Nodular fibromyoma of the uterus. Is uterine fibroids dangerous? When is surgery needed and what alternative treatments are available? nodular 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 abdomen in size, pain during sexual 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 bladder and causes urination disorders (incontinence, frequent urges). A retrocervical fibroid puts pressure on the rectum and causes bowel problems (such as constipation). 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 ligaments that support the uterus in 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, use additional research: 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 (uterine body) to them. It also plays a certain role hereditary factor. 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.

Fibroma of the uterus is benign education growing in muscle layer reproductive organ. The disease develops over many years long time is asymptomatic and accompanied clinical manifestations predominantly between 30 and 50 years of age. The tumor grows throughout the reproductive period and regresses at menopause. The nature of the course of the disease is determined by the size and location of the nodes, their number and the presence of concomitant pathology.

By clinical course fibromyoma is no different from uterine fibroids. The difference is known only to the doctor ultrasound diagnostics and a pathologist. These specialists can recognize fibroids and give detailed description tumors. special histological structure node has some effect on the course of the disease and prognosis, but is not a key factor in choosing a method of treatment - both conservative and surgical.

Such a different uterine fibroids

AT national leadership for obstetricians-gynecologists, it is indicated that fibroids are a benign hormone-sensitive proliferate, consisting of altered smooth muscles of the myometrium. The terms "fibroma", "fibromyoma" and "leiomyoma" are claimed to be synonymous. By and large, this is true. In routine practice, the district gynecologist does not have special significance what kind of tumor grows in the uterus - leiomyoma or fibromyoma. The causes, symptoms, methods of diagnosis and treatment for each of these pathologies will be similar.

Since benign tumors have a lot in common, in everyday life both gynecologists and patients can call these pathologies fibroma, myoma, fibromyoma, and leiomyoma.

Histologists and pathologists do not agree with this interpretation and point out that fibromyoma is a tumor, which includes both muscle and connective tissue fibers in approximately the same proportion. These specialists divide all benign tumors of the uterus into two types:

• Leiomyoma - a node, mostly consisting of muscle tissue;
• Fibroma is a tumor in which more than 50% is occupied by connective tissue fibers.

Fibromyoma of the body of the uterus is an intermediate condition in which the amount of muscle and connective tissue in its composition is approximately equal. AT International classification diseases (ICD-10), all these conditions go under one code - D25, since for a practicing gynecologist the difference between them is insignificant and is more of a research interest (in histology and pathological anatomy).

On a note

Under the term "myoma" any kind of tumor can be hidden, and only tissue analysis will show what kind of node is in the uterus.

To determine the type of myomatous node, it is necessary to analyze the tissues of the tumor.

Causes of the disease and key risk factors

The condition preceding the appearance of a uterine tumor is considered fibromatosis. This term refers to the diffuse growth of pathological foci. It is impossible to single out one node among the rudiments of fibroids. The uterus slightly increases in size, but does not deform. At this stage, the disease is usually asymptomatic and detected incidentally during an ultrasound scan.

The appearance of a fibromatous node is preceded by the following conditions:

• Previously sexual development: the onset of the first menstruation before 12 years, the appearance of secondary sexual characteristics before 9 years;
• Refusal to have a child. The likelihood of developing the disease increases in nulliparous women over the age of 30;
• Late first birth (30-45 years);
• Postponed abortions or miscarriages. A single termination of pregnancy can also provoke the growth of a myomatous node, but more often we are talking about the numerous scrapings of the uterine cavity that accompany this process;
• Instrumental interventions on the reproductive organs;
• Transferred operations on the uterus;
• Traumatic and prolonged childbirth;
• Overweight and obesity;
• Prolonged stressful situations.

Obese women are more likely to develop uterine fibroids.

All these conditions provoke an increase in the level of estrogen in the body and thereby trigger cell proliferation. In the course of repeated cycles of hyperplasia, there is an accumulation of phenotypically altered smooth muscle cells, from which the embryo of fibroleiomyoma is subsequently formed. In the medical history of a woman with a uterine tumor, there is almost always data indicating a burdened gynecological history. Pathology is also detected in nulliparous young patients, but such cases are much less common.

On a note

Pelvic inflammatory disease is also considered a risk factor for developing fibroids. Endometritis does not increase estrogen levels, but weakens immune defense organism and contributes to the violation of apoptosis - natural programmed cell death. Proliferation of myocytes leads to the appearance of fibromyoma rudiments and further to its active growth.

In modern gynecology, attention is paid not only to estrogen, but also to progesterone - another female hormone. Studies have shown that the tumor grows during pregnancy, as well as when prescribing gestagens (Dufaston, Utrozhestan). In this regard, the period of gestation, as well as the use of hormonal drugs, should be attributed to risk factors for the development of the disease.

Practice shows that fibromyoma continues to grow during pregnancy.

Other theories of the appearance of fibroids deserve attention:

• Frequent ovulation. modern woman gives birth to a child once or twice. The rest of the time in her body there is a monthly maturation of follicles, the formation of dominant among them and ovulation. The uterus prepares each cycle for possible pregnancy, building up a layer of the endometrium. Muscle tissues also proliferate, which provokes their uncontrolled growth and the appearance of a tumor;
• Injuries and operations on the uterus. Damage to myometrium tissues can lead to its incorrect restoration and activation of cell division, which also provokes the appearance of a myomatous node.

There is no difference in the development of leiomyoma and fibroma. The reasons for the appearance of each type of tumor are the same. At a certain stage of proliferation, more connective or muscle fibers accumulate in the tissues of the node, and this determines its type.

It is important to know

Benign tumors of the uterus grow in reproductive period and almost never seen in adolescents. Fibromyoma in a virgin is a rarity. In practice, such situations occur if the patient remains a virgin at the age of 25 years and older. Gynecologists call irregular sexual life or its absence is one of the risk factors for the development of uterine fibroids.

The photo below shows the types of fibroids:

• Subserous - is close to the outer layer, can protrude beyond the uterus on the leg;
• Interstitial - located inside the walls of the body;
• Submucosal - enters the uterine cavity.

Particularly distinguish nodes located in the cervix or exiting the vagina.

Types of myomatous nodes depending on their localization.

Clinical picture of the disease: how to understand that there is a tumor in the uterus?

The following diagnostic criteria help to suspect the development of the disease:

• Change in the nature of menstruation. If menstruation has become abundant and prolonged, you should undergo an ultrasound scan and find out if there is any in the uterus benign tumor. The nodes located submucosally or intramurally change the nature of menstruation, increasing their duration and volume. Often there are drawing pains in the lower abdomen and in the lower back, which pass after the completion of bleeding. Subserous tumors do not affect menstruation and remain asymptomatic for a long time;
• Uterine bleeding. If heavy menstruation does not end, the volume of blood loss increases, the woman's condition worsens, you should get an appointment with a doctor (in case of heavy bleeding, call ambulance). This symptom occurs in many gynecological diseases, and fibromyoma is only one of the likely diagnoses;
• Intermenstrual acyclic bloody issues. A similar sign can indicate both fibroids and endometrial hyperplasia, so you can’t do without consulting a doctor. Acyclic bleeding occurs mainly in interstitial multiple formations, when almost the entire muscular layer of the uterus is deformed and is not able to fully contract;
• Chronic pain syndrome. Pain is not the main symptom of fibroids. This tumor often makes itself felt by menstrual irregularities. On the early stages there is no pain, and only with the growth of the node do unpleasant pulling sensations appear in the lower abdomen. The pain can be given to the sacrum and lumbar region, felt in the thigh and perineum. With large sizes of fibroids, tingling is noted under the ribs, in the epigastric region;
• Weight gain and belly growth. Occurs in large and giant tumors. Fibromyoma can reach a significant size up to the size of a full-term pregnancy, and it is impossible not to notice such a formation.

One of the signs of the presence of a large fibromyoma in the uterine cavity is an increase in the size of the abdomen in a woman.

Fibromyoma is dangerous for its complications that occur with the rapid growth of the node and the refusal of therapy. A tumor in the uterus can provoke the development of such conditions:

• Feeling unwell, general weakness, tinnitus, heart palpitations and dizziness are all signs iron deficiency anemia. Iron deficiency occurs against the background of blood loss during menstruation or in the middle of the cycle, after heavy bleeding. This condition may be accompanied by a decrease blood pressure and fainting;
• Frequent urination. Occurs with subserous tumors that press on the bladder. Giant formations can block the lumen of the ureter or urethra and lead to acute urinary retention;
• Constipation is another sign of subperitoneal fibroids pressing on the rectum. In advanced cases, the tumor can lead to intestinal obstruction;
• Severe abdominal pain occurs with torsion of the fibromyoma stem and the development of necrosis. The pain becomes cramping, there may be bloody discharge from the vagina, fever, nausea and vomiting;
• Cramping pains radiating to the perineum indicate the birth of a submucosal node. Expulsion of the tumor is accompanied by bleeding.

The emerging myomatous node and its exit into the vaginal cavity causes a woman severe pain reminiscent of labor contractions.

Pregnancy with fibromyoma: what determines the prognosis?

It is important for all women who dream of motherhood to know:

• It is possible to conceive a child with uterine fibromyoma. A small tumor does not interfere with fertilization and gestation;
• The best prognosis is given with subserous formations. Myoma, located outside the uterus, practically does not interfere with the course of pregnancy;
• Submucosal nodes are unfavorable for motherhood. A tumor that enters the uterine cavity deforms it, prevents fertilization and childbearing. With submucosal formations, miscarriage often occurs for up to 12 weeks;
• Fibromyoma during pregnancy can grow, increasing to a quarter of its original size. The maximum growth of the node is noted in the first half of gestation;
• During pregnancy, the blood supply to fibroids is disrupted, which can lead to tumor necrosis and require urgent surgery.

It is important to know

Gynecologists advise to undergo a complete examination before pregnancy, in order not only to identify the tumor, but also to receive treatment before conceiving a child. Competent therapy will reduce the risk of complications and increase the chances of a favorable outcome.

Since fibroids can grow during pregnancy, it is better to do a full examination in advance and undergo the prescribed course of treatment.

Why does the tumor grow

Fibromyoma has one feature - it grows rather slowly. Connective tissue fibers do not proliferate too quickly, so such a tumor may not change for years. Slower increases in size only fibroma - a node, more than 50% consisting of connective tissue. Leiomyomas - muscle formations - are characterized by rapid growth.

Node resizing is affected by the following states:

• Pregnancy and childbirth. Some fibroids grow during gestation, while others shrink. It is noticed that at small nodes the probability of their regression is somewhat higher;
• Abortions and miscarriages. Any hormonal changes and surgical interventions on the uterus threaten the uncontrolled growth of the node;
• Climax. With the onset of menopause, the production of sex hormones decreases, which leads to a natural regression of the tumor. If the formation increases after the onset of menopause and grows after the age of 50-60 years, you should immediately be examined by a gynecologist. Such symptoms occur during the formation of sarcoma - malignant tumor uterus;

During menopause, benign neoplasms, as a rule, tend to decrease. If the tumor grows, it may be a sign of malignancy of the tumor.

• Taking hormonal drugs. Some drugs cause fibroids to shrink in size, while others help them grow.

The effect of heat on the growth of fibroids has not been proven, but doctors do not advise their patients to get involved in procedures related to warming up the body. If seen fast growth education (more than 4 weeks a year), you can not play sports, spend a long time on the beach, go to the bathhouse, sauna, solarium.

It is important to know

In recent years, fibroids have ceased to be considered as a precancerous condition, but oncological alertness remains. Sarcoma and fibroids are accompanied by the appearance of similar symptoms, so it is possible to distinguish one condition from another only after complete examination. Fibroma cannot degenerate into cancer, but the possibility of simultaneous development of a malignant tumor in the altered or intact myometrium is not ruled out.

Tactics for suspected fibromyoma

To detect a tumor is carried out:

• Examination by a gynecologist. With a bimanual examination of the uterus, the doctor pays attention to its increase, the presence of nodes. With tumors of small sizes, no significant changes are observed;
• Laboratory examination for myoma is not indicative. The doctor may recommend doing a blood test for hormones to identify comorbidities, determine tumor markers if sarcoma is suspected;
• Ultrasound procedure. On ultrasound, the fibromyoma is seen as a hypoechoic formation. During the examination, areas of connective tissue are determined, occupying up to 50% of the tumor;
• Hysteroscopy. Allows you to identify submucosal nodes, distinguish them from polyps, take an aspirate from the uterine cavity, conduct diagnostic curettage;

One of the types of diagnosis of neoplasms in the uterus is hysteroscopy, with which you can see pathological changes and take a tissue sample.

• Laparoscopy. It is indicated for subserous formations, compression of the pelvic organs by a tumor;
• Histological examination of a macro- and micropreparation is carried out after removal of the node. Allows you to identify the type of tumor, distinguish malignancy from benign.

On a note

Myoma of the uterus is often accompanied by another pathology reproductive organs(polyps and endometrial hyperplasia, adenomyosis, ovarian cysts). Also, the examination often reveals mastopathy, pathology thyroid gland(hypothyroidism).

Principles of therapy: how to be treated?

At a reproductive age, fibroids cannot resolve themselves, so sooner or later, a patient with fibromyoma will need therapy. The choice of treatment method depends on the size of the node. All educations are divided into several types:

• Small: up to 2.5 cm and up to 5-6 weeks of uterine enlargement;
• Medium: 2.5-5 cm and 6-12 weeks;
• Large: from 5 cm and from 12 weeks.

The ultrasound image shows a large tumor.

Tumor size is important for selection drug therapy, as well as determining the method of operation. Characteristics of fibroids, depending on its size, are presented in the table.

12 important questions about fibroids:

1. Do I need to stop fibromyoma? Yes, if the tumor grows, is accompanied by the appearance of clinical symptoms, interferes with a full life and the conception of a child;
2. Can the disease be cured without surgery? If the tumor is less than 3 cm in diameter, hormonal drugs are prescribed to reduce the size of the node. Medications do not lead to a complete regression of fibroids, but they inhibit its growth, help buy time for pregnancy and childbirth, or allow you to reach menopause;

In certain cases, hormonal drugs can stop the growth of small fibroids.

1. Should fibroids be removed before pregnancy? Yes, if it is a tumor larger than 2.5 cm and it prevents the conception and bearing of a child;
2. Is surgery always necessary for a benign neoplasm? No, with small node sizes, you can get by conservative methods- taking hormones;
3. What is the best way to treat a tumor - pills or injections? Priority is given to injectable depot forms - one injection is valid for 28 days;
4. Do I need to remove fibroids in menopause? Yes, if the tumor grows, provokes bleeding and leads to the development of other complications;
5. Can the disease be cured by outpatient radio wave surgery? No, this method is not used in the treatment of uterine tumors;
6. If fibroid is not removed, will it turn into cancer? No, a tumor of the muscular layer of the uterus almost never transforms into a sarcoma, and even the rapid growth of a node does not always indicate an oncological process;
7. Can myoma be cured? folk remedies(ASD-2, decoctions of herbs - upland uterus, red brush, celandine, half-burnt, etc.)? Non-hormonal drugs they cannot make fibroids disappear, but they help strengthen immunity and increase the chances of a favorable outcome of the disease;

Some means traditional medicine have a positive effect on immune system, however, are not able to completely get rid of the tumor.

1. Are suppositories with antiseptics and antibiotics used for fibroids? No, such drugs do not affect the growth of the node, but can be used to treat comorbidities;
2. How long is sick leave after removal of a benign tumor? Depending on the type of surgery sick leave issued for a period of several days to 1.5-2 months;
3. Is there disability after removal of fibroids? At favorable outcome The operation removes only the tumor, and after recovery, the woman can return to her usual life. Disability can be given with the development of serious complications, after which the patient's ability to work is lost completely or partially.

The treatment of uterine fibromyoma is carried out by an obstetrician-gynecologist. According to the indications and with the development of complications, other narrow specialists (proctologist, urologist) are involved. The earlier the disease is detected, the less the amount of medical intervention and the better the prognosis. For timely detection of fibroids, it is recommended to visit a gynecologist at least once every 6 months, even in the absence of complaints.

Complaints in women with uterine fibroids: what to look out for

Useful video about uterine fibroids in questions and answers

Nodular uterine myoma is a very common pathology that is diagnosed in a large number women.

At its core, this is a benign formation in the uterus that develops in the myometrium, and represents one or more nodes.

The disease is more common in women over 30 years of age.

Diagnosed in 15% of women in menopause.

What it is?

A nodular tumor consists of several nuclei, the development of this formation occurs at an extremely slow pace, so it is very difficult to diagnose the disease in the early stages.

Like any other neoplasm, nodular fibroids grow between tissues, and as they grow, they squeeze more and more nearby organs.

Not so long ago, uterine fibroids were considered a precancerous condition, so the entire organ was removed from the woman in order to avoid the development of an oncological process. Today, doctors are confident in the good quality of this formation, which, nevertheless, should be treated and, if necessary, operated on. A nodular fibroid develops as a result of changes in the cells of the myometrium.

Existing types

Depending on where exactly the myomatous node is localized, nodular uterine fibroids are divided into such , as:

1. - the node is located on the outer shell of the organ. Such nodes can have a leg (long or short). Fibroids on a long stalk are more dangerous, because the stalk can twist, and thereby provoke necrosis.
2. - the tumor is located under the mucous membrane. This form is usually accompanied by solo pain, bleeding, and, as a result, anemia.
3. - nodes that are localized in the depth of the muscle layer. Such nodes can grow both inside the cavity and outside.

• prolongation of the period of menstruation;
• intermenstrual bleeding;
• copious menstrual flow;
• pain before and during menstruation, as a rule, pain is felt in the uterus, but sometimes patients also complain of lumbar pain;
• anemic syndrome, which is caused by significant blood loss;
• with a large tumor, the volume of the abdomen increases, which is visual sign the presence of myomatous formation in the uterus.

Fibroids of significant size put pressure on the intestines and bladder, and may cause various pathologies from these organs - constipation or problems with urination.

Other types

Uterine fibroids can be nodular and diffuse. Nodal, in turn, are divided according to the place of localization into their own types, which were analyzed above. As for the diffuse type of formation, it is characterized by the absence of a specific form and node, but is represented by an increase in muscle tissue in the form of a blurry neoplasm. Most often, this type of fibroids develops against the background of frequent inflammatory processes in the organ.

Fibroids can vary in size:

• up to 2 cm, fibroids are considered small;
• up to 6 cm - medium;
• fibroids larger than 6 cm are called large.

Also, fibroids are differentiated according to their relationship to the axis of the uterus.:

• fibroids located in the body of the organ - corporal;
• if the growth of fibroids is directed towards the vagina, it is a cervical tumor;
• if the formation presses on the bladder and causes problems with urination, this is an isthmus fibroid.

Read also about.

Diagnostic measures

Myomatous nodules are not considered complex. Most often, fibroids are diagnosed on the chair at the gynecologist. But only on the basis of this study it is impossible to say about the shape of the fibroids, its size and exact localization.

Therefore, additional hardware studies are assigned.:

• dopplerographic study;
• hydrosonography - ultrasound procedure which is carried out using a special liquid;
• laparoscopic examination, which, in addition to diagnosis, consists in removing the formation;
• - transvaginal examination of the uterine cavity using a hysteroscope.

In some cases it is necessary clinical analysis blood, since the submucosal form of fibroids often provokes the development of anemia, which can be determined by low level hemoglobin in the patient's blood.

Conservative treatment

Suitable for formations small size, it can only be prescribed by a competent specialist. Self-administration of drugs can lead to serious consequences.

Doctor prescribes therapy (this is especially true in the presence of fibroids, causing bleeding) . As a rule, B vitamins, iron preparations, folic acid are prescribed.

Hormone therapy is also prescribed, which includes:

• gonadotropin antagonists that slow down the synthesis of estrogen - Goserelin, Buserelin, Leuprorelin and others;
• androgen derivatives;
• gestagens;

With significant blood loss, tranexamic acid is prescribed, which prevents the destruction of platelets.

Tumor size for surgery

Decision on accepted by doctors in the presence of certain indications:

• large - more than 12-15 obstetric weeks;
• fast - in a year the tumor increases for several obstetric weeks;
• severe pain that is not relieved by medication;
• simultaneously with fibroids, a woman begins to develop other pathologies reproductive system;
• prolonged and heavy menstrual bleeding;
• compression of other organs by myoma, which violates their functionality;
• necrosis;
• leg twist.

Surgical intervention

Surgery can be performed in the following ways:

1. Hysterectomy. This is complete, this type of operation is indicated when other operations are not practical. Also, such an intervention is prescribed for women who have reached the menopause, as well as those who have a predisposition to malignant processes.
2. . organ-preserving surgery. It is prescribed for women with small nodules, nodular formations on a long stalk.
3. Laparotomy. All surgical manipulations are carried out through an incision made in the abdominal cavity. This type of intervention is not often practiced, and it is prescribed only for very large fibroids or if the formation has led to a deformation of the uterus.
4. . A minimally invasive way to get rid of myoma formation through centimeter punctures in the abdominal cavity.

By itself, uterine fibroids are not terrible disease if it is noticed in time and properly treated, no complications will arise. The advanced stage of fibroids is dangerous - it can lead to dangerous conditions that can end very badly.

Prevention

To reduce the risk of developing nodular formations in the uterus, it is enough to adhere to simple rules, which, in principle, should be the way of life of every woman:

• rejection of bad habits;
• proper and balanced nutrition;
• regular but moderate physical activity;
• maintaining optimal weight;
• pregnancy and childbirth under 40;
• attentive attitude to your body, which implies regular preventive examinations by a gynecologist.

Possible consequences

The dangers of fibroids have already been mentioned above, and now we will talk about the consequences that a woman who delays the treatment of fibroids in a conservative way and does not leave doctors a chance to perform an organ-preserving operation may face.

That is, what consequences await a woman after removal of the uterus:

• infertility;
• weight gain;
• decreased libido;
• increased risk of prolapse of the vaginal walls;
• pain during intimacy;
• depressive states;
• fast fatiguability;
• memory loss;
• problems with urination.

The genital area is of course most affected by hysterectomy.. Most women develop sexual dysfunction. However, in order for a woman's sexual activity to normalize, it is necessary rehabilitation period which may require psychological help.

NOTE!

The listed complications are not mandatory, sometimes they have blurred manifestations or are completely absent. This is possible if doctors maintain normal blood circulation to the ovaries, and there is no drop in hormone levels.

Conclusion and Conclusions

Summing up, we can say that nodular formations in the uterus are a common phenomenon, and when timely treatment not so terrible. With the preservation of the body, a woman may well become pregnant and become a mother. As for menopausal women, competent treatment neoplasms reduces the risk of degeneration of a benign tumor into a malignant formation to almost zero. Therefore, gynecologists strongly recommend that all women regularly undergo preventive gynecological examinations.

Useful video

From the video you will learn what nodular uterine fibroids are:

In contact with

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 in more early age.

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• Intramural myomas. When the nodes are located in the thickness of the uterus and grow there.
• Submucosal fibroids. When nodes are located under inner shell 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.

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Reasons for development

It should be noted that the development of uterine fibroids directly depends on the balance of hormones in the body. Hormonal disruptions that cause fibroids occur due to various diseases. For example, it can be anovulation, endometriosis, polyps.

But there are many additional reasons that contribute to the development of myomas and fibromyomas. These include frequent spontaneous and medical abortions, improper use of contraceptives, prolonged absence sexual intercourse, and also, if there is no production breast milk after childbirth.

Another group of causes are diseases of the genital organs of an inflammatory and infectious nature, venereal diseases. It is also a manifestation of various neoplasms and cysts, most often it is an ovarian cyst. Leads to myoma wrong treatment endometriosis or its absence.

It should be noted factors that contribute to the development of myoma formations:

Symptoms

Nodular uterine fibroids are manifested by the following symptoms:

Nodular uterine fibroids is enough dangerous state, as this often leads to infertility in women.

This is due to the fact that the node can interfere with the process of passage of the egg through fallopian tube. As a result, fertilization does not occur.

For pregnant women, the presence of myomatous nodes is dangerous, as they can provoke premature birth and spontaneous abortions. This disease is diagnosed most often during pregnancy, when a woman is registered with an obstetrician-gynecologist and undergoes a planned ultrasound.

Treatment and diagnosis

Diagnosis begins with an examination by a gynecologist, while the specialist can assess the location, size and number of nodes. Next, the doctor directs the patient to an ultrasound examination of the pelvic organs. Types of ultrasound:

Ultrasound will help determine the size, structure, localization of neoplasms.

Also, instrumental diagnostic methods include magnetic resonance imaging and computed tomography.

The form of treatment is chosen by the doctor, depending on the size, location and stage of development of the neoplasm.

The main method is the drug effect. Often together with in a medical way recommend treatment with folk remedies. Doctors seek to cure this disease with medicines and prescribe surgical intervention only in extreme cases.

At the same time, hormonal drugs are prescribed that affect the myomatous node, reducing it in size and normalizing menstrual cycle. These drugs normalize the level of hormones in the body, since nodular uterine fibromyoma is most often manifested due to hormonal failure.

It is also important to carry out adequate treatment concomitant disease inflammatory, infectious or venereal type.

Nodular fibroids are treated surgically if:

An urgent operation is prescribed for severe uterine bleeding, if the leg is twisted, and also when an internal node occurs in combination with an acute abdomen.

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If the treatment was ineffective, or was completely absent, then an already advanced form of the disease appears, and as a result - surgery will consist in the removal of the entire organ (uterus).

It's a hysterectomy. Depending on how affected the organ is, they can additionally remove the cervix and appendages.

Treatment of fibroids with endometriosis

If the manifestation of myomatous nodes occurs in combination with endometriosis, then, as a rule, therapy is prescribed. hormonal drugs. In this case, the patient should take progesterone derivatives.

It is these drugs that can inhibit the growth of pathological cells of the node and areas of endometriosis. These drugs include a group of long-acting gonadoliberin antagonists. According to medical practice such therapy is effective in 55% of cases.

But it should be noted that such treatment is more often used for older women. age group, since these drugs only temporarily stop the growth of fibroids in combination with endometriosis before the onset of menopause.

For young women, surgical treatment is recommended. In this case, minimally invasive interventions are used. The operation is indicated if the size of the myomatous node reaches 12 weeks or more in combination with endometriosis. Necessary surgical intervention if the node is rapidly growing.

An operation is urgently prescribed if there are prerequisites for the development of a node or focus of endometriosis into a malignant form.

Surgical treatment consists of simultaneous laparoscopic surgery. That is, myomectomy is performed - this is the removal of the node, and the removal of foci of endometriosis. A small incision is made in the abdominal wall. If endometriosis and the node are located near the cervix, then the operation can be performed without an incision, through the vagina.

Such an operation should not be postponed, as this may lead to the fact that later the entire organ will have to be removed. After laparoscopy, young women can become pregnant.

Treatment with folk remedies

Quite often, when nodular uterine fibroids occur, treatment with folk remedies is used. But before using such treatment, you should always consult with your doctor.

It is necessary to influence the disease with folk remedies in a complex way, sometimes they should be combined with medicines.

Decoctions and infusions:

There are many women who got rid of fibroids with the help of folk remedies. There are a lot of recipes, but you need to understand that this method can help only if nodular fibroids small size. Treatment with folk remedies should not replace surgery, as it is very dangerous.

It should also be noted that treatment with folk remedies, like medication, will not give the expected results if the woman does not adhere to healthy lifestyle life.

Are you still sure that it is impossible to GET RID OF uterine fibroids forever WITHOUT OPERATION?

Have you ever tried to get rid of uterine fibroids? Judging by the fact that you are reading this article, the victory was not on your side. And of course, you know firsthand what it is:

• constant pain in the side, heaviness in the abdomen ...
• profuse menstrual flow, uterine bleeding...
• anemia...
• loss of energy, depression, apathy...
• weight change...
• constipation and urinary problems...

Now answer the question: does it suit you? Can UTERINE MYOMA be tolerated? And how much money and time have you already "leaked" for ineffective treatment? After all, sooner or later it will grow to a size when only an OPERATION can help! Why take yourself to the extreme! Do you agree? That is why we decided to publish an exclusive technique from Elena Malysheva, in which she revealed the secret of getting rid of uterine fibroids.

Nature has rewarded women with the opportunity to bear, give birth and feed children, allowing them to fully enjoy the happiness of motherhood. But obstacles associated with the development of diseases of the female reproductive system can become an insurmountable obstacle to happiness. One of them is fibroids. What is fibromyoma, what are the causes of its development, and what methods of treatment can eliminate this pathology?

Different names apply to uterine fibroids. These include the following definitions:

• myoma;
• leiomyoma;
• leiofibroma.

All of them mean damage to the body of the uterus by a benign tumor. The tumor develops in the muscular layer of the uterus, called the myometrium. However, often women have to deal with a disease such as breast fibromyoma.

This disease affects a quarter of all women who have to deal with pathologies of the reproductive system. At the same time, fibromyoma most often develops in the representatives of the beautiful half of humanity at a reproductive age of 20 to 45 years. Often, fibroids occur in women whose age is close to menopausal. With the onset of menopause, fibroids can significantly decrease in size, or completely resolve.

Despite the fact that the causes of the development of the disease are still unclear, experts associate them with hormonal dysfunction. This is evidenced by the following factors:

• the tumor contains many receptors for sex hormones;
• a tumor, including breast fibromyoma, most often develops in women with high level estrogen;
• decrease in estrogen levels in menopause leads to a decrease in fibroids;
• a tumor can occur in women during menopause under the influence of taking estrogen-containing drugs.

Causes of the disease

benign neoplasm in the uterus or in the breast does not develop on its own. Various unfavorable factors contribute to this.

• The development of the disease affects women with impaired reproductive function, who failed to endure and give birth to a child under 30 years old. Wherein prerequisite is an breast-feeding lasting at least six months.
• The development of fibroids is facilitated by multiple abortions and diagnostic curettage.
• The disease affects women who experience frequent stress.
• A tumor, both benign and malignant, can develop due to intense exposure to ultraviolet radiation. This means that women should not long time be in direct sunlight, as well as visit the solarium.
• The disease is caused inflammatory processes flowing in the body of the uterus or its appendages.
• The tumor may arise due to unreasonable long-term use hormonal contraceptives.
• Fibroids can be caused by polycystic ovaries.

Signs of a neoplasm

In the early stages, fibromyoma does not manifest itself in any way, and therefore women do not go to the doctor for diagnosis. Pathology is detected only when it reaches a significant size, worsening the quality of life.

The main manifestations of the disease include the following symptoms:

• profuse prolonged menstruation, accompanied by severe pain;
• uterine bleeding and spotting during the intermenstrual period;
• pain in the chest and lower abdomen, accompanied by spasms;
• painful intercourse;
• difficulty urinating with frequent urges;
• pain radiates to the lumbar region and lower limbs;
• an increase in the abdomen;
• prolapse of the walls of the vagina;
• infertility.

If a woman has a small tumor that does not cause inconvenience, does not impair the quality of life, and does not increase in size, the treatment of fibroids can only consist in monitoring the course of the disease. Often, such a pathology develops in women on the eve of menopause.

Varieties of fibroids

There are several types of fibroids, which differ depending on the location and intensity of growth.

• The submucosal form, implying a submucosal type of location of the tumor, develops inside the uterus under its mucous layer.
• Interligamentous fibromyoma is located between the ligaments that support the uterus.
• The diffuse form is characterized by the presence of multiple growths inside the body of the uterus.
• Subserous or serous fibromyoma is a hormone-dependent tumor in the muscle tissue of the uterus, located in its outer part.
• The nodular form is distinguished by the presence of nodes in the thickness of the uterus, which, in the process of growth, can change the place of dislocation.
• The interstitial form is characterized by the location of the tumor in the muscular wall of the uterus and is characterized by increased growth rates.

Fibromyoma formations are also divided into the following types:

• simple, characterized by slow growth, and amenable to drug treatment;
• proliferating, which grow rapidly, but do not contain non-standard cells;
• presarcoma - a tumor in the tissue of which contains non-standard cells that contribute to its degeneration into a malignant neoplasm.

How to distinguish fibroids from fibroids

Despite the fact that both of these names are applied to any benign tumor of the uterus, fibroids and myomas differ somewhat from each other in their structural structure.

Myoma consists mainly of muscle tissue. The main component of fibroids is connective tissue. Fibromyoma is diagnosed when half of it consists of connective tissue.

The remaining features of fibroids are identical to fibroids. Its formation comes from the muscle core, which, in the process of growth, is overgrown with connective tissue.

Diagnosis of the disease

To determine the tumor, various diagnostic measures are used, determined by the doctor based on the patient's complaints. First of all, the doctor studies the nature of the course of menstruation, and also pays attention to the presence of pain and other diseases.

Next, a woman is examined on a gynecological chair, as a result of which it is possible to determine how enlarged the uterus is. If leiomyoma is suspected, women should be systematically shown to the doctor so that he can determine the intensity of tumor growth. This indicator is evaluated in the same way as during pregnancy. For example, if the tumor corresponds to 8 weeks of pregnancy, such uterine fibromyoma does not require treatment. It just needs careful monitoring.

If within a year the tumor has increased even up to 4 weeks, a slow growth of fibroids is diagnosed. If this indicator exceeded 4 weeks, then the tumor is growing rapidly and requires medical or surgical intervention.

Nodular fibromyoma of the uterus can be detected already during the examination of the cervix with the help of mirrors. However, colposcopy allows an accurate diagnosis. Given that this disease is hormone-dependent, women are prescribed blood tests that determine their hormonal status, namely, the level of estrogen and progesterone.

Ultrasound can most reliably determine the presence of a tumor, the size and location of its localization. And with the help of echography, it is possible to determine the type of tumor and examine the processes occurring inside it. If a woman is concerned about prolonged heavy bleeding, she may be prescribed a diagnostic curettage of the uterus, which allows to exclude or confirm the pathological growth of the endometrium, as well as to identify the presence of cancer cells.

Specific studies

Other diagnostic methods include the following methods:

• metrosalpingography allows you to detect a submucous node, as well as assess the condition of the endometrium of the uterus, its size and the presence of a possible deformation of its body;
• hysteroscopy is used to examine the body of the uterus and obtain a fragment of the tumor for further study;
• laparoscopy is used to more accurately diagnose the state of the organ and determine the subserous form of the tumor;
• intrauterine phlebography is performed to assess the condition of the vessels of the uterus, as well as to detect nodes;
• MRI is used to examine the tumor in the event that ultrasound does not allow you to see the ovaries, for example, with obesity.

Methods of treatment

Treatment of uterine fibroids or a tumor located in the breast can be either medical or surgical. The method of medical intervention is determined only after a complete examination. Moreover, each of the methods used is distinguished by a variety of techniques and has certain indications.

Medical treatment involves medicines that allow you to save childbearing function women, reduce the intensity of tumor growth, as well as reduce its size. In addition, during the treatment, measures are taken to eliminate the factors contributing to the development of fibroids.

This method of treatment is prescribed in the following cases:

• if a woman is planning a pregnancy;
• in the absence of symptoms of the disease;
• if the size of the fibromyoma does not exceed 12 weeks of pregnancy;
• in the presence of multiple nodes, both in the intramuscular and in the serous layers of the uterus;
• in the event that a woman is contraindicated for surgical intervention;
• if necessary, reduce the intensity of tumor growth before surgery;
• as an additional therapy used in the postoperative period.

As the main medicines used in the treatment are progestogen-containing drugs. The patient is also prescribed a remedy that can relieve pain during menstruation, as well as get rid of anemia and other associated symptoms.

It is necessary to be treated with medical drugs for six months, after which the doctor evaluates the result that was achieved without resorting to surgery.

Surgical treatment

Operations are most often prescribed if hormone therapy is contraindicated for women, or if the tumor in the uterus or in the chest is impressive. Young women, as a rule, are prescribed a myomectomy, which allows them to eliminate nodes in the uterus, while preserving the organ and all its functions.

In some cases, part of the uterus is removed, which allows you to save the menstrual functions of the organ. If a woman is shown a radical intervention, then either the uterus with appendages or all organs of the reproductive system are removed. The same method allows you to eliminate the prolapse of the walls of the vagina.

AT recent times Increasingly popular is the method of treating a tumor without surgery, during which embolization of the uterine artery is performed. This allows you to block the flow of blood to the fibromatous nodes. Another way is to cauterize the nodes with ultrasound, which allows you to neutralize the tumor cells. However, these methods often lead to the development of relapses that can provoke uterine prolapse.

Treatment with folk remedies is used as an additional therapy to medication and surgical methods tumor treatment, both in the uterus and in the chest. However, herbal medicine can also be used as the main method of treatment in the presence of a small, slow-growing tumor that does not require hormone treatment. In addition, this method of treatment is the safest.

Bibliography

1. Gestosis: theory and practice. Ailamazyan E.K., Mozgovaya E.V. 2008 Publisher: MEDpress-inform.
2. Clinical guidelines. Obstetrics and gynecology. Savelyeva G.M., Serov V.N., Sukhikh G.T. 2009 Publisher: Geotar-Media.
3. Pregnancy and childbirth with extragenital diseases. UMO vulture medical education, Apresyan S.V., Radzinsky V.E. 2009 Publisher: Geotar-Media.
4. Clinical guide to contraception. /Translated from English/ Edited by Professor V.N. Prilepskaya - 2009, M.: BINOM Publishing House.
5. Obstetrics. Clinical lectures: textbook with CD / Ed. prof. O.V. Makarova.- M.: GEOTAR-Media, 2007. - 640 p.: ill.