home House buildings

Uterine fibroids: causes and consequences. Modern methods of diagnosis and treatment. Why are uterine fibroids dangerous and how to treat them? Causes and symptoms of uterine fibroids symptoms causes

In the structure of gynecological diseases, uterine fibroids occupy a leading place. According to official data from doctors, more than 30% of women suffer from this disease. And if previously uterine fibroids were considered a pathology of women of mature age (from 35–40 years), then in recent years this diagnosis is often heard by twenty-year-olds.

Uterine fibroids can be practically asymptomatic for a long time and can only be detected during a routine examination by a gynecologist. Also, sometimes the diagnosis is established already at the stage of complications of this disease. That is why every woman should know how to recognize the signs of uterine fibroids in order to early diagnose this pathology.

What are uterine fibroids?

The name of this disease has many synonyms: leiomyoma, fibroma, fibromyoma, etc. Many of them are already outdated and have more historical or “folk” significance. The international classification of diseases uses the term “uterine leiomyoma”.

Essentially, this disease is a benign tumor. In this case, so-called fibroid nodes are formed from the muscle and connective tissue fibers of the uterine wall. A myomatous node can be imagined as a “tangle”, which is formed by chaotically intertwined “threads” of muscle and connective tissue. It is usually surrounded by a capsule formed from compressed muscle cells. Also in the area of the formed nodular formation, a transformation of the blood supply and innervation occurs.

The exact reasons for the formation of this benign tumor, as well as its tendency to grow, are still unknown. The most decisive factors are considered to be hormonal imbalance and heredity.

It has been established that with the onset of persistent menopause, in the vast majority of cases, the size of the tumor decreases significantly.

Types of fibroids

Symptoms and signs of uterine fibroids directly depend on the location of the pathological nodules. They are usually found in the body of the uterus. Only in 5% of cases the tumor may have an atypical localization, for example, cervical.

So, we can distinguish the following types of disease according to the location of the tumor:

Subserous. The nodes are located on the outer surface of the uterus under the serosa (peritoneum). Their growth often occurs outward. Sometimes such formations may have a stalk, which contains in its structure the vessels and nerves that feed the tumor.

Intramural. The location of the tumor-like formation is limited to the muscular wall of the uterus. Such nodes are usually relatively small in size, and the disease often has a long-term asymptomatic course.
Submucosal. It is considered the most dangerous variant of the course of this pathology. The tumor is located under the lining of the uterus (endometrium). Its growth occurs in the uterine cavity. Such nodes manifest themselves quite quickly and are prone to malignancy (malignant degeneration).
Atypical. The nodular formation comes from the cervix or the lower part of the lateral rib of the uterus (cervical or interligamentous fibroids).

Very often, myomatous nodes have mixed localization (for example, interstitial-subserous, submucosal-interstitial, etc.), which is associated with the predominant direction of their growth. They can also occur in multiple versions. Consequently, the symptoms of uterine fibroids in these cases will be varied and sometimes atypical.

Main manifestations

If the tumor-like formation is small in size and localized under the peritoneum or deep in the muscles of the uterus, then usually nothing bothers the woman. As the tumor grows or new formations appear, symptoms appear. The submucosal location of the nodes usually manifests itself much earlier.

The most characteristic manifestations of uterine fibroids include:

Menstrual disorders, as well as bleeding. They are an early sign of submucosal fibroids.
Pain or discomfort in the lower back and lower abdomen.
Disruption of the normal functioning of the pelvic organs adjacent to the uterus.
Infertility.
Complicated pregnancy and some others.

Now it’s worth considering these and other manifestations of uterine leiomyoma in more detail.

Menstrual irregularities

A change in the frequency and nature of menstrual flow is most often one of the early signs of uterine fibroids. This is facilitated by: impaired uterine contractile function and hormonal disorders that accompany the course of the disease.

The menstrual cycle may become irregular and more often shortened. Menstruation becomes more abundant and longer. The appearance of so-called acyclic bleeding (occurring outside of menstruation) is possible.

With submucosal fibroids, bleeding most often occurs, both during and outside of menstruation. Long-term and abundant bleeding quickly leads to the development of anemia, or anemia. This condition is characterized by a decrease in the level of red blood cells (erythrocytes) and hemoglobin, increasing weakness, decreased blood pressure, etc. The hemoglobin level can decrease quite significantly, which requires appropriate therapy.

Pain, discomfort in the lower abdomen

Unpleasant sensations and even pain in the lower abdomen and lower back are a common complaint with uterine leiomyoma. The appearance of such symptoms is associated with the peculiarities of the anatomical localization of nodular formations, namely:

The location of the tumor under the peritoneum and its growth outward can irritate the nerve fibers of the pelvis, which is manifested by aching or nagging pain in the abdomen and lower back of an almost constant nature.
If the subserous node is relatively large and located behind the uterus, then such fibroids can manifest as lower back pain (“sciatica”). Such patients can be treated for a long time and unsuccessfully for neurological disorders, without knowing the true cause of their occurrence.
A significant increase in the size of the uterus with intermuscular location of the nodes causes displacement of the pelvic and abdominal organs, which is also manifested by pain and a feeling of heaviness in the abdomen.
Interstitial nodes also disrupt the normal contractile activity of the uterus during menstruation. This manifests itself as nagging or cramping pain before or during menstruation.
The submucosal node also disrupts the contractile function of the uterus. In addition, this location of the tumor often provokes its gradual protrusion directly into the uterine cavity. All this causes cramping pain, especially pronounced during menstruation.

Very often, a woman does not attach importance to such pain and finds other reasons for its occurrence (sciatica, normal painful periods, intestinal dysfunction, etc.).

Dysfunction of the pelvic organs

In the vicinity of the uterus there are some anatomical formations: the bladder and ureters, rectum, loops of the small intestine, etc. If the tumor is significant or if the nodes are located and grow outward, a disruption in their normal functioning may occur due to compression or displacement.

Thus, when the myomatous node and the bladder are “neighborhood,” urination disorders often occur: frequent or, conversely, urinary retention, cramping. If the tumor is located near the rectum, constipation often occurs that is not amenable to conventional therapy.

Infertility

Localization of the myomatous node under the uterine mucosa is often accompanied by infertility. This is usually associated with concomitant structural changes in the endometrium, which makes the process of implantation (attachment of a fertilized egg to the uterus) impossible.

In addition, deformation of the uterine cavity by the tumor also prevents normal implantation. And the hormonal imbalance that accompanies the course of the disease often leads to a lack of ovulation or a significant disruption in the production of hormones that support the course of pregnancy.

Fibroids during pregnancy

If conception and implantation with uterine fibroids do occur, then the subsequent course of pregnancy is directly related to the size and location of the nodes.

The best prognosis for pregnancy is when small nodes are located far from the uterine cavity.

Particularly dangerous is the large size of the tumor of any location and the submucosal location of the node. Typical problems during pregnancy with uterine fibroids are:

Spontaneous interruption in the 1st–2nd trimesters (miscarriage).
Premature onset of labor.
Impaired functioning of the placenta with the occurrence of hypoxia (oxygen starvation) of the fetus. This can lead to inhibition of its development and even death.
Threat of termination of pregnancy at any stage.
The risk of intrauterine infection and the occurrence of inflammatory complications after childbirth.
Incorrect placement of the fetus.
Impaired contractility in the postpartum period with the development of bleeding and other consequences.

It should be noted once again that quite often with this disease several nodes are detected, which can be located in different layers of the uterus. For example, with a submucosal and subserous location of the tumor, signs of uterine fibroids will be noted, characteristic simultaneously for both localizations: bleeding, characteristic of the submucosal node, and constant pain, as a symptom of subserous formation.

Complications

The appearance of clinical symptoms (bleeding, pain, etc.) can already be considered a complicated course of the disease. However, there are more serious complications of fibroids that can pose a threat to the health and even life of a woman. Examples of such conditions are:

Ischemia of the node.
Nascent myomatous node.

Such complications require immediate medical attention and, in most cases, are subject to surgical treatment.

Torsion of the leg of the myomatous node

Myomatous nodes located subserosally (subperitoneal) undergo this pathological change. Usually this type of node grows on a broad base, but sometimes they have a pedicle, which is formed by the layers of the peritoneum with feeding vessels and nerves running inside.

Torsion of a uterine tumor can occur as a result of a sharp change in intra-abdominal pressure, sudden movements, physical activity, etc. Often this pathological condition occurs during pregnancy or in the first time after childbirth.

There are two types of torsion:

Full (360 degrees).
Incomplete (less than 360 degrees) – twist, bend.

In the case of complete torsion of the tumor stalk, the nutrition of the node is quickly disrupted with the subsequent development of ischemia and necrosis. The main symptoms of this condition are:

Sharp pain in the abdomen.
Increased body temperature, chills, weakness and other manifestations of intoxication associated with the penetration of node necrosis products into the blood.
Nausea, vomiting.
Symptoms of “acute abdomen” are clinically determined.

This condition requires immediate surgical treatment.

In the case of incomplete torsion, the symptoms are less pronounced. In this case, a wait-and-see approach is possible under the supervision of a hospital doctor. Surgical treatment in such cases can be carried out several days later as planned after a complete examination of the patient.

Ischemia and necrosis of the node

Malnutrition (blood supply and/or innervation) of the myomatous node most often develops as a result of torsion of its feeding pedicle in subperitoneal localization. However, malnutrition and nodes located deep in the muscle wall (interstitial) are quite common.

Delayed diagnosis of ischemia of the myomatous node can be complicated by the development of tissue necrosis (necrosis). This condition is life-threatening for a woman.

The main risk factors for the development of node ischemia are:

Torsion of the leg of the myomatous node.
Rapid growth of the intermuscular node with compression and deformation of the uterine vessels.
Pregnancy and early postpartum period.

Unfortunately, this complication develops in almost 15% of pregnant women with uterine leiomyoma. This is facilitated by hormonal changes in the body during pregnancy, as well as the physiological characteristics of the blood supply to the uterus (decreased blood flow, difficulty in venous outflow, changes in the blood coagulation system, etc.).

The main manifestations of ischemia and necrosis of the myomatous node are:

Pain in the abdomen. In a pregnant woman, you can even feel the painful area of the surface of the uterus.
Increase in body temperature to subfebrile levels.
With the development of necrosis of the node, symptoms of “acute abdomen” appear, nausea, vomiting, the temperature rises sharply, and the general condition worsens.

Delay in providing emergency care can lead to the development of peritonitis (inflammation of the peritoneum) followed by death.

Birth of a myomatous node

This complication occurs with the submucous (submucosal) type of uterine fibroids. In this case, the tumor grows inside the uterus (into the uterine cavity). Often such nodes have a stalk and can protrude noticeably into the uterine cavity until they are completely separated from the muscular wall. This process is called the birth of a myomatous node. If the tumor penetrates the cervical canal and vagina, it can be noticed even during a routine gynecological examination. Such a node is called born.

The process of birth of a submucosal fibroid node is always accompanied by quite pronounced clinical manifestations:

Pain in the lower abdomen, which is often cramping in nature.
Bleeding of varying intensity up to profuse.
If there is a malnutrition of the node, its ischemia and necrosis occurs, which is accompanied by the corresponding symptoms described above.
Prolonged bleeding causes the development of anemia. In this case, weakness, pallor of the skin, decreased blood pressure and increased heart rate (tachycardia) are noted.

This complication also requires medical intervention.

Diagnostics

It is usually possible to suspect the presence of leiomyoma already at the stage of a routine gynecological examination: an increase in the size of the uterus is detected, which often has an irregular shape. If changes are detected in the normal anatomical structure and location of the uterus, the gynecologist will suggest additional diagnostic procedures. These include:

Ultrasound scanning of the pelvic organs (transabdominal and transcervical). This is the most accessible and informative diagnostic method that allows you to establish reliable signs of uterine fibroids. In this case, the location and size of the nodes, their structure, etc. are assessed.
Hysteroscopy. It is used primarily in cases of suspected submucosal tumor localization. Allows you to determine the exact location of the pathological focus, structure and size of the tumor. In some cases (pedunculated node), simultaneous removal of the formation is possible.
Laparoscopy. It is usually performed in complex clinical cases and has certain indications. More often it is simultaneously combined with therapeutic measures.
Magnetic resonance imaging. Serves as an addition to ultrasound examination or for atypical localizations of nodes.

In addition, various general clinical, biochemical and hormonal studies are carried out aimed at assessing the woman’s condition and diagnosing concomitant pathological conditions.

Principles of treatment and prevention

Currently, there are two directions in the treatment of uterine fibroids:

Conservative (hormone therapy).
Surgical.

Surgical treatment of fibroids does not always involve complete removal of the uterus. The latest surgical techniques have been developed to remove individual nodes, significantly reduce and slow down their growth.

The choice of a specific treatment method is individual for each woman with this disease and depends primarily on the location and size of the nodes, the presence of complications and the patient’s desire to preserve reproductive function.

There is no specific prevention of the disease, since the mechanism of tumor formation is not reliably known. However, given the importance of early diagnosis of the disease in the success of its treatment, the most important preventive direction is regular visits to a gynecologist with dynamic ultrasound examination of the pelvic organs. The recommended frequency of visits to a gynecologist in the absence of complaints is once a year.

In conclusion, it should be noted that uterine fibroids are not such a “harmless” disease. A long asymptomatic course, nonspecific signs of this pathology and a woman’s ignoring of its early manifestations lead to a late diagnosis of uterine fibroids. In such cases, the disease can be diagnosed for the first time already at the stage of complications or when the tumor is large, followed by surgical removal of the organ.

When the first symptoms of the uterus appear, women often do not know what to do; they are treated with folk remedies, but this only aggravates the situation. The disease progresses and over time, doctors identify a large myomatous node. They suggest that the woman have her uterus removed. There is no need to worry, because surgery can be avoided not only if there are symptoms of uterine fibroids in the early stages of the disease, but also with progressive tumors.

Please note that this text was prepared without the support of our website.

Contact us, the best doctors. They are leading experts in the field of innovative organ-preserving techniques for treating fibroids, including uterine artery embolization.

If necessary, you can get urgent advice. After uterine artery embolization, patients forget about the symptoms and signs of the disease. Their quality of life improves significantly.

Classification of uterine fibroids

Gynecologists at the clinics with which we cooperate consider uterine fibroids as a response of the female body to the action of damaging factors, the main of which is menstruation. During menstruation, the uterus prepares for the upcoming pregnancy. The cells of its muscle layer change structure and increase in size. After menstruation, most of them return to their original state. The structure of some myocytes may not change. In this state they move on to the next cycle and begin to divide. This is how fibroids develop.

Depending on the structure of the neoplasm, the following types of fibroids are distinguished:

leiomyoma – smooth muscle fibers predominate;
rhabdomyoma - contains a large amount of striated muscle tissue;
fibroids - consists of a large amount of connective tissue;
angiomyoma - there are many blood vessels in the myomatous node.

Cellular fibroids are characterized by a predominance of smooth muscle tissue. Elements of connective tissue cells are represented in smaller quantities. The growth of cellular fibroids occurs at a slow pace, and there are no atypical cell changes. The signs of “bizarre” fibroids are as follows: dystrophic changes in the tissue of formation, absence of cell atypia and diffuse germination. It develops over a long period of time and has a long development time. The size of hemorrhagic or apoplectic fibroids increases when taking hormonal contraceptives, during pregnancy and after the birth of a child. It is characterized by swelling and hemorrhages.

Depending on the number of nodes, uterine fibroids can be single or multiple. Single fibroids are rare. More often, several smaller formations develop near the main node of large size. Depending on the location of the nodes in the uterus, the following types of fibroids are distinguished:

subserous - formed under the serous membrane of the organ;
submucous – localized under the mucous membrane of the uterus:
intramural or intermuscular – located in the myometrium.

Depending on the degree of deformation of the uterine cavity, gynecologists distinguish the following types of submucous fibroids:

Type 0 – fibroid formation is completely located under the mucous membrane, does not grow into the muscular layer of the uterus;
Type I – less than half of the node penetrates the myometrium;
Type II – more than 50% of the node is located in the muscular layer of the uterus;
Type III – there is no myometrial layer between the mucous membrane and the tissues of the fibroid formation.

There are 3 types of subserous fibroids. With zero type of tumor, the pedunculated node is completely located in the abdominal cavity. The first type of subserous myoma is characterized by the presence of nodes predominantly in the abdominal cavity. Less than 50% of the node grows into the myometrium. The second type of subserous fibroids is characterized by the localization of more than half of the formation inside the myometrium.

Most often, fibroids are located in the body of the uterus. With cervical fibroids, the formation grows towards the vagina. Atypical forms include the following fibroids:

epiperitoneal;
paracervical;
retrocervical;
interligamentous;
precervical;
retroperitoneal.

Doctors often determine the size of fibroids by the degree of enlargement of the uterus in accordance with the stage of pregnancy. Gynecologists at our clinics believe that this indicator is not informative enough to choose a treatment method. We determine the size of myomatous nodes based on the results of ultrasound examination. Doctors at our gynecological clinics, depending on the diameter of the nodes, distinguish the following types of fibroids:

small, larger than 1.5-2 cm;
medium – up to 4-6;
large fibroid nodes, with a diameter of 6 cm or more.

Symptoms of uterine fibroids in the early stages of the disease are absent or mild. This is an asymptomatic fibroid. If there is a clinical picture of the disease, doctors call fibroids symptomatic.

The first signs of fibroids

In the early stages of the disease, most uterine fibroids do not show any symptoms. The first signs of a pathological process are detected during an ultrasound examination of the pelvic organs, which is performed when the patient consults for another pathology. Nowadays, the age of women who are diagnosed with uterine symptoms in the early stages of the disease has decreased significantly. Already at 20-25 years old, signs of the presence of a neoplasm may appear. For this reason, we recommend that every woman regularly (at least once a year) be examined by a specialist. The gynecologists of the clinics with which we cooperate carry out timely diagnosis and treatment, which helps preserve a woman’s health using the most gentle methods possible.

unusual course of menstruation (duration more than 8 days, pain, the appearance of blood clots);
pain in the pelvic area;
the appearance of a feeling of pressure and heaviness in the pelvic area;
pain in the back and legs;
pain during sexual intercourse.

As the disease progresses, compression of the bladder occurs, urination becomes more frequent, and the size of the abdomen increases. When the intestines are compressed, constipation occurs.

The presence of one or two symptoms of uterine fibroids in the early stages is a reason to consult a doctor. A gynecologist performs a bimanual examination of a patient. To assess your overall health and develop the correct treatment strategy, the following examination is prescribed:

ultrasound examination of the pelvic organs using transvaginal and transabdominal sensors;
hysteroscopy;
computer and magnetic resonance imaging;
vaginal smear;
blood test to determine the level and ratio of hormones;
determination of the concentration of tumor markers in the blood.

The first ultrasound signs of fibroids

Ultrasound examination of the pelvic organs allows us to identify ultrasound symptoms of uterine fibroids in the early stages of the disease. Most often, doctors identify the following echographic signs of uterine fibroids:

the presence of foci of reduced echogenicity (they are echo signs of small fibroids or evidence of degeneration of myomatous nodes due to the deposition of calcium in them);
a significant increase in the size of the uterus and the appearance of several zones with reduced echogenicity;
signs of the diffuse nodular form of the disease.

Doctors at our fibroid treatment clinics conduct dynamic examinations of patients who are suspected of having fibroids. They monitor changes in the size of formations in the uterus and their growth rate. Fibroids in the early stages of the disease can be treated, which allows the woman to save the main organ of the reproductive system. For this reason, we recommend that you do not put off going to the doctor for a long time. If the first symptoms of fibroids appear in the early stages of the disease, immediately get examined by our doctors.

Conservative treatment of uterine fibroids

If symptoms of uterine fibroids occur in the early stages of the disease, gynecologists carry out conservative therapy. Gynecologists believe that drug treatment should be carried out in the following cases:

the patient's childbearing age;
location of fibroids between the myometrial muscles;
small size of the uterus altered by the neoplasm;
no change in the shape of the female reproductive organ.

In the presence of small nodes that do not increase in size, monophasic hormonal drugs are prescribed (Nemestran, Norkolut, Primolut-Nor). Hormones are often used before surgery to remove fibroids. The drugs stop the growth of fibroids, reduce the risk of large blood loss and postoperative complications.

To treat fibroids, gonadotropin-releasing hormone agonists are used:

buserelin;
zoladex;
diferelin.

They reduce the size of the pathological formation, but have a temporary effect. All drugs in this group have significant side effects. After discontinuation of the medications, fibroid growth resumes.

Minimally invasive methods of treating the disease include laser removal of fibroids. The operation is not accompanied by blood loss or pain, but the doctor has the ability to remove only visible nodes. Over time, new voluminous formations begin to grow from the rudiments of fibroids.

Surgical treatment of fibroids

If a woman has symptoms of uterine fibroids in the early stages of the pathological process, FUS ablation of fibroid nodes is successfully used to treat fibroids. The procedure is carried out under the control of computed tomography. Ultrasound waves directly affect the fibroid, causing tissue necrosis of the node. This procedure is performed in the presence of myomatous nodes measuring less than 3 cm and the presence of symptoms of uterine fibroids in the early stages. It cannot be performed if the tumor is deep or the node is located in the cervical region. The procedure is contraindicated if the diameter of the formation is more than 10 cm, the distance between the fibroid node and the skin is more than 12 cm, and there are intestinal loops or scars in the path of the beam. FUS ablation is not performed during pregnancy and in the presence of more than 6 nodes.

Most gynecologists believe that the absolute indications for surgical treatment of fibroids are the rapid growth of fibroids and pathological bleeding. Surgery is also performed if the fibroid tumor has increased the size of the uterus for more than 15 weeks of pregnancy or if it is smaller, but compresses adjacent internal organs and worsens the quality of life.

Doctors at our clinics are of the opinion that the indications for surgical treatment of fibroids have been unreasonably expanded. Our endovascular surgeons successfully perform uterine artery embolization both in the presence of symptoms of uterine fibroids in the early stages of the disease, and in cases of advanced fibroids. If after the procedure not all myoma formations completely disappear, the nodes that have decreased in diameter are removed by surgeons laparoscopically in technically more favorable conditions.

For many years, doctors believed that fibroids were benign tumors that could develop into malignant tumors. Showing excessive oncological alertness, they removed the woman’s main reproductive organ. The results of scientific studies conducted in our fibroid treatment clinics indicate that atypical cells in fibroid nodes appear no more often than in healthy uterine tissue, so in most cases of the disease, removal of the uterus can be avoided.

Myomectomy is an organ-conserving operation during which surgeons remove uterine fibroids. Surgery is performed laparoscopically, laparotomically or hysteroscopically. After dissection of the anterior abdominal wall, scars form on the skin, which in the future create a cosmetic problem. Laparotomy myomectomy is a difficult operation that is often accompanied by blood loss. Complications often occur after a hysterectomy.

During a laparoscopic myomectomy, the surgeon inserts instruments into the abdominal cavity through small incisions in the front wall of the abdomen. It removes nodes under the control of an image of the surgical field displayed on the monitor. During surgery, there is a risk of injury to the vessels of the abdominal cavity or internal organs. In this case, in order to save the patient’s life, the surgeon is forced to perform a laparotomy approach and remove the uterus.

After myomectomy, scars form on the uterus. They can cause pregnancy pathologies or uterine rupture during childbirth. In patients for whom our surgeons perform uterine artery embolization, the structure of the uterus is not disturbed, pregnancy and childbirth proceed without complications. Women give birth through the vaginal birth canal. They do not require a caesarean section or obstetric aids.

The essence of the uterine artery embolization method is to clog the vessels feeding the fibroid. In this case, the fibroid nodes decrease in size or completely undergo reverse development. During the procedure, the endovascular surgeon makes a puncture in the femoral artery. He injects a sclerosing substance through a thin catheter into the vessels feeding the node. Microparticles (ebola) block the lumen of the arteries through which the fibroid receives nutrients and oxygen. Over time, fibroids are replaced by connective tissue, decrease in size or disappear.

The procedure is absolutely safe, since the particles that clog the fibroid arteries do not penetrate the vessels that supply healthy areas of the uterus. The postoperative period lasts 1 day. After this, the patient is sent home from the clinic. The advantage of this method of treatment in the presence of symptoms of uterine fibroids in the early stages is that there is no risk of relapse of the disease. After embolization of the uterine arteries, the woman’s symptoms of the disease disappear, libido and reproductive function are restored.

Bibliography

Bobrov B.Yu. Obstetrics and gynecology / Bobrov B.Yu., Alieva, A.A.-No. 5, 2004.-68 p.
Mikhalevich S.I. Overcoming infertility. Clinic, diagnosis, treatment. / Mikhalevich S.I. - Minsk: Medicine - 2002 – 234 p.
Kustarov V.N. Uterine fibroids / Kustarov V.N., Linde V.A., Aganezova N.V. - SPb.: Special. Lit -2001- 360 p.

Uterine fibroids are a benign hormone-dependent neoplasm that develops from the muscular layer of the uterus. The development of fibroids, as a rule, occurs due to a violation of the division of one cell of the smooth muscle layer of the uterus - the myometrium. As a result of a slow process, a node is formed - a fibroid. This pathology is found on average in 80% of women, but only 30–40% of women aged 30–35 years have uterine fibroids clinically manifested.

Please note that this text was prepared without the support of our website.

On our website you can get acquainted with a variety of information about the diagnosis and treatment of fibroids, and get advice from the site’s expert council at any time convenient for you.

Types of fibroids depending on their location:

Intramural – located in the thickness of the endometrium;
Subserous - located in the outer (serous) layer of the uterine wall and grows into the abdominal cavity;
Submucosal – located in the inner layer of the uterine wall (submucosal), grows into the uterine cavity;
Cervical uterine fibroids - develops in the vaginal part of the cervix;
Intraligamentous - located between the broad ligaments of the uterus.

How to identify uterine fibroids yourself

How to recognize uterine fibroids at home? The answer to this question is difficult, since this disease is asymptomatic in 50-60% of patients. The clinical picture of uterine fibroids in most cases is blurred and nonspecific, depending on the woman’s age, the course of the pathological process and the size of the tumor.

Symptoms that can help you identify uterine fibroids at home:

bleeding – heavy and prolonged periods. The intensity of bleeding depends on the location of the node in the muscular layer of the uterine wall (submucosal, subserous, intramural, etc.). Bloody discharge may appear in the middle of the menstrual cycle;
Pain – chronic dull, nagging, pelvic pain in the lower abdomen. They intensify during menstruation and can also appear during sexual intercourse. The appearance of acute and cramping pain indicates torsion of the fibroid stalk or malnutrition in the node;
An increase in abdominal circumference - the nodes cause compression of nearby pelvic organs (bladder, rectum), resulting in constipation, frequent urination or urinary retention, pain in the lumbar spine;
Swelling of the mammary glands - associated with a violation of the reproductive function of a woman, an increase in the level of estrogen in the blood;
Infertility - due to a violation of the integrity of the endometrium (the inner layer of the uterine wall), the process of fixation of the fertilized egg in the uterus does not occur
Anemia – has a chronic form due to constant bleeding and decreased hemoglobin in the blood. Women's skin turns pale, they feel weakness, headache, and decreased concentration.

After discovering these symptoms, you should see a gynecologist or get it from leading specialists in this field for a complete clinical and laboratory diagnosis and selection of individual treatment. Using UAE, a new, revolutionary method of treating uterine fibroids on the basis of the European Clinic, our specialists have won the recognition and trust of many women who turned to them for help.

Uterine fibroids in postmenopause

During the postmenopausal period, a woman experiences a decline in the production of all sex hormones, which leads to the “stabilization” of fibroid growth and the cessation of all symptoms. Bleeding during this period, in turn, can serve as a poor prognostic factor for a woman’s health. The detection of a uterine tumor on ultrasound in 90% of cases indicates sarcoma (malignant tumor).

Fibroids during pregnancy

The appearance of uterine fibroids during pregnancy is facilitated by a hormonal imbalance in the body of a young mother. The presence of fibroids increases the contractility of the uterus and in 67% of cases leads to miscarriages, spontaneous abortions and premature births.

It negatively affects the growth and development of the baby, squeezing the blood vessels of the placenta, thereby stopping the supply of nutrients and oxygen to the fetus.

Considering all of the above, a timely visit to the antenatal clinic, registration and constant monitoring can promptly save your life and the life of your child.

Fibroids during puberty

During puberty, a girl experiences a massive hormonal surge in her body, which affects not only the hormones of the reproductive system, but also the thyroid gland, adrenal glands, etc.

Despite the low incidence of fibroids at this age, any parent should be alert to bloody, heavy discharge that lasts more than a week, pain in the lower abdomen that is not associated with the menstrual cycle.

Clinical protocol: uterine fibroids - diagnosis and treatment

In the 21st century, thanks to new scientific discoveries and modern technologies

and competent training of specialists, diagnosis and treatment tactics for uterine fibroids have become more accessible and of high quality.

The main initial step in diagnosing uterine fibroids is making an appointment with a gynecologist, who will subsequently prescribe you certain laboratory and instrumental examinations.

Examination by a gynecologist

An examination by a gynecologist consists of an oral interview (history taking) and a direct examination in a gynecological chair. During the examination, the gynecologist asks you about:

the course of the menstrual cycle (at what age did the first menstruation begin, the nature of bleeding, regularity, presence of pain);
presence of chronic diseases (diabetes mellitus, arterial hypertension);
presence of infectious diseases (STDs);
surgical interventions (laparoscopy, appendectomy).

During a bimanual examination on a chair, the gynecologist determines the size of the uterus, myomatous nodes and their location, and measures the size of the fibroids in accordance with the weeks of pregnancy. A series of laboratory tests are prescribed to determine the level of hemoglobin and iron in the blood to diagnose anemia.

Ultrasound of the pelvic organs

Ultrasound of the pelvic organs is divided into types:

transvaginal (through the vagina), widely used for primary diagnosis and follow-up;
transabdominal (through the abdominal wall, provided there is a full bladder);
transrectal (through the rectum). This method is used for adolescents and women with heavy blood loss during menstruation;
hydrosonography is an ultrasound scan of the uterus, in which a sensor is inserted into the uterus itself along with saline solution. The sensitivity of this method for diagnosing uterine fibroids is 100%.

On an ultrasound monitor, uterine fibroids appear as rounded areas, clearly visible against the background of healthy tissue. Using this method, you can obtain information about the size of the myomatous node, its structure and location, and the presence of a pedicle. The study is carried out in the first phase of the menstrual cycle.

Dopplerography

Doppler ultrasound not only helps to assess blood flow in myomatous nodes, but also serves to assess the effectiveness of uterine artery embolization.

Hysteroscopy

The “gold standard” for diagnosing uterine fibroids, especially submucous nodes, is hysteroscopy, which evaluates the type, size of the node and its location. The technology involves inserting a thin tube (hysteroscope) through the natural genital tract into the uterine cavity. The entire procedure takes place under general anesthesia and is absolutely painless. With the help of hysteroscopy, it is possible to remove diagnosed fibroids.

MRI

Magnetic resonance imaging is used when ultrasound data are questionable, or to more accurately clarify the location of fibroids, in order to preserve the integrity of nearby pelvic organs and the reproductive function of the body. The diagnostic sensitivity without contrast is 67%, with contrast – 98%.

Specialists can see a neoplasm with a diameter of 5-4 mm. They have a round shape and clear boundaries.

Laparoscopy

Laparoscopy is rarely used to diagnose uterine fibroids, more often for differential diagnosis. This is a minimally invasive surgical procedure. Using special laparoscopic instruments, the gynecologist assesses the size, localization of fibroids and the involvement of other organs in the process, and can also remove the tumor. The entire procedure takes place under general anesthesia with tracheal intubation.

Competent diagnosis and the correct choice of one or another method of instrumental research account for 2/3 of the success of treatment (conservative or surgical).

Among the many modern approaches in the surgical treatment of uterine myomatous nodes, a special place is occupied by such manipulation as uterine artery embolization (UAE). The essence of UAE is the introduction of a round-shaped medical polymer (emboli) into the uterine arteries using a thin endovascular catheter. These emboli selectively close the lumen of the arteries of the myomatous node, as a result of which the delivery of nutrients to the fibroid is disrupted and its subsequent destruction.

Don’t be afraid to seek help from a gynecologist if you experience the symptoms listed above and you independently identify uterine fibroids at home. Russians carry out modern diagnosis and treatment of uterine fibroids using UAE technology. Our expert council is headed by candidate of medical sciences, obstetrician-gynecologist Lubnin D.M. and candidate of medical sciences, endovascular surgeon B.Yu. Bobrov, guarantee you a round-the-clock consultation and an answer to any question you are interested in.

Remember that your good women's health is the key to the beauty and happy life of you and your children.

Bibliography

Bobrov B.Yu. Obstetrics and gynecology / Bobrov B.Yu., Alieva, A.A.-No. 5, 2004.-68 p.
Mikhalevich S.I. Overcoming infertility. Clinic, diagnosis, treatment. / Mikhalevich S.I. - Minsk: Medicine - 2002 – 234 p.
Kustarov V.N. Uterine fibroids / Kustarov V.N., Linde V.A., Aganezova N.V. - SPb.: Special. Lit -2001- 360 p.

is a hormonal-dependent, benign, tumor-like formation of the uterus, emanating from its smooth muscle and connective (fibromyoma) tissue. Uterine fibroids can be single, but more often - in the form of multiple myomatous nodes with different localization. Uterine fibroids can range in size from a small nodule to a tumor weighing about a kilogram, when it is easily identified by palpation of the abdomen. The size of fibroids is usually compared with the size of the uterus at a given stage of pregnancy. Small uterine fibroids can develop without clinical manifestations and are accidentally discovered during a gynecological examination.

General information

Uterine fibroids are a hormonal-dependent, benign, tumor-like formation of the uterus, emanating from its smooth muscle and connective (fibromyoma) tissue. Uterine fibroids can be single, but more often - in the form of multiple myomatous nodes with different localization. Uterine fibroids can range in size from a small nodule to a tumor weighing about a kilogram, when it is easily identified by palpation of the abdomen. The size of fibroids is usually compared with the size of the uterus at a given stage of pregnancy.

Uterine fibroids most often occur in women during the reproductive period. In postmenopause, the growth of uterine fibroids usually stops and its reverse development occurs. In general, uterine fibroids are diagnosed in more than 20% of women when visiting a gynecologist with certain complaints or by accident.

Causes

Complications

Uterine fibroids are insidious and dangerous with their numerous complications. The most common problems are impaired blood supply to the myomatous node with the development of necrosis, torsion of the tumor stalk, bleeding, and anemia. Submucous uterine fibroids can cause uterine contractions and the birth of a myomatous node through an open cervix, accompanied by pain and bleeding. Miscarriage and infertility can also accompany the development of uterine fibroids. Malignant degeneration (malignization) of uterine fibroids into a cancerous tumor accounts for up to 2% of cases.

Diagnostics

The diagnosis of “uterine fibroids” can be established already at the initial gynecological examination. During a two-hand vaginal examination, a dense, enlarged uterus with a tuberous, nodular surface is palpated. Ultrasound examination of the pelvic organs allows a more reliable determination of the size of uterine fibroids, its localization and classification.

An informative method for diagnosing uterine fibroids is hysteroscopy - examination of the cavity and walls of the uterus using an optical hysterocope. Hysteroscopy is performed for both diagnostic and therapeutic purposes: identification and removal of uterine fibroids in certain locations. Additionally, hysterosalpingoscopy (ultrasound examination of the uterus and fallopian tubes), probing of the uterine cavity, diagnosis of sexually transmitted infections and oncopathology can be performed.

Treatment of uterine fibroids

Conservative therapy can only restrain the development of uterine fibroids for a certain time, but not eliminate it completely. Therefore, therapeutic methods are more justified in the treatment of women of older childbearing age, inhibiting the development of uterine fibroids until menopause, when they resolve on their own.

Surgery

The transition to surgical tactics for uterine fibroids is indicated in the following cases:

with large sizes of myomatous nodes (over 12 weeks of pregnancy)
at a rapid rate of increase in uterine fibroids in size (more than 4 weeks per year)
with severe pain syndrome
when uterine fibroids are combined with an ovarian tumor or endometriosis
with torsion of the leg of the myomatous node and its necrosis
in case of dysfunction of adjacent organs - bladder or rectum
for infertility (if no other reasons are identified)
with submucous growth of uterine fibroids
if there is a suspicion of malignant degeneration of uterine fibroids

When deciding on the nature of the surgical intervention and its volume, the patient’s age, state of general and reproductive health, and the degree of expected risk are taken into account. Depending on the objective data obtained, surgical intervention can be conservative, with preservation of the uterus, or radical, with complete removal of the uterus. For young, nulliparous women with uterine fibroids, whenever possible, conservative surgical treatment tactics are chosen to preserve reproductive function.

Myomectomy. Organ-conserving operations include myomectomy - enucleation of uterine fibroid nodes. In the future, a woman may become pregnant, but there is a risk of relapse of the disease. In the postoperative period, the use of hormonal treatment and constant monitoring by a gynecologist is indicated for the timely relief of the beginning relapse of uterine fibroids. The least traumatic is to perform myomectomy through hysteroscopy. In this case, the uterine fibroids are excised using a laser under the visual supervision of a doctor; the manipulation is usually carried out under local anesthesia.
Myometrectomy. Another option for organ-sparing surgery for uterine fibroids is myometrectomy with reconstructive restoration of the uterus. The essence of the operation is the excision of overgrown myomatous nodes in the wall of the uterus while preserving the healthy submucosal-muscular-serous tissue of the organ. This ensures the preservation of menstrual and reproductive function in the future.
Radical operations. They suggest complete removal of the organ along with myomatous nodes and exclude the possibility of having children in the future. Such operations include: hysterectomy (complete removal of the uterus), supravaginal amputation (removal of the uterine body without the cervix), supravaginal amputation of the uterus with excision of the cervical mucosa. When fibroids are combined with an ovarian tumor or when fibroid malignancy is confirmed, panhysterectomy is indicated - removal of the uterus and appendages.

Conservative myomectomy or supravaginal amputation of the uterus is possible using a laparoscopic technique (usually for uterine fibroids up to 10-15 weeks of pregnancy). This significantly reduces surgical tissue trauma, the severity of the adhesive process in the future, and the postoperative recovery period.

High-tech treatment methods

An alternative to surgical treatment of uterine fibroids is the procedure of uterine artery embolization (UAE), which has been used relatively recently. The essence of the UAE technique is to stop blood flow through the arteries supplying the myomatous node. The UAE procedure is performed in a cath lab under local anesthesia and is completely painless. Through a puncture of the femoral artery, a catheter is inserted into the uterine arteries, through which an embolization drug is supplied, blocking the vessels feeding the uterine fibroids.

Subsequently, due to the cessation of blood supply, myomatous nodes significantly decrease in size or disappear completely. At the same time, all the symptoms of uterine fibroids that bother the patient subside. The method of uterine artery embolization has already shown its effectiveness: the risk of disease recurrence after UAE is completely absent, and in the future, patients do not need additional treatment for uterine fibroids.

Prognosis and prevention

With timely detection and proper treatment of uterine fibroids, the further prognosis is favorable. After organ-conserving operations, women in the reproductive period are likely to become pregnant. However, the rapid growth of uterine fibroids may require radical surgery to exclude reproductive function, even in young women. Sometimes even small uterine fibroids can cause infertility.

To prevent recurrence of uterine fibroids in the postoperative period, adequate hormone therapy is necessary. In rare cases, malignancy of uterine fibroids is possible. The main method of preventing uterine fibroids is regular observation by a gynecologist and ultrasound diagnostics for timely detection of the disease. Other measures to prevent the development of uterine fibroids are the correct selection of hormonal contraception, prevention of abortion, treatment of chronic infections and endocrine disorders. Women over 40 years old should limit themselves to prolonged exposure to the sun.

Article outline

Myoma (uterine fibroids) is a common disease that occurs due to rapid cell division. Most often, the pathology affects people between 30 and 50 years of age, but now cases of the disease developing during reproductive age have become more frequent. Every woman should understand what it is, how to treat it and whether it is dangerous, in order to quickly recognize the disorder and consult a gynecologist.

Today there are many methods of therapy and diagnosis, so there is no need to panic, get upset, or sound the alarm. This is not a malignant formation, the disease responds well to therapy and is accurately detected by hardware methods. Below you will learn everything about uterine fibroids, what causes them, symptoms and treatment, types and causes.

What it is

A benign tumor consists of connective tissue of the uterine wall. Education grows quickly, and it is extremely difficult to control the process. Multiple fibroids are often diagnosed when a woman develops more than 2 nodes. Pathology develops due to increased production of sex hormones - estrogens.

Usually the tumor is located inside the cervix or its cavity. The nodules vary in size, reaching several centimeters. For some, the disease develops very quickly, while for others it does not make itself known for many years, remaining on the uterus in the form of a small nodule.

Some people mistakenly believe that if left untreated, malignant fibroids occur. Studies have been conducted in gynecology, the results of which refute this theory. Oncology appears only as a consequence of a previous illness, but the phenomenon is rare.

Uterine fibroids develop for various reasons: the woman’s age, concomitant diseases, hormonal imbalance. The main symptom is periodic, heavy or constant bleeding, sometimes accompanied by pain in the uterus. In extreme cases, anemia occurs, causing increased heart rate, dry, pale skin, and severe weakness.

The diagnosis is made at any age, in 20% the disease is detected at 30 years of age, in 10% in virgins, and in 50% in women over 50 years of age. To avoid negative consequences, it is recommended to undergo examination by a gynecologist at least once a year. In addition, it is important to pay attention to any irregularities in the menstrual cycle - an increase in the amount of blood, lack of pregnancy and ovulation, pain, etc.

Types of uterine fibroids

Fibroids in women can be of several types and large or small sizes. Classification is determined by the number of nodes, the nature of growth, and the place of origin. Based on the specific location, the following types of nodes are distinguished:

Interstitial.
Intraligamentary.

There are cases when a woman is found to have 2-3 types at once. In addition, in medicine there are “pedunculated” fibroids, which connect to the walls of the organ. The complications and consequences of this type are sad in cases where torsion occurs. Depending on the classification of fibroids, the doctor decides what to do and what treatment to choose.

Interstitial

Occurs most often. It usually affects the uterus, but can develop in the cervix. It grows inside the organ, towards the abdominal cavity, protrudes outwards or develops in the myometrial area. The disease is diagnosed at 30-45 years of age. Nodes can be single or multiple. Some formations reach more than 10 cm and are removed surgically.

While the knot is small, the woman does not feel much discomfort. At the beginning of the inflammatory process, pain in the lower abdomen and mucous discharge in copious amounts are observed. When the size of the formation exceeds 4 cm, compression of the bladder and intestines occurs, resulting in symptoms such as frequent trips to the toilet, urination with pain, and dyspeptic disorder.

Intraligamentary

The internal organs of the pelvis are held in place by ligaments, which are responsible for their normal position. In the presence of fibroids, serious disorders may occur, characterized by changes in the anatomical structure of organs. Intraligamentary fibroids are usually not accompanied by disruptions in menstruation, but cause problems with conception and pregnancy.

This type of disease is accompanied by pain in the abdomen or back, urinary disturbances, and enlargement of the kidneys and ureter. The nature of the manifestations is influenced by the size of the node, their location, and quantity. Interligamentous fibroids are rare. To determine this, ultrasound of the uterine cavity is used, then tomography or magnetic resonance imaging. The optimal treatment is removal of fibroid tissue if the nodes are actively growing.

Subserosal

A benign tumor is located outside the uterus and grows into the abdominal cavity. Large nodes are easy to identify during examination, small ones are detected using ultrasound. During the period of active growth, the pathology is accompanied by frequent constipation, frequent urination, and hemorrhoids.

After the onset of menopause, the tumor may decrease in size on its own (more details in). In other circumstances, it is removed surgically. Most often, subserous uterine fibroids in women are activated after performed or spontaneous abortions.

Submucosal

The nodes are located in the endometrium. The formations progress rapidly and grow outside the cervix, causing severe gripping pain. During the period of active growth, nodes cause the following complications:

Miscarriage;
Inability to bear a child;
Heavy bleeding;
Severe pain, spasms.

The submucosal type of fibroids can be caused by an excess of estrogen, frequent abortions, difficult childbirth, inflammatory diseases, etc. Treatment occurs surgically after hormone therapy.

Why are uterine fibroids dangerous?

Having heard the terrible diagnosis, the girl begins to panic and find out how fibroids can be dangerous for a woman’s life. It should be noted right away that the occurrence of cancer is minimal.

The main risk is the subsequent development of complications, but following the doctor’s recommendations and constant monitoring will eliminate adverse reactions.

If fibroids are not treated, the following consequences occur:

Severe uterine bleeding is a dangerous process due to the development of anemia and can threaten the patient’s life.
Purulent inflammation in the nodes and nearby tissues - without modern treatment, septic complications arise.
Torsion of the node “on the pedicle” - possible rupture of the pedicle, internal bleeding, or “acute abdomen” syndrome.
Inability to have children - pregnancy outside the uterus, miscarriage, infertility, difficult childbirth may develop.
Necrosis is the death of nodes.
Birth of a mass with uterine inversion.
Malignancy is when a benign tumor turns into a malignant one. The phenomenon is extremely rare, but it’s not worth the risk.

The development of pathology is accompanied by severe, sometimes unbearable pain. The main danger of uterine fibroids is possible complications, including death.

Causes

The appearance of pathology is due to various circumstances, which have not yet been fully studied. The main factor is hormonal imbalance that occurs due to illness, stress, poor diet, etc. Let’s look at what causes fibroids below:

Hereditary causes;
Hormonal imbalance – that is, a violation of the amount of estrogen and progesterone;
Lack of orgasm;
Adenomyosis;
Diabetes, hypertension;
Gynecological diseases, inflammation, diabetes, slow metabolism;
Frequent abortions - the probability increases by 2 times;
Stress that has a bad effect on the thyroid gland, adrenal glands, etc.;
Obesity, lack of exercise;
Installed intrauterine device.

Doctors have proven that women who have given birth are less susceptible to developing fibroids. The disease often appears during pregnancy, in particular if it is late.

Excess estrogen and excess progesterone

Fibroma is considered a hormonal disease, since growths form due to hormonal imbalances. That is why neoplasms do not occur in girls who are not of childbearing age.

When problems with the menstrual cycle occur, an imbalance in the production of progesterone and the hormone estrogen occurs. Hormonal disruptions provoke the growth of tumors, so suspicion of fibroids (first of all) needs to be confirmed by studying the hormonal status.

Diabetes and hypertension

Women suffering from such diseases are susceptible to developing fibroids at an early age. If there is a strong accumulation of fat deposits in the waist area, this indicates a tendency for formations to grow. Girls living in cities get sick more often. Their metabolism is disturbed due to stress or poor lifestyle, which provokes the occurrence of gynecological pathologies.

Women's nutrition

Diet plays an important role. Excessive amounts of trans fats or refined foods eaten, as well as a lack of fiber, provoke an imbalance of sex hormones. Poor nutrition causes obesity.

If a woman eats a balanced diet, eats cereals, seafood and plant foods, and avoids sugars and fats, the risk of fibroids is minimal. A person who eats right looks young and healthy.

Pregnancy, childbirth and abortion

Abortion, miscarriage, difficult childbirth with injuries, curettage are common causes of gynecological diseases. A woman who has given birth is less susceptible to the appearance of fibroids.

Lack of orgasm

Rare, irregular sex, as well as lack of orgasm, leads to stagnation in the pelvis. Chronic stagnation causes hormonal imbalance and, as a consequence, the development of fibroids.

Diagnostics

In modern medicine, diagnosing pathology is not difficult. A recently appeared tumor is identified during examination by a gynecologist. The patient has an increased size of the uterus, deformation of the walls and thickening are observed.

To confirm the diagnosis, the following additional studies are performed:

MRI, CT - rarely used.
Hysteroscopy is the removal of uterine tissue in order to subsequently transfer the resulting material for research.
Laparoscopy.

The scope of research is determined individually for each woman. An examination and ultrasound examination are usually sufficient.

Symptoms of fibroids

The early stages proceed unnoticed. Tumor formation can be detected as it grows.

First signs:

Menstruation irregularities;
Bleeding;
Constipation, frequent urination;
Miscarriages;
Infertility;
Anemia;
Sudden enlargement of the abdomen without any justification;
Bloody discharge during sex;
Pain in the lower abdomen and lower back, heaviness;

With growth, constant bleeding, cramping pain, anemia, and a large belly are observed. The growth of fibroids during pregnancy is dangerous due to premature, protracted labor, fetal hypoxia, and delayed fetal development.

Echo signs of uterine fibroids are important for the doctor. With their help, the location and type of growth is calculated.

The nature of pain in various forms

As the pathology develops, the pain becomes stronger and more unbearable. In the interstitial form, the tumor puts pressure on surrounding organs, causing a feeling of heaviness and pressure. The subserous form is accompanied by debilitating back pain, the submucous form is accompanied by cramping, which is constant.

Bleeding and the menstrual cycle

The submucosal form, developing, causes constant, incessant bleeding, which provokes the occurrence of iron deficiency anemia and other complications. The woman quickly gets tired, headaches and weakness appear, as well as dystrophic changes in the myocardium.

Is it curable or not?

Since the disease is common, new treatment methods are being actively developed throughout the world. There are a lot of them, ranging from taking hormonal medications to surgery. After diagnosis, a woman does not know what to do with uterine fibroids.

First of all, you need to visit a good gynecologist who will tell you exactly whether there is a disease or not, and how it can be cured. Then individual treatment is prescribed, which differs depending on the size and location of the tumor, as well as the woman’s age.

Knot dimensions

Myoma nodes can be both small and large, reaching sizes of more than 10 centimeters. Small formation - up to 2.5 cm, medium - up to 13 weeks, large - more than 12-15 weeks of pregnancy. The larger the nodes, the greater the risk of complications and bleeding.

How to treat uterine fibroids

There are 2 main methods of therapy:

Conservative treatment of uterine fibroids is the mandatory use of hormonal drugs, symptomatic treatment with painkillers.
The main thing is surgical intervention, which is effective in severe stages.

The method is prescribed based on symptoms, tumor size, patient’s age, intention to give birth, and growth rate of uterine fibroids. It is best to treat early, when surgery is not yet necessary. Conservatism is most effective during reproductive age.

Having discovered a tumor during menopause, the doctor restrains its development until it completely resolves or decreases in size.

Gonadotropin-releasing hormone agonists

This method initiates a temporary menopause, which leads to a reduction in the size of the tumor by 52%. The group includes drugs containing triptorelin, goserelin, buserrelin and leuprorelin. The course of therapy is 4-6 months. The size of the nodes is reduced by 50%, but the risk of relapse cannot be excluded. This group is often used before surgery to reduce bleeding by reducing the growth.

Antigonadotropins

The drugs are rarely used as they cause some adverse reactions. It should be taken only when other methods are powerless even with long-term use. The group consists of such active ingredients as Gestrinone and Danazol. The drug eliminates symptoms, but does not affect the size of fibroids, so it is often prescribed in the preoperative period.

Gestagens

Effective, inexpensive drugs that block estrogen synthesis. Unfortunately, fibroids are not completely cured with the use of this product. There were cases when the patient's condition worsened. Typically, drugs in this group are prescribed for concomitant diseases, for example, endometrial hyperplasia, since the cause of the pathologies may be a hormonal disorder.

Antiprogestogens

Mifepristone - binds to progestogen receptors, blocking the effect of progesterone. The substances reduce the size of the tumor, reducing symptoms. The drug is available in the form of tablets of 3-6 pieces, and is often used before operations.

Operations

Surgery for uterine fibroids is performed in several ways. The most popular are hysteroscopy and laparoscopy. This is due to the absence of scars, preservation of reproduction, and rapid recovery. The doctor focuses on the woman’s age, the size of the formation, its location and quantity.

A laser is mainly used, which cuts off the tumor without causing bleeding and does not leave deep scars. Today, the UAE method is actively used - embolization of the uterine arteries. During the procedure, the doctor injects a special drug into the vessels to stop the flow of blood to the affected tissues.

They begin to die off as they are deprived of oxygen, gradually decreasing in size. The method is used for any number of nodes and their location. Gentle surgery is powerless in cases where it is impossible to stop the growth of the tumor. Then the doctor removes the uterus completely.

When is surgery prescribed?

The operation is prescribed in several cases:

The nodes are more than 12 weeks old and put pressure on the internal organs;
Combination of fibroids with other gynecological diseases;
Severe uterine bleeding;
Active growth of nodes or their necrosis;
Birth of a node or necrosis.

Intervention is also necessary (surgery is needed) for suppuration in the area of the fibroid.

Popular methods of treating uterine fibroids surgically will be described below.

Embolization

– a unique method used to stop the blood supply to fibroids. After the operation, the growth shrinks and resolves, as blood stops flowing into it. Doctors give positive prognoses; some are confident that the operated woman remains able to bear and give birth to a healthy child. This depends on the size and type of fibroids, as well as the correctness of the operation.

Advantages of the operation:

Normalization of menstruation.
Disappearance of problems with urination.
No risk. The operation does not require anesthesia, takes no more than 15 minutes, rehabilitation lasts up to 7 days.
Good efficiency.

The method eliminates relapses and additional treatment; it is enough to perform one operation, and the pathology disappears forever. If the rules of rehabilitation or prevention are not followed, sometimes the disease reappears.

Hysteroscopy

A popular method that is carried out through the vagina, removing the growth with a special instrument. As a rule, after removal, no adverse reactions or complications arise, the risk of relapse is minimal, and the woman can give birth.

Often before surgery, the doctor prescribes preoperative preparation, which consists of taking hormonal medications. The method is more necessary to normalize the size of the uterus, but the tumor also decreases.

Myomectomy

The laparoscopic method is performed using special punctures in the abdomen. Removal of fibroids by myomectomy is low-traumatic; after extraction, the material is sent for research. With the help of myomectomy, uterine fibroids can be cured, preserving the woman’s ability to give birth to a healthy child, and without leaving visible marks on the body. The disadvantages of the method include possible relapse and the need for repeated intervention.

Fuse ablation

The nodes are removed under MRI control, the procedure is safe and convenient for the doctor. The cells are heated by an ultrasonic pulse until they are destroyed. The entire process may take 4 hours as it consists of several stages. After the operation, the symptoms of the pathology disappear, relapses are excluded, and the size of the growth decreases. Unfortunately, the method is not suitable for all women and is selected individually.