• Lack of intimate life or promiscuous sex;
• Inflammation of the uterus, ovaries and appendages;
• Prolonged and frequent exposure to ultraviolet radiation;
• Diseases of the thyroid gland, adrenal glands and other endocrine organs.

What is the danger of the disease?

Fibroma of the body of the uterus occurs in every fifth woman. What is it, and how is this pathology different? Basically, the tumor develops in the body of the uterus, cervical fibromyoma is quite rare. The tumor can grow to a huge size over time and cause serious health problems.

Fibromyoma can provoke serious complications:

1. For nutrition of myoma formations are required significant resources. Against this background, biochemical parameters of blood change. In addition, heavy blood loss leads to anemia (anemia);
2. In severe cases, torsion of the base of the fibromatous node is possible, as a result, necrosis (tissue death) and sepsis (blood poisoning) may occur;
3. There is a risk of prolonged bleeding and large blood loss, especially with large fibroids. This condition is very dangerous, a serious threat to the life and health of a woman.

How does the disease manifest itself?

Symptoms and signs of fibroma in the initial stages of the development of the disease are mild. It is quite difficult to recognize the pathology on your own. Since the signs of uterine fibroids are almost invisible, only a doctor can detect the presence of a tumor during a gynecological examination.

In case of suspicion of the presence of a neoplasm, after examination, the gynecologist gives a referral for an ultrasound examination. This diagnostic method is the most accurate, using ultrasound, you can determine the presence of a tumor, the number of nodes, their location, size. Symptoms of uterine fibroids can manifest themselves in different ways, it depends on the stage of the disease.

Symptoms of uterine fibroids:

• Abundant menstruation with severe pain syndrome;
• Feeling of pulling pains in the lower abdomen;
• Bloody discharge between periods;
• Pain radiating to the lumbar;
• Increase in the circumference of the abdomen;
• Pain during intercourse.

A distinctive feature of a fibrous tumor of the uterus is the presence of cramping pain during menstruation. In some cases, pain can be sharp, occur unexpectedly, and may persist permanently. In case of long and heavy menstruation may develop anemia.

In the presence of this dangerous disease, every third woman suffers from infertility. The disease can lead to miscarriages, disruption of communication in the work of the pelvic organs: uterus, appendages, ovaries, bladder. Prolonged exposure to bladder receptors in uterine fibromyoma leads to frequent urination. And if the tumor squeezes the rectum, then constipation and problems with the intestines can occur.

Treatment of fibroids at an early stage

What is fibromyoma and how is it treated? Conservative treatment is very effective at an early stage of the disease. Usually a woman does not notice any special changes in her health status yet, the symptoms of uterine fibroids are usually mild. The tumor is diagnosed by ultrasound. If the formation is small, then no specific treatment is prescribed, the patient passes periodic diagnostics. In the patient's chart, the dynamics in the development of the tumor is noted, an ultrasound examination is prescribed every six months.

Treatment medicines is assigned when nodes increase. At this stage of the development of the disease, it is important to control the growth of nodes and the duration of menstruation. Since frequent and profuse blood loss can lead to a deterioration in the general condition of the body and to the development of anemia. With the right tactics of treatment, it is possible to avoid surgical intervention.

In what cases is prescribed drug therapy:

• The young age of the patient;
• Positive dynamics of treatment, slow tumor growth;
• If the fibromatous nodes are small, up to about 10-12 weeks;
• The body of the uterus is not changed;
• The fibromatous node is located in the smooth muscle layer of the organ.

In the treatment of fibroids, medications based on tranexamic acid are most often prescribed. This substance has a hemostatic effect, which reduces the risk of developing anemia. At the initial stage of treatment, doctors mainly prescribe hormone therapy, this allows you to lower the level of estrogen production, and the tumor decreases in size.

Many women try to cure fibroids with folk remedies, but the effectiveness of such tactics has not been proven. On the contrary, a woman can lose precious time and aggravate her condition. Therefore, it is important to undergo timely diagnosis and contact specialists.

In what cases is surgical intervention required?

Sometimes, surgical treatment of fibroids is still indispensable. The presence of the following symptoms may indicate the need for surgery:

• If seal sizes are 14 weeks or more;
• There is a rapid increase in size in a short time;
• Localization of the tumor in places of increased danger;
• Abundant uterine bleeding;
• Low blood hemoglobin, chronic anemia;
• Torsion of the fibromyoma leg, violation of its nutrition, subsequent tissue death;
• Associated ovarian tumors;
• Hyperplasia of the endometrium;
• An increase in the size of the tumor, in which it presses on the internal organs.

The reasons for the rapid growth of the tumor have not been established for certain. Most experts agree that fibromatosis of the soft tissues of the uterus is a hormone-dependent pathology. That is, its active growth begins with an increase in the level of estrogen in the woman's blood. This fact is confirmed by a decrease in the tumor and stop the growth of nodes in women during menopause, when the production of the hormone estrogen decreases.

The method of surgical intervention is selected individually, taking into account:

• dynamics of tumor development;
• the size of education at the moment;
• the location of the tumor;
• woman's age;
• diseases in history.

For patients under the age of 40, a sparing myomectomy is preferable. During such an operation, only fibromatous nodes are removed, while after removal of the tumor, the childbearing function is preserved, since healthy tissues of the uterus are not affected.

The most popular methods of myomectomy are:

Hysteroscopy- removal of uterine fibroids is carried out using a hysteroscope through the cervix. This method is great for those patients who want to get pregnant in the near future. Surgery is performed under general anesthesia, the duration of the operation rarely exceeds 20 minutes. The advantages of hysteroscopy are minimal trauma, painlessness, quick rehabilitation.

Laparoscopy During the operation, small incisions are made in the lower abdomen, through which the tumor is removed. Among the advantages of this method, one can note the easy and rapid course of the postoperative period. If the tumor has not changed its growth dynamics during the postmenopausal period, then a more radical treatment is carried out in this way - removal of the uterus. After the operation, a woman is given sick leave for an average of 21 days.

Now medicine offers more gentle treatment - uterine artery embolization. A drug is delivered to the arteries that feed the tumor through the femoral artery, which blocks the vascular bundles. Under these conditions, the fibroid dies. The operation is performed without anesthesia, the patient stays in the hospital for one day. Another innovative method of treatment - FUS ablation. This is the heating of tumor tissues with the help of clearly directed ultrasound. The technique has not yet been fully investigated, therefore, it is used only at the request of patients.

Many women are concerned about whether fibroma can affect the likelihood of conception and the birth of a healthy child. As a rule, fibromatosis of the soft tissues of the uterus does not affect a woman's ability to conceive. According to statistics, after an operation to remove myoma nodes, the probability of pregnancy is reduced by 40%. However, if the fibroid is small and does not require surgical intervention, then it does not affect the course of pregnancy and childbirth. In addition, a large number of cases have been registered when the tumor during pregnancy or after childbirth noticeably decreases in size or may completely disappear.