One of the most common benign tumors of the female genito-urinary area is uterine fibroid, which is formed from connective tissue cells and grows from the walls of the uterine body.
Concept and statistics
Fibro formations can be formed in any organic structures, however, they are most often formed in the walls of the uterine body, in the ovaries and in the dermis, on the skin surface, etc.
The dimensions of such formations are quite diverse,small fibroids with a diameter of several millimeters and tumors of 20-30 cm.
This photo shows fibroid of the uterus
There are different variants of formations: multiple nodal clusters or single formations. Usually, fibrotic processes are latent, and the patient learns of the tumor by accident.
According to statistics, fibroids are more common in 30-40-year-old women( 40%) and only 20% of cases of fibrous uterine formation are found in women younger than 20 years.
Types of
There are several specific groups of fibrous formations:
- The interstitial uterine fibroid is formed inside the uterine walls and is considered the most common. As a result of uncontrolled growth of such formations, the size of the uterus increases;
- The submucosal fibroma grows inside the uterine body, under the mucous interlayer. When such a tumor starts to grow, the woman experiences painful symptoms and cramps, quite often there are heavy bleeding;
- Fibrous interconnected tumors are formed in the space between the uterine ligaments. With the surgical removal of such formations, the probability of traumatic injuries of individual vessels and organs is great;
- Undergrowth formations are formed on the outer layer of the uterine body. Such tumors are dangerous for asymptomatic development. They can grow to gigantic proportions, squeezing neighboring structures;
- Parasitic fibroids are formations attached to other organic structures;
- Stem fibrous variety - occurs due to the appearance in the subsonic formations of the pedicle, with the inflection of which the tumor begins to grow actively, which is accompanied by intense soreness.
In accordance with the type of fibrous formation, a definite clinical picture is formed.
Causes of development of
Specialists have not yet fully determined the fibrotic etiology, although it was possible to identify the regularity of the onset of fibroids on the background of hereditary predisposition and hormonal instability. But not always in the presence of such factors, fibroma is formed.
As additional provoking factors are:
- Complex delivery;
- Later onset of menstruation;
- Abortion;
- Frequent curettage in diagnostic studies;
- Lack of delivery by the age of 30;
- Treatment or contraception with estrogen-based drugs;
- The presence of pathologies of the female genital area;
- Lack of regularity and satisfaction in sexual relations;
- Obesity;
- Hypertension;
- Diabetes;
- Thyroid pathology;
- Stress states;
- Hypodynamic inactive life.
The activity of fibroid growth is affected by pregnancy, because at this time the ladies have an increased estrogen level.
After delivery, the fibrous formations decrease in size. Also uterine fibroids begin to decrease in the post-menopausal period, when the estrogen content drops significantly.
Symptoms of uterine fibroid
Often uterine fibrotic processes occur for patients hidden, but in about a quarter of patients this formation is accompanied by characteristic manifestations.
Among the most common fibrotic symptoms experts distinguish:
- Abundant uterine bleeding, containing bloody clots and accompanied by especially intense soreness;
- Painful sensations in the low-tidal region, the feeling of pressure that fibroma has on the pelvic area;
- Anemic symptoms associated with severe blood loss and manifested in the form of low pressure, tremor of hands, rapid fatigue, weakness and chronic fatigue, frequent dizziness;
- Painful sensations in the back of the thighs, lower half of the back;
- Soreness in sexual intercourse;
- Compression effect on the urinary and intestinal structures, causing an increase in urination, constipation, bloating, incontinence, etc.;
- Increase in the volume of the abdominal area, which is mistakenly written off for obesity or pregnancy;
- Problems with fertilization, early miscarriages and other reproductive disorders.
What is the difference between fibroids and fibroids?
Both types of tumors are found more often in women older than 30 years of age. Initially, in the walls of the uterine body, nodes begin to form which gradually expand.
In terms of symptoms, both fibrotic and myomatous tumors manifest soreness and uterine bleeding, anemic processes, menstrual disorders and disorders, problems with bowel or bladder function.
These formations differ in that the fibroid consists of connective tissue structures, and the myoma is formed from muscle tissue. In addition, education data differ and the therapeutic approach - myomas are treated primarily by surgical methods, and fibroids are successfully treated with drug-conservative techniques.
When the pregnancy is
Fibroids rarely affect the reproductive capacity, however, they often provoke abortion, infertility, premature delivery, etc.
With a large size of fibroids with the onset of pregnancy, activation of its growth will occur, and for the future baby in the uterine cavitydoes not remain at all.
This leads to a spontaneous miscarriage, which most often happens after an 11-week period.
Often, large fibrous formations provoke premature delivery of labor. In such a situation, the chances of rescuing a child increase with the period of pregnancy.
Large parameters of fibroma affect the location of the fetus in the uterine cavity, which complicates natural childbirth and often causes the need for a cesarean section. Therefore, the combination of fibroids with pregnancy is highly undesirable. But if this happens, then the patient must always be under gynecological supervision.
Diagnosis
Fibrous lesions are revealed in gynecological examination.
To confirm the diagnosis, ultrasound is usually given, much less often - magnetic resonance imaging or computed tomography diagnostics.
If necessary, a hysteroscopic examination is performed in which biomaterial can be taken for biopsy. To do this, a special tool is introduced into the uterine neck - the hysteroscope.
Treatment of fibroids
Treatment procedures are usually appointed by gynecologists and endocrinologists, who constantly monitor the patient. If the size of fibrous uterine formation does not exceed 12 weeks of pregnancy, then conservative treatment tactics are indicated.
In addition, indications for conservative therapy are:
- Interstitial or subserous character of education;
- Presence of contraindications to surgical treatment;
- No intermenstrual or excessively heavy menstrual bleeding;
- No complaints of the patient for the presence of intense soreness.
The pharmacological approach to the therapy of fibrosis is based on the use of iron-containing drugs, non-steroidal anti-inflammatory drugs, hormonal drugs and vitamins. The main focus of this treatment is on hormonal therapy.
Surgical removal of
The surgical approach to the therapy of fibroids is justified in the case of the submucosal nature of the formation and in the presence of a pronounced clinical picture.
In addition, the operation is indicated for large sizes and associated pathological processes such as ovarian tumors, endometriosis or necrosis of tumor tissues.
If the fibrous process has a submucous type of development, then a hysteroscopic removal of the nodes is indicated. Especially priority are organ-preserving surgical operations for patients planning pregnancy.
If necessary, treatment of fibroids is carried out with the help of hysterectomy, which is considered a radical therapeutic technique. Such treatment is usually applied to those ladies who do not plan birth of children.
Arterial embolization is considered to be a very young technique, when specialists inject special solutions to the vessels feeding uterine fibroids, causing them to clog. Uterine embolization refers to rather highly effective methods of treatment, but is inaccessible because of its high cost.
Folk remedies
Some experts confirm that fibroids can be cured with the help of traditional medicine recipes. For this purpose, various alcohol tinctures, herbal preparations, decoctions, etc.
are used. But such treatment is permissible only after qualified medical consultation and approval of the gynecologist.
Otherwise, instead of treatment, you can provoke the development of complications, to eliminate which the patient will have to remove the uterus.
Complications and prognosis
Among the common complications can be called a torsion of the fibrous stem, hemorrhage or necrosis of tumor tissue. When torsion, a woman complains of severe pain in the area of the uterus. And necrotic processes are accompanied by hyperthermia, pain manifestations, etc.
Fibers become ill in about 1% of patients. Another complication is iron deficiency anemia. More than half of patients after treatment of fibrous formations safely become pregnant and give birth to healthy offspring.
As for the forecasts, in general, the chances for cure in patients are quite high, because fibroids still belong to benign tumor formations. With conservative therapy there is a chance of relapses, and in the surgical treatment it is practically absent.
Prevention
Specific prophylaxis to prevent and prevent the onset of uterine fibroids has not been developed.
However, a good preventive effect is achieved when excluding fibroma-provoking factors like abortions, infectious pathologies of the female sexual sphere, hormonal failures, stress disorders, uncontrolled contraception, etc.
This video demonstrates a hysterectomy of the uterus with a giant fibroid: