Female organs of reproduction are often subjected to tumor lesions. One of these ailments is myoma of the uterus, which is a benign formation capable of producing hormones.
The concept of
This formation is formed from connective tissue fibers and smooth muscle tissues. Myomatous formations occur in the form of a single formation or multiple nodules scattered throughout the uterine cavity.
The photo shows how the multiple uterine myoma with intermuscular and subperitoneal arrangement of the
nodes looks. The tumor can be of minor dimensions or grows to a kilogram of formation, so large that it can easily be palpated.
Usually among gynecologists it is customary to indicate the parameters of uterine myoma by comparison with the size of the uterine body during pregnancy.
What causes myoma of the uterus?
Myoma, unfortunately, does not belong to rare pathologies, the greatest prevalence is observed in 20-40-year-old women.
Specialists endow myoma with a predominantly hormonal origin, which is confirmed by innumerable studies. If there is no hormonal balance, then in the future the probability of getting a fibroid increases.
In addition, other factors can cause the onset of fibroid:
- Inflammatory processes in the tissues of the appendages or fallopian tubes;
- Various complications in the bearing of a child, delivery;
- Abortion;
- Endometriosis uterine lesions;
- Kistoobrazovanie in the ovaries;
- Obesity;
- Hereditary predisposition;
- Long-term sunshine;
- Endocrine disabilities;
- The risk of the appearance of education increases in nulliparous after 30 years;
- Impaired immune system;
- Endocrine disruptions, etc.
Specialists note that when taking contraceptive estrogen preparations there is an active increase in the tumor, and when a woman enters the postmenopausal period, the myoma can regress and resolve itself.
But there were cases when such an education was found in patients with a healthy hormonal background.
Symptoms in the early and late stages of
Usually the early stages of uterine fibroids are latent in nature, that is, the tumor formation is asymptomatic, and is usually detected with an accidental gynecological medical examination.
In the progressing stages there may appear signs like:
- Lengthening and abundance of menstruation;
- Isolations containing bloody clots;
- Bleeding between menstruation;
- Anemia Symptoms;
- Soreness in the lumbar region or lower half of the peritoneum. Pain syndrome is aching and persistent or occurs systematically. Pain symptomatology occurs mainly with active progression of the neoplasm.
If the tumor reaches large parameters, it begins to squeeze the nearest tissues - rectum, bladder, etc. Such compression is usually manifested by frequent constipation, urination difficulties, etc.
Especially large symptomatic uterine fibroids can lead to venous compression, which manifests as shortness of breath,palpitation.
Classification
I have several classifications of similar formations. In accordance with the number of nodes of uterine myoma there are such types:
- Single;
- Multiple.
According to the localization, the following species are distinguished:
- ;
- ;
- Corboreal myoma.
In accordance with the sizes there are:
- Large;
- Medium;
- Small myomatous neoplasm.
According to the nature of growth and location, uterine fibroids are classified into:
- Sub-serous - when the node is located under the abdominal wall;
- Intramural - when the myoma is formed in the musculoskeletal layers of the uterus;
- Submucous - the tumor is formed in the depth of the myometral layers;
- Intraligmentary myoma - when the formation is located on the sides of the uterus.
The picture shows the location of the nodes with the uterine myoma
According to the morpho-histochemical features of fibroids are divided into:
- Simple;
- Proliferating;
- Predsarkomy.
Education with centripetal growth
When submucosal formation grows in the muscular layer more than 30% of the total size, it is said of the myomatous growth with centripetal type of growth.
Myoma of the uterus with centripetal growth is characterized by especially long and abundant monthly, frequent intermenstrual bleeding.
Patients have anemia, low hemoglobin level. The resulting intermenstrual bleeding is caused by necrotic processes in the myomatous node or a violation of its integrity. The lack of hemoglobin affects the appearance of the patient, she becomes pale, her face acquires puffy features.
With combined growth of
nodes Often the myomatous nodes have a mixed growth pattern. One node can grow in the thickness of the uterine wall, the other - into its cavity, etc. In a similar situation, the clinical manifestations intersect, and the symptomatology is more extensive.
Most often the myoma is characterized by a multiple character, when several points of active tumor growth are formed, which do not always develop simultaneously. Some myomatous nodules reach large sizes, and the remaining ones can still be in an embryonic state.
How fast is education growing?
The rate of development of myomatous nodes depends on many factors:
- Presence of chronic pathologies of the gynecological sphere;
- Prolonged use of hormonal contraceptives;
- Having a large number of abortions in the past;
- Long-term ultraviolet irradiation;
- The absence of labor and lactation in women after 30.
With rapid growth of myomatous tumor, the woman observes menorrhagic changes( bleeding profuse at monthly intervals), anemic signs, and in the uterus hyperplastic changes of tissues occur. Such manifestations require an operation to remove the uterine body.
What is different from uterine fibroids?
Many people are interested in what is the difference between fibroids and fibroids.
As for myoma, it is a benign formation, consisting mainly of a muscle-tissue component.
Fibromyoma is considered to be a tumor, which is formed mainly from connective tissue fibers.
Than the disease threatens?
If the myomatous uterine formations are ignored, then they are fraught with adverse consequences:
- Infertility. Myomatous nodes create an obstacle to the penetration of spermatozoa into the uterine cavity. Education covers the pipes, making conception impossible;
- Disorder of organic functions. After reaching a large size, the tumor begins to squeeze the tissues that control the urinary and defecation processes;
- The tumor disrupts the quality of life of , delivering a lot of discomfort and pain. Sometimes the pain becomes unbearable, the woman is difficult to move, bend over, walk with a straight back, etc.;
- Complications of delivery and the threat of premature birth.
- Lethalization of myomatous nodes. Similar occurs because of a twisting of a tumor of a leg or foot or absence of a food of a myoma. This process is accompanied by inflammation of the genitourinary tract, swelling and internal hemorrhages. There is a high risk of inflammatory processes in the peritoneum( peritonitis) and necrotic processes can move to other organs;
- The absence of therapy leads to the development of the advanced stage of myoma formation, that is fraught with complete removal of the uterine body .Such an operation permanently deprives a woman of the possibility of motherhood.
Against the background of the lack of therapy under the influence of unfavorable factors, the malignancy process can begin, when the myomatous nodes begin to malign. Similar occurs in 1% of clinical cases.
Restrictions on
In order for myomatous uterine education in fertile women to bring a minimum of harm to reproductive functions, timely diagnosis and proper treatment are necessary.
A set of recommendations has been developed for such patients:
- Categorically it is impossible to lift heavy objects, which threatens to lower the uterine body and other complications;
- Stresses that negatively affect the hormonal background are unacceptable;
- Sunbathing, solarium, hot water treatments, saunas or baths and other procedures accompanied by heat exposure are prohibited;
- The presence of myomatous education categorically does not accept pregnancy or abortion, which causes hormonal bursts provoking increased tumor growth;
- Various procedures for correcting a figure like liposuction are also prohibited;
- Massage of the lumbar, femoral or abdomen is categorically unacceptable;
- It is especially wary to treat douches with folk remedies, which doctors cause skepticism.
Is pregnancy and childbirth possible with myoma?
Pregnancy in uterine myomatous processes is possible, but this happens infrequently, because the formation can transmit the tubes, which prevents the passage of spermatozoa into the uterus.
Therefore, experts recommend removing the tumor before pregnancy.
If the formation is large enough, leads to deformation of the uterine body, then removal is shown, after which it will be much more difficult to save fertility.
These surgical procedures are often complicated by bleeding, in which the uterine body can be removed.
Delivery with miomatous uterine formation is usually protracted, caesarean section may be recommended. Although many women with pregnancy with fibroids and subsequent births are quite tolerable.
In the initial stage, the tumor can easily be confused with the pregnancy , so to confirm the diagnosis, experts assign a woman to a diagnostic procedure such as laboratory tests of blood and urine, ultrasound, etc.
Diagnosis
The diagnostic process for suspected myomatous education involves the following activities:
- Anamnesis history. Particular importance is given to the age criteria of the patient, since such a myomatous pathology is found mainly in women of reproductive age. As a rule, women have complaints about menstruation, which can become more prolonged, plentiful, painful, irregular;
- Gynecological examination. It is performed on the gynecological chair with the help of the necessary tools. The size of the uterine body, the location of the ovaries, the shape and mobility of the cervix, etc.;
- Ultrasonic diagnostics of low-tidal organs helps to accurately detect myomatous formation, determine its parameters, location;
- Hysterographic study. Hysterography refers to X-ray contrast techniques, which allows you to visually see the uterine cavity. For this, a contrast agent is introduced into the body of the uterus, and then a picture is taken;
- Diagnostic curettage. It is usually performed to determine endometrial changes, as well as to exclude cervical or uterine cancer;
- Hysteroscopic examination. Helps to visualize the uterine cavity. It is carried out by using special equipment, which is introduced into the uterus. This method has not only a diagnostic purpose, but also a therapeutic one. In this way, various polyps are removed, a biomaterial for histological examination is obtained.
- Laparoscopy. This technique applies to surgical methods. The laparoscope is inserted through the punctures in the peritoneum and displays the image of the organ under examination. During the procedure, it is possible to obtain biomaterial for histology or removal of small tumors, etc.
Is it possible to cure the disease without surgery?
The approach to the treatment of uterine fibroids is determined in accordance with the stage of education.
In the early phases of the tumor process, it is possible to solve the problem in conservative ways, i.e., non-surgically.
Of course, the uterine myoma can not completely disappear this way, however, it can stop its growth and even reduce the initial size is quite possible.
In conservative therapy, various groups of hormonal drugs are used:
- Antiprogestagens. Promote the cessation of tumor growth. Treatment can reach a half-year period. The most famous drug of this group is Mifepristone;
- Agonists of GnRH( gonadotropin-releasing hormones). They inhibit pituitary activity, which reduces ovarian activity. This action leads to a decrease in the tumor, eliminates bleeding. The duration of therapy is 3-6 months. Popular drugs are Leiprorelin, Tryptorelin, or Goserelin;
- Antigonadotropic. Such drugs inhibit the production of follicle-stimulating and luteonizing hormone, which suppresses ovulation and stops the growth of the tumor. Treatment is long, up to six months with the use of drugs like Gestrinone or Danazol.
All these drugs lead to a correction of the hormonal background, which stops the progression of the tumor and allows delaying surgical interventions. In addition, the use of antifibrotic drugs to prevent connective tissue growth is indicated. A popular drug of this group is Pirfenidone.
If myoma is accompanied by anemia, then iron preparations are prescribed, with inflammations - NSAIDs like Naproxen or Ibuprofen, bleeding - Dicycin, Etamsilate. Adaptogens such as Eleutherococcus, Ginseng, Apilac are also shown, which increase the resistance to harmful effects.
Surgical treatment
Quite often, surgical treatment can not be avoided. Typically, this happens when:
- Large amounts of education;
- Absence of the necessary effect from conservative techniques;
- Development of life-threatening complications.
Organ-preserving surgical procedures and radical removal are used. Classical laparoscopy is considered one of the highly traumatic ways in which the peritoneal opening is performed. In this way, both radical and organ-preserving interventions can be performed.
Laparoscopic surgical procedure is usually used for the removal of subperitoneal myomatous formations, provided that they are small in size.
Prophylactic recommendations
With the preventive purpose against uterine fibroids, it is recommended to follow the principles of healthy nutrition, timely treatment of abnormalities in the hormonal status, regularly undergo gynecological examination and plan pregnancy.
In addition, prevent a similar pathology of harmonious sexual relations with the presence of orgasms, the use of contraceptives, the treatment of probable postpartum consequences, etc. In general, avoid the emergence of a myomatous tumor can be by eliminating the factors provoking it.
A video about the symptoms and methods of treating uterine fibroids: