Subserous myomatous node. Interstitial myomatous nodes: description, possible causes, symptoms and treatment

Subserous fibroid- a benign hormone-sensitive neoplasm, which consists of smooth muscle cells of the myometrium and is located under the serosa of the uterus. In 60-70% of cases the disease is not clinically manifested. Some patients are bothered by pain in the lower abdomen and lower back, reproductive function, signs of pressure on the pelvic organs. To confirm the diagnosis, ultrasound, angiography and Dopplerography of the uterus, tomography are prescribed pelvic organs, laparoscopy. Treatment involves the use of hormonal drugs, myomectomy and radical interventions.

General information

Subserous, or subperitoneal, fibroids (leiomyomas) are most often detected in women over 30 years of age. However, the current prevalence of the disease in age group 20-30 years increased by 30-35%. Women during menopause become ill extremely rarely; usually the cessation of menstrual function is accompanied by tumor involution. In girls before menarche, subserous myomatous nodes are not detected. These statistics confirm the leading role of the hormonal factor in the development of subperitoneal leiomyoma. The incidence among city women is significantly higher than among women living in rural areas.

Causes of subserous fibroids

According to many experts in the field of gynecology, the main factors provoking the development of leiomyoma with subperitoneal nodes are endocrine disorders and pathological changes at the level of myometrial cells. The immediate causes of hormonal imbalance are:

• Violations central regulation . Injuries and damage to the blood vessels of the brain, tumors, and constant stress affect the secretory activity of the hypothalamic-pituitary region. One of the manifestations of such disorders is the hyperproduction of FSH and LH - gonadotropic hormones that regulate the endocrine function of the ovaries.
• Extragenital endocrine pathology . Hypothyroidism, autoimmune thyroiditis, diabetes mellitus, adrenal diseases and some other diseases are accompanied by impaired estrogen production and changes in the ratio of their individual fractions.
• Ovarian diseases. For neoplasms, inflammatory processes, traumatic injuries of the uterine appendages may change the secretion of estrogen and progesterone - the main female hormones that affect the proliferative activity of myometrial cells.
• Obesity. Adipocytes have endocrine secretory activity and are capable of secreting estrogen.
• Long-term hormonal contraception. Long-term suppression of ovulation using synthetic sex hormones can disrupt their natural production.
• Congestion in the pelvic organs. Low physical activity, irregular sex life without sexual release lead to venous stagnation in the uterus and appendages with the subsequent development of hormonal imbalance.

Since hormonal disorders are not detected in all patients with subserous myoma; some authors believe that pathological sensitivity or activity of cells in the muscular layer of the uterus plays a significant role in the development of the disease. Such violations lead to:

• Hereditary factor. Scientists have identified two groups of genes that can influence the development of myomatous nodes. Some of them provoke increased proliferation of myometrial cells, others change sensitivity to estrogen and progesterone.
• Myometrial injuries. Frequent abortions, invasive diagnostic and medical procedures, surgical interventions on the uterus cause local changes in smooth muscle cells.

Pathogenesis

At the first stage of the formation of the subserous node, pathological changes occur at the cellular level. In some smooth muscle cells, under the influence of sex hormones, metabolic processes are accelerated, and an increase in tissue permeability is noted. The second stage of pathogenesis is characterized by the appearance of cellular accumulations, defined as microscopic nodes. At the third stage, neoplasms are determined macroscopically. Nodes can form on a wide base or a thin stalk along which the vessels feeding them pass. An important point in the pathogenesis of subperitoneal fibroids is the gradual decrease in the sensitivity of proliferating cells to the stimulating influence of hormones and the further development of the tumor under the influence of its own autocrinoparacrine factors. As the disease increases, it manifests itself clinically as a decrease in myometrial contractility and pressure on adjacent organs.

Classification

Subserous leiomyomas may have different sizes, number of nodes, histological structure and features of location in relation to the uterus. Accordingly, the disease is classified according to the following criteria:

• By size. There are small fibroids ranging in size up to 4-5 weeks of pregnancy (up to 20 mm), medium ones - from 4-5 to 10-11 weeks (20-60 mm) and large ones - from 12 weeks (more than 60 mm).
• By number of nodes. Subperitoneal fibroids can be single or multiple.
• According to morphological structure. Based on the type and proliferative activity of smooth muscle cells, tumors are classified as simple, proliferating, and presarcoma.
• According to location features. Subserous neoplasms can grow on the surface of the uterus facing the abdominal cavity or between its ligaments; have a wide base or stem.

Symptoms of subserous fibroids

Clinical symptoms are detected only in 30-40% of patients and indicate a significant age of the disease. Single and small neoplasias usually develop asymptomatically and are first detected when gynecological ultrasound. Subperitoneal growth of nodes is not characterized by menstrual irregularities. If the tumor has a wide base, the contractile activity of the myometrium may be impaired, which is clinically manifested by heavy and prolonged periods, the development of anemia with pale skin, complaints of general weakness, fatigue, low performance, periodic dizziness and headaches.

For large tumors there is pain syndrome and signs of pressure on adjacent organs. Patients complain of periodic lower back pain, which may intensify during menstruation. Especially strong painful sensations occur when the myomatous node fuses with the peritoneum. With the pressure of neoplasia on bladder the urge to urinate becomes more frequent. Compression of the rectum is manifested by constipation, increased urge to defecate, increased hemorrhoids. Much less often fibroids disrupt venous drainage from the extremities, which is accompanied by swelling. Unlike submucous tumors, subperitoneal neoplasms have less effect on reproductive function - the inability to become pregnant or bear a child is usually noted only by those women in whom the growth of a node has led to the formation of a bend in the uterus or significant deformation of its cavity.

Complications

Most dangerous complications subserous fibroids are torsion of the legs, necrosis or infarction, which are accompanied by intense pain in the lower back and lower abdomen, severe weakness, sweating, vomiting, fever, dysfunction of the rectum and bladder. With a subperitoneal location of the tumor, secondary anemia due to blood loss, infertility and premature termination of pregnancy, myxomatous transformation of the tumor, hyperplastic processes in the endometrium. Malignancy occurs extremely rarely (no more than 0.25-0.75% of cases).

Diagnostics

When diagnosing subserous fibroids, a special role is played by special methods studies that make it possible to detect neoplasms, determine their size, and clarify the characteristics of the blood supply, location, and structure. In diagnostic terms, the most informative are:

• Gynecological examination. During a bimanual examination, an enlarged uterus and nodes on its surface are palpated.
• Transvaginal and transabdominal ultrasound. Fibroids associated with the uterus and growing to the side are detected abdominal cavity, their sizes, structure and localization are determined.
• Dopplerography and angiography of the uterus. Allows you to assess the intensity of blood flow and visualize circulatory system uterus and detect signs indicating a malignant process.
• MRI and CT of the pelvic organs. They provide the most accurate topographic picture of the pelvic organs and myomatous nodes.
• Diagnostic laparoscopy. Subperitoneal leiomyomas are defined as round, pale pink formations with a shiny, smooth surface.

From laboratory tests may be indicative general analysis blood (erythropenia and low level hemoglobin) and study of the level of sex hormones (FSH, LH, estradiol, progesterone). Differential diagnosis includes pregnancy, uterine sarcoma, ovarian tumors and retroperitoneal neoplasms. If necessary, the patient is consulted by a gynecological oncologist, endocrinologist, urologist, surgeon, or therapist.

Treatment of subserous fibroids

Patients with small subperitoneal nodes with preserved reproductive function, no complaints or signs of neoplasia growth are recommended to undergo dynamic observation with examination by a gynecologist once a year. For other forms of the disease, the specialist suggests appropriate conservative, combined or surgical treatment. For women with slow-growing tumors up to 12 weeks in size and moderately severe clinical symptoms, hormonal and symptomatic therapy. The treatment regimen may include:

• Inhibitors of gonadotropin hormone secretion. The administration of antigonadotropins and GnRH agonists (gonadotropic releasing hormones) helps to stabilize and reduce the size of the nodes.
• Progestin and estrogen-gestagen drugs. Allows you to correct hormonal imbalance and stop tumor growth in women of reproductive age, stabilize the effect of GnRH and antigonadotropins.
• Androgens. For the purpose of medicinal cessation of menstrual function, it is recommended for patients over 45 years of age who are not planning a pregnancy.
• Symptomatic remedies. In the presence of pain, analgesics are prescribed; in case of metrorrhagia, hemostatic agents and drugs for uterine contraction are prescribed. According to indications, iron supplements, vitamins, mineral complexes etc.

One of the best solutions for patients childbearing age with a single or several slow-growing neoplasia measuring from 50 mm in the presence of clinical manifestations is combination therapy. The method involves performing a conservative myomectomy, before which GnRH agonists are prescribed to stabilize the growth of myomatous nodes. A course of treatment with drugs that inhibit the secretion of gonadotropic hormones is also recommended in the postoperative period to prevent relapse.

For rapidly growing subperitoneal fibroids larger than 60 mm in size, severe pain, metrorrhagia, disorders of reproductive function and pelvic organs, surgical methods are indicated. Unlike submucosal fibroids, when treating subserous neoplasms, it is not recommended to use uterine artery embolization due to high risk necrosis. Taking into account the reproductive plans of women and the characteristics of the course of the disease, various organ-preserving and radical interventions are performed:

• Laparoscopic and laparotomy myomectomy. For cutting and enucleation of subperitoneal nodes, mechanical, electrical and laser surgical instruments are used.
• FUS ablation. Despite its low invasiveness, the method is used to a limited extent. It cannot be prescribed in the presence of 6 or more nodes, large neoplasia and pedunculated tumors.
• Semi-radical and radical operations. During transvaginal, laparoscopic or laparotomic surgery, defundation, high and regular supravaginal amputation or total hysterectomy are performed.

Prognosis and prevention

Subserous fibroids are a benign neoplasm with a low risk of malignancy and a favorable prognosis. Timely detection of the disease and correct treatment tactics make it possible to restore menstrual and reproductive function. To reduce the risk of developing subperitoneal nodes and complications in the presence of a tumor, it is recommended to regularly see a gynecologist (especially in diseases accompanied by hyperestrogenemia), rationally use contraceptive methods, and undergo invasive procedures strictly according to indications.

Thousands of women across the country are diagnosed with fibroids. Developing myomatous nodes at an early stage do not show symptoms and are more often detected during a routine examination, plunging the patient into shock. The features and causes of this disease are quite diverse, so every woman is obliged to take care of her health and promptly respond to the early “bells” of the body.

Diagnosis of fibroids: what should you know about the disease?

This disease is quite common and can develop already during puberty. Therefore, the question, uterine myomatous node - what is it, women ask quite often. The most active risk group is the fairer sex from 30 to 45 years old. This age has the highest incidence, since the body of a woman in the late reproductive period and preceding menopause is subject to changes in hormonal levels.

Myomatous nodes themselves are benign tumor formations that develop in the myometrium - muscle layer uterus. They consist of chaotically located immature myocytes of the uterine walls. Neoplasms can be either single or multiple. Their size in most cases varies from 5-7 millimeters to 5-6 centimeters. However, in medical practice Cases have been recorded when a newly born myomatous node grew to enormous sizes, and its weight reached several tens of kilograms.

As for the treatment of the disease, a few years ago the only option was surgery. Nowadays, when medicine has made significant strides forward, neoplasms can be defeated using gentler methods, including with the help of drug therapy.

Causes of development of myomatous tumors

Despite active development medicine, it has not yet been possible to establish the exact causes of the development of this tumor process. Therefore, scientists are inclined to believe that the growth of myomatous nodes is a consequence of hormonal imbalance. But the factors that precede such a violation women's health, quite a lot. The main ones are:

• genetic predisposition;
• difficult childbirth;
• abortions and others mechanical damage uterus;
• row concomitant diseases, including diabetes mellitus, malfunctions thyroid gland, increased blood pressure;
• poor circulation in the pelvic organs due to a sedentary lifestyle.

Types of neoplasms

The place of origin of this disease is middle layer the walls of the uterus - the myometrium. It is here that the pathological cell, due to a number of reasons, begins to actively divide and form myomatous nodes. In medical practice, neoplasms are classified according to location and direction of growth into three main types:

The most common type of disease is interstitial (intramural) myomatous node. According to medical statistics, its share in the total number of diagnosed cases is about 60%, therefore special attention Let's focus on this type of pathology.

Features of the development of the disease

Any fibroid begins to originate precisely in the middle layer of the uterine wall - the myometrium. A myomatous node can develop quite slowly, but only until a hormonal imbalance occurs in the body due to natural age-related changes or external factors. The further direction of growth directly depends on the location of the pathology. If it is located on the border with the endometrium, then in the absence of timely therapy, the interstitial myomatous node can transform into a submucosal one. And in a location bordering on perimetry - subserous.

Thus, when diagnosed with interstitial fibroids, the choice possible method therapy should be determined immediately. Delaying treatment may lead to further development diseases and many negative consequences, such as infertility, anemia due to heavy bleeding, etc.

How to recognize the disease?

It is no secret that many women in our country ignore preventive examinations by a gynecologist, even if they require a medical examination at work. It is easier for our fair half of humanity to buy a document with seals from unscrupulous medical workers than to think about the question, uterine fibroids - what is it? But the danger of the situation is that many diseases of women genitourinary system on early stages are asymptomatic, including fibroids. Symptoms appear even when the tumor has grown to a significant size and interferes with the normal functioning of the organs of the reproductive system. At the same time, clinical signs are individual in nature and depend on the location of the tumor, its size, the presence of concomitant diseases, the age of the patient and many other factors.

Clinical picture of the disease

Possible clinical manifestations in advanced forms of fibroids are:

• heavy, painful menstruation;
• menstrual irregularities;
• bleeding during the menstrual cycle;
• pain syndrome in the lower abdomen and lumbar region;
• frequent urination;
• constipation

Myoma necrosis: symptoms and consequences

Lack of timely diagnosis and treatment of fibroids can lead to the most dangerous consequences. One of them is necrosis of the myomatous node. The death of neoplasm cells can occur due to twisting of the stalk, and, consequently, blockage of the vessels feeding the tissue. With this development of events, clinical signs are not long in coming and appear in the form of:

• cramping pain in the abdomen, radiating to the lower back and perineal area;
• difficult painful urination;
• hyperthermia;
• dysfunctions of the gastrointestinal tract;
• symptoms of intoxication.

Over time, the symptoms become more pronounced. Lack of qualified medical care for a patient in this condition can lead to irreversible processes in the body and even death.

Modern methods of diagnosing the disease

Even in the absence of symptoms, identifying an intramural myomatous node is quite simple. To do this, you must follow a schedule of preventive visits to the gynecologist. An experienced doctor will palpate and identify the tumor, and then, using mirrors and additional instruments, will assess the size of the pathological process.

When a tumor is detected, the patient is prescribed a number of additional diagnostic procedures, the first of which is ultrasound. The study is carried out using a transvaginal sensor, which allows you to clearly establish the location and assess the degree of development of the pathology. In addition, the results of such diagnostics provide the doctor with information about the condition of the endometrium, because endometriosis is a common companion to fibroids.

In most cases, when the myomatous node is located along back wall, such a study is sufficient to formulate correct diagnosis. In particularly severe or controversial situations, the patient is recommended to undergo other instrumental diagnostic studies: MRI or CT.

The choice of treatment is the prerogative of professionals

Even taking into account the fact that fibroids are a benign tumor, it is strictly forbidden to ignore them. And if, after the next medical examination, the doctor reveals myomatous nodes, you should immediately begin to restore your health and immediately begin treating the disease. Today there is no panacea that could cure fibroids like the flu in a few days, so it is better to entrust the choice of the most effective method of therapy to an experienced doctor. The specialist not only knows the answer to the question, what is a myomatous node - what is it, but also has enough experience to choose the safest and most effective treatment option for each patient.

Earlier the only way To restore women's health with uterine fibroids, surgery was necessary. However, today medicine has advanced greatly, and with small tumors it is possible to solve the problem with medication.

Surgical method of treatment

Doctors recommend removing the pathological formation when the size of the diagnosed fibroids reaches 12 or more weeks of pregnancy. Also, indications for surgical intervention may be rapid tumor growth, or bright clinical picture illness (severe pain, frequent heavy bleeding etc.). But even if the doctor recommends removal of myomatous nodes, this is not yet a reason for concern. Modern surgical capabilities are quite extensive, so the consequences of the operation will be insignificant.

Types of surgical intervention for uterine fibroids

Today, the following surgical treatment methods are used for uterine fibroids:

• Laparoscopic myomectomy. It is performed using a highly sensitive device (laparoscope) through small incisions on the abdominal wall. The advantages of this method include fast recovery, preservation of the uterus and the ability to plan a pregnancy after the established period of rehabilitation.
• Hysteroscopic myomectomy. Allows you to completely remove the myomatous node using a hysteroscope, which is inserted through the vagina into the uterine cavity. Surgery is indicated for patients with submucous fibroids.
• Laparotomy myomectomy. The tumor is removed through an incision in the abdominal wall. Nowadays, such an operation is performed exclusively in extreme cases, since the postoperative period is quite long and difficult for the patient.
• Hysterectomy. A technique that involves complete removal reproductive female organ. It is carried out in especially severe cases, when a large myomatous node is diagnosed, the symptoms of the tumor threaten the health and life of the patient, and the localization of the fibroids does not allow for a more gentle operation.
• Arterial embolization. A fairly effective treatment method that involves blocking blood flow in the artery supplying the fibroid. There is a risk of developing an infection, which can provoke necrosis of the myomatous node. In addition, the postoperative period is accompanied by severe pain.
• FUS ablation. It is carried out through hardware irradiation of the tumor process with ultrasonic waves. The method is contraindicated for multiple myomatous nodes, and is also contraindicated for women planning pregnancy in the future.

Drug therapy

At early diagnosis neoplasms, conservative treatment allows women to take control pathological process in your body, and even bear the desired child. Such therapy is possible only in cases where the fibroid is localized exclusively in the myometrium, is characterized by a slow rate of development, and also has a relatively small sizes(up to 12 weeks of pregnancy).

This method of therapy is based on taking hormonal drugs to restore proper functioning. female body. In combination with these drugs, doctors prescribe symptomatic medications in each specific case.

Drugs for drug therapy of fibroids

• Antigonadotropins. Helps slow down and stop tumor growth. Most often from this group, doctors prescribe the drug Gestrinone to patients. It is indicated for women who have a medium-sized intramural myomatous node.
• Gonadotropic releasing hormone agonists. Drugs in this group have complex pharmacological action. They are prescribed to women to reduce the level of sex hormones, causing a condition similar to menopause. Systematic use of these medications can significantly reduce the risk of uterine bleeding and partially relieve pain. Most often, drugs from this drug group are prescribed: Triptorelin, Goserelin, Buserelin or Zoladex. After completing the course of therapy menstrual cycle quickly returns to normal.

Subserous node - benign neoplasm in the uterine cavity, formed from muscle and connective tissue. Although it resembles a tumor, it is not one. Rather, it is a tumor-like growth that forms on the anterior or posterior wall of the uterus.

Although subserous myomatous node is not related to the carcinogenic process, it can be extremely dangerous for a woman. Treatment of the disease depends not only on the stage of its development, but also on the causes that provoked it. They need to be studied first.

Subserous myomatous node: causes of occurrence

Subserous uterine fibroids are also called subperitoneal fibroids because of their location. As a rule, the neoplasm does not leave the muscular layer of the reproductive organ (interstitial or intramural myomatous node). The beginning of the process of its formation can be facilitated by:

• hormonal imbalance;
• frequent artificial termination of pregnancy;
• menopause;
• ovarian pathologies;
• regular and severe stress;
• chronic diseases of the genital organs of an infectious nature;
• problems with the thyroid gland;
• overweight.

Also, a subserous node of the uterus can occur if a woman refuses to breastfeed. Artificial birth or the absence thereof is another predisposing factor to the development of subserous interstitial fibroids.

Therefore, it is extremely important for young girls to think about natural childbirth And breastfeeding baby. Terminating a pregnancy or transferring a baby to artificial nutrition are already extremes that must be taken in the absence of an alternative.

What does an interstitial subserous myomatous node look like?

Subserous myomatous node can be single, but it can also be multiple. If the neoplasm is located in the myometrial region, it is called interstitial (intramural). When a tumor-like element is localized in the subperitoneal space, it is called a subserous node.

The subserous-interstitial node of the uterus grows from the myometrium towards the peritoneal space. It can have either a wide base or a rather thin leg. The sizes of such neoplasms vary - from several mm to 10 cm.

The localization of subserous intramural fibroids is different, however, the most favorable and easily treatable tumor is considered to be a tumor located on the anterior or posterior wall of the genital organ. If it is located in the cervix or fallopian tubes, this can lead to infertility. The fact is that such a node significantly narrows the lumen for sperm to penetrate into the cavity of the reproductive organ.

A single subserous intramural node with fibroids looks like a growth enclosed in a muscle capsule. It is attached to one wall of the uterus - posterior or anterior.

Multiple growths can be localized on both walls and have different sizes. In the absence timely treatment Torsion of the legs of one or several fibroids may occur, which can lead to serious complications.

Interstitial subserous fibroids: symptoms and signs

A subserous node with uterine fibroids can cause various ailments, the severity of which depends on its location and size. Thus, an intramural tumor-like growth, which reaches a size of 2-4 mm in diameter, does not cause any abnormal changes in the patient’s well-being.

However, the node can not only enlarge, but also periodically become inflamed, which often causes the appearance severe pain lower abdomen, pulling sensations in the lower back, abundant vaginal discharge white, reddish or brownish in color. Menstruation becomes more painful and prolonged, sometimes large amounts are discharged. blood clots(if the interstitial node in the uterine cavity has reached a large size).

Myoma, located on the back wall of the reproductive organ, and rapidly growing, begins to put pressure on adjacent internal organs. First of all, the pathological process affects the rectum, as a result of which the patient experiences frequent and prolonged constipation, discomfort or pain during bowel movements.

If the intramural subserous node is located on the anterior wall of the reproductive organ, then its enlargement puts pressure on the bladder. This causes frequent (often false) urges to urinate, and emptying the bladder becomes a rather painful process.

Does a subserous intramural node affect pregnancy?

Uterine fibroids are a real challenge for expectant mothers. Since there are known cases of spontaneous termination of pregnancy due to the rapid growth of a tumor, women’s fears are not unfounded. However, if the subserous node with fibroids is quite small and there are no prerequisites for its enlargement, there is no need to worry. Many women successfully carry and give birth completely healthy babies, after which they move on to the issue of treating pathology.

If there are multiple subserous nodes located on both walls of the genital organ, this means that expectant mother is at risk of premature birth or miscarriage. In the second and third trimester, in addition to the risk of miscarriage, heavy uterine bleeding. They happen different intensity, however, do not reduce the risk of serious complications.

Treatment of interstitial-subserous fibroids

Therapy for the presence of a myomatous node in the cavity of the reproductive organ depends on several factors:

• size;
• presence or absence of a leg;
• symptoms;
• the presence of complications or the risk of developing them.

At severe course diseases resort to surgery to remove the node. In young women, gentle surgery is often performed to help preserve reproductive function.

In the early stages of the disease, it is possible to carry out a course conservative treatment based on the use of hormonal medications.

But since in most cases the interstitial-subserous node is detected already in the later stages of the development of the pathology, it is rarely possible to do without surgery.

So, if the patient plans to conceive and give birth to a child in the future, she undergoes laparoscopy, during which only the pathological tumor is excised. It is removed through special punctures made in the peritoneum. The reproductive organ is not affected.

Another modern type of operation used for myomatous tumors is UAE. Embolization of the uterine arteries involves stopping the blood supply to the node, as a result of which it significantly decreases and stops growing. Sometimes the tumor can even resolve on its own.

If the disease progresses and the woman’s well-being rapidly deteriorates, doctors resort to radical surgery– hysterectomy. This type of surgery involves complete removal of the uterus, which eliminates the possibility of pregnancy. However, this method of treating myomatous neoplasms is used extremely rarely.

Complications of pathology

In the absence of adequate treatment, interstitial-subserous neoplasm can have quite unpleasant and dangerous consequences. These include:

• torsion of the leg of a fibroid tumor;
• anemia developing against the background of intense bleeding;
• tissue necrosis of the stalk of the tumor-like formation;
• termination of pregnancy in the early stages;
• premature birth;
• infertility.

When the first warning signs This pathology should be examined by a doctor. In the early stages, the disease is easily treatable using methods traditional medicine in combination with hormonal drugs, so don’t miss your chance to recover without surgery and significant health consequences.

In recent years, women are increasingly faced with diseases reproductive system. Pathologies may have various reasons origin, ranging from poor ecology to lack of childbirth and frequent abortions. Myomatous nodes have become a fairly common tumor. They appear most often during reproductive age. However, during this period they may simply not be detected. However, by the time menopause and menopause occur, many symptoms of this disease appear.

Whether to treat myomatous nodes or not is a matter for each woman personally. However, it is worth showing the tumor to a doctor. In most cases, the pathology does not develop into malignant tumor, however, such a possibility still exists. This article will tell you about what a myomatous node can be. You will find out the specific location of the tumor. Also find out how you can cure uterine fibroids.

Nature of the tumor process

A myomatous node formed on the reproductive organ or in its cavity is a benign formation. The size of this pathology is calculated in weeks of pregnancy. Small myomatous nodes most often do not manifest themselves at all. However, as the size increases, a woman begins to notice various signs. Most often these include the following:

• stomach ache;
• delayed menstruation or prolonged bleeding;
• (for large formations);
• constipation and intestinal obstruction;
• pathologies of the urinary tract and so on.

Myomatous nodes usually have a round shape and consist of intertwined muscle fibers. They can be single or multiple, located on a thin stalk or sit tightly on the surface of the reproductive organ.

How are uterine fibroids detected?

This pathology is common cause contacting a gynecologist. Almost 250 women out of 1000 are diagnosed with fibroids at the next examination. The way to detect a tumor can be different.

If the size of the tumor is less than 2 centimeters in diameter, then it can only be seen during an ultrasound examination. If multiple lesions appear and intensive growth occurs, an experienced gynecologist can make a similar diagnosis by palpation. Also, uterine fibroids are often detected during computed tomography and magnetic resonance imaging.

Types of fibroids

As you already know, a tumor can be single or multiple. In addition, there is an additional classification that allows you to divide pathology into methods of its formation. Types of tumor can be as follows:

• submucosal myomatous node (submucosal neoplasms with a thin stalk);
• interstitial or intramural formation (intermuscular pathologies located in the wall of the reproductive organ);
• subserous type (located on the outer wall of the uterus and often has a stalk);
• intraligamentary tumor (node ​​located on or between ligaments).

In addition to those listed, cervical and nascent nodes are less common. In this case, the tumor body is located in or simply hangs into it.

Is it necessary to treat the pathology?

Myomatous node treatment can be different. It all depends on where the tumor is located. The presence of symptoms of the disease also plays an important role. If a woman does not express any complaints, then the doctor most often recommends simply observing the tumor. In this case, regular examinations are prescribed and ultrasound examinations. When the tumor begins to gain momentum and increase in size, treatment is mandatory.

Correction can be carried out in several ways. Removal of fibroids is often recommended. However, for this there must be certain indications ( enhanced growth, presence of complaints, and so on). In addition, the doctor can choose conservative therapy. However, it does not always give a positive effect. Often, after hormonal correction, tumor growth begins to increase, and it becomes even larger than at the very beginning. Let's consider the main methods of treating myomatous nodes.

Drug therapy

Most often, specialists prescribe hormonal drugs containing gonadotropin-releasing hormone agonists. This group of drugs helps reduce the production of estrogen. Due to this, tumor growth is reduced. However, after discontinuation of the drug, a reverse enhanced effect may occur. At the same time, the size of the tumor begins to increase rapidly and reaches its previous size. Often, a subserous myomatous node can enlarge its stalk and twist it.

In addition to hubbub, it can be prescribed. It promotes thrombosis of some vessels. As a result, the nutrition of the tumor is disrupted. The subserous myomatous node and others may die completely. However, this does not guarantee that there will be no relapse.

Often drug therapy used before surgery. In this case, the effect of treatment will be maximum.

Arterial emobilization

This procedure allows you to cure both interstitial myomatous node and other types of tumor. It is performed exclusively within the walls of a hospital. It does not require the use of anesthetics or prolonged hospitalization.

The patient is injected into femoral artery a catheter that, under X-ray observation, penetrates one of the uterine vessels. After this, a drug is infused to block blood flow. The consequence of this is clogging of the arteries that feed the fibroids. There is no need to worry about the condition of the reproductive organ during this treatment. Blood will flow to it through the remaining arteries and small vessels.

Ultrasonic exposure

Intramural myomatous node, like other types of similar tumors, can be cured by exposure to ultrasonic waves. The procedure does not require pain relief or hospitalization.

During the manipulation, the woman lies on the table, and the doctor directs the flow of waves to the pelvic area. The operation is performed under the control of an ultrasound or MRI machine. Radiation waves help heat tumor tissue. In this case, neighboring organs are not damaged. Under this influence, the node dies and its structure is replaced

This method treatment is used in young women and nulliparous representatives of the fairer sex. The manipulation is quite new and expensive. Unfortunately, not everything is yet medical institutions have the opportunity to conduct similar treatment.

fibroid removal

Doctors recommend removing the subserous myomatous node surgical method. This formation is located on the outer wall of the reproductive organ. Most often, the tumor has a thin stalk that can twist. Also, this neoplasm can affect the functioning of neighboring organs: fallopian tubes, ovaries and intestines. The operation to remove such a tumor is performed under general anesthesia. In this case, a laparoscopic or laparotomic method can be used. Using special instruments, the doctor excises the base of the fibroid stalk and removes the damaged tissue.

Interstitial myomatous node can also be removed in a similar way. However, this damages the tissues of the reproductive organ. A so-called resection of the mucous membranes occurs. Such a correction can have quite disastrous consequences, especially if a woman is planning a pregnancy. That is why young patients are recommended to choose more modern techniques treatment.

Removal of the uterus

If large myomatous nodes are detected, the woman is advised to remove the reproductive organ. However, it is worth taking into account the patient’s age and whether she has children. Of course, if possible, the doctor tries to preserve the uterus. However, this does not always work out.

It is performed when there is extensive damage to the mucous membranes and the presence of symptoms that interfere with normal life. The operation is performed under general anesthesia. In this case, the woman is hospitalized for several days.

What is the difference between subserous fibroids and interstitial nodule?

These tumor formations differ in their location and influence on the functioning of the female body. So, the subserous node is located in the abdominal cavity. However, it does not cause frequent bleeding, in contrast to interstitial fibroids. Also, the tumor does not affect pregnancy and the process of conception. With such a disease, hormonal imbalances rarely occur. Whereas an interstitial tumor leads to anemia, large blood loss and frequent pain in the pelvis.

Consequences of fibroids

Most often, timely detected and treated pathology does not cause any consequences or complications. If you have identified small nodes, then correction can be postponed indefinitely. In this case, it is necessary to carefully monitor the growth of the tumor.

If you don’t care about your health and don’t pay attention to uterine fibroids, then they can quickly increase in size and lead to infertility. Also, pathology has the possibility of degeneration into malignant form, however, this happens very rarely.

Frequent bleeding and disruptions in the body’s functioning negatively affect a woman’s well-being. That is why, if a disease is detected, you need to contact a gynecologist as soon as possible. Women over forty years old should regularly visit ultrasound rooms and undergo preventive examinations. This will allow you to identify a possible tumor in time and begin treatment.

Summing up

You now know a lot about uterine fibroids. Many women become pregnant safely and give birth with this pathology. However, during pregnancy the tumor may become larger and pose a threat to the life of the fetus. Those women whose mothers and grandmothers suffered from uterine fibroids are more likely to develop this pathology.

Take care of your health. If you have questions or symptoms of illness, contact your gynecologist for advice. If necessary, the doctor will prescribe additional research and recommend treatment. Good health to you!

Among benign formations occurs quite often.

It has many varieties - some tumors develop inside the uterus, others are located on the outer layer of the uterine body, and others form in the muscular layer of the organ. One of these types is subserous myomatous tumor.

What is subserous uterine fibroid?

Typically, such formations have a fairly wide base, connected to the uterine tissues through a thin stalk. This leg is a kind of channel through which nutrition for the tumor passes. The nodule can be single in nature, although multiple small formations are also found.

Such myomatous tumors are found more often in women of reproductive age. They grow slowly and develop latently. Subserous myomatous tumor is dangerous due to torsion of the pedicle, which results in necrosis of tumor tissue.

Causes

The main factor contributing to the development of benign subserous tumors in women is changes in the hormonal status of women.

According to doctors, the tumor is not capable of forming in healthy body, therefore, for its development specific prerequisites are needed such as:

1. Operative manipulations in women's genitourinary organs. This category includes various diagnostic curettages, abortions, laparoscopic examinations, etc. These interventions injure the uterine muscle tissue what provokes the formation of a tumor;
2. Genetically determined predisposition to this pathology;
3. Presence of a history of operations on;
4. Various types of inflammation or infection in the genitourinary area;
5. Long-term contraception with hormonal contraceptives;
6. Tumors in the appendages or mammary tissues;
7. Functional problems in the thyroid and adrenal structures.

Typically, the causes of the disease are a group of factors that, to varying degrees, influence the formation of the myomatous process in the uterine body.

Clinical picture

Externally, a subserous tumor looks like a node. This type of myomatous formations is considered the safest, since it differs in its external uterine localization and grows towards the retroperitoneal space. Such a tumor does not provoke an increase in the uterine body and cannot affect the menstrual cycle.

Such a formation does not harm pregnancy, which occurs without difficulties with such a disease; a subserous formation cannot harm delivery, however, it is quite capable of causing a spontaneous miscarriage.

Sometimes reproductive difficulties occur if the formation is located in close proximity to the tubes and compresses them.

Since the formation grows into the abdominal space, it develops mainly without symptoms, at least during the period while the node is of insignificant size. When the formation grows, it begins to compress the surrounding tissues and organic systems, which leads to their functional disorders.

In general, subserous myomatous formation can be characterized by the following symptoms:

• Frequent constipation;
• Hemorrhoidal inflammation;
• Difficulty and frequent urination, causing pain;
• Hyperthermia
• Hypersweating, dizziness;
• Discomfortable sensations in the abdomen and lower back when sitting or standing;
• Pain symptoms aching character, localized in the area above the pubis, in the lower back, and lower half of the abdominal wall.

Painful symptoms tend to occur against the background long stay“on your feet”, long walks or heavy physical activity. Often the pain becomes cramping in nature, which indicates the development of an exacerbation or active growth of the tumor.

The severity of pain symptoms is usually determined by the parameters, location and development of the myomatous node. If the tumor fuses with the abdominal wall, the patient will constantly suffer from pain.

Varieties

Subserous myomatous nodes can be multiple or single.

Single ones are distinguished by the presence of a shell like a capsule.

Multiple formations are found somewhat less frequently, but they are accompanied by more severe painful symptoms.

If multiple myomatosis acquires large sizes, then compression of neighboring structures occurs, which disrupts their activity. In addition, they are divided into interstitial or intramural uterine fibroids.

Intramural

Intramural subserous fibroids are localized on the outer uterine layer. This formation is considered the “safest”, since it does not affect the size of the uterine body and the menstrual cycle, and does not interfere with reproductive abilities.

Such a tumor is formed from smooth muscle fibers, as well as connective tissue structures. It is believed that such fibroids occur in a kind of lighter version.

Interstitial subserosal

The subserous-interstitial myomatous node is formed in the thickness of the wall of the uterine body, but grows towards the small pelvic cavity. Such a formation belongs to the category of mixed tumors and is somewhat different from a traditional subserous tumor.

It develops in the muscle layer, and therefore leads to a slight increase in the body of the uterus. An interstitial subserous myomatous node can negatively affect surrounding tissues, but its size rarely exceeds 10 cm.

Stages

Experts stage the development of such myomatous formations into several stages:

1. First stage – active growth is observed, the tumor is characterized by the full course of metabolic processes and increased vascular permeability;
2. Second the stage is characterized by rapid progression, but it is still impossible to detect a formation without microscopic examination;
3. On the third stage, myomatous formation is easily detected during a medical examination.

Typically, such tumors are of a multiple nature, when several formations develop simultaneously.

How dangerous is this disease?

The danger of subserous fibroids lies in the high probability of torsion of the pedicle, through which the formation receives the necessary nutrition. This complication is usually caused by atrophic changes in tissue.

As a result of such changes, necrosis of tumor tissue occurs, provoking purulent-inflammatory processes in nearby structures.

Tissue death is usually accompanied by hyperthermic symptoms, intense pain, severe tachycardic symptoms, excessive sweating, dizziness and other intoxication symptoms.

Diagnosis and treatment

When diagnosing subserous myomatous formations, the following diagnostic measures are most often used:

• Echography;
• Magnetic resonance imaging, which allows you to obtain a layer-by-layer image of the tumor;
• Diagnostic curettage in this case is carried out to determine changes in the mucous uterine tissues;
• Hydrosonographic diagnostics - allows you to detect even the smallest tumors and determine the degree of their development;
• Laparoscopic examination is used if it is impossible to differentiate the pathology.

Most often, treatment of the subserous form of uterine fibroids is surgical, especially in the presence of large formations, heavy blood loss, torsion of the pedicle, rapid growth and progression of the tumor.

In the photo, removed subserous uterine fibroids

To carry out surgical procedures, several common techniques are used, such as laparoscopic myomectomy, which involves removing the tumor through several punctures through enucleation.

In addition, hysteroscopic myomectomy is used, when the node is removed through the vagina. IN difficult cases the formation is removed along with the appendages and uterus, i.e. a total hysterectomy is performed.

In recent years, it has become widely used, which involves removing a tumor using ultrasound.

Treatment with folk remedies

Among traditional methods treatment of subserous uterine fibroids, healing ointments, extracts, medicinal tinctures or vaginal suppositories. Usually, for the preparation of such medicines, raw materials are used in the form of poisonous plants that have antitumor activity.

Therefore, such medications should be taken with extreme caution. Experts do not rule out the presence therapeutic effect from such healing remedies of traditional medicine, however, they are recommended to be used as additional therapy and in the absence of contraindications.

Prognosis and prevention

Subserous forms of myomatous formations differ high rate benign, therefore they do not have a tendency to malignancy. The forecasts are generally positive, however, if there is rapid growth and progression of the pathology, surgical intervention may be necessary.

Even benign tumors can significantly ruin a woman’s life and deprive her of opportunities for motherhood. Therefore, it is necessary to contact a specialist when the first suspicion of pathology appears.

Annual gynecological examination will serve as an excellent prevention of the neglect of such tumors, since it allows them to be differentiated in a timely manner.

In addition, to prevent myomatous formations, it is necessary to avoid abortions, give birth and breastfeed a child until the age of 30, promptly treat gynecological problems, monitor hormonal status, and avoid long-term hormonal contraception.

This is the only way to protect yourself from the occurrence of serous uterine myomatous formations, and, therefore, to avoid possible complications such as infertility, purulent-inflammatory processes in the uterus and total hysterectomy, which deprives the patient of a chance for successful motherhood.

The video shows laparoscopic surgery for subserous uterine fibroids: