uterine fibroids

Uterine fibroids< /P>Uterine fibroids is a common benign neoplasm that develops from elements of the muscular tissue of the uterine wall. This disease is most common in women 35-50 years old.

 

Types of myomas:

  • Intramural – the tumor formation is located in the thickness of the uterine wall
  • Submucosal – the tumor is located under the mucous membrane, and part of it protrudes into the uterine cavity
  • Subserous – the tumor is located under the peritoneum

Probable causes of the disease:

  • Hormonal disorders, which usually manifest as menstrual irregularities.
  • Irregular sexual activity, especially after 25 years.
  • Hereditary predisposition.
  • The presence of diseases such as arterial hypertension, diabetes, obesity.
  • Pathology of the thyroid gland

Signs of disease:

Very often, the disease is asymptomatic, and only a gynecologist during the next preventive examination can detect it. With intramural localization of fibroids, a woman may be disturbed by menorrhagia, i.e. prolonged and profuse menstruation. Acyclic bleeding that is not associated with the menstrual cycle also occurs, they are called metrorrhagia.

Such chronic blood loss very often leads to the development of iron deficiency anemia, as a result of which blood oxygen saturation decreases. And this, in turn, causes increased fatigue and weakness. Anemia is externally manifested by pallor of the skin and visible mucous membranes.

With a subserous location of the tumor in the lower abdomen, discomfort occurs, periodic aching or sharp pains that can radiate to the lumbar region, leg or perineum. Nearby organs are also affected – the rectum and bladder. When the tumor is significantly enlarged, it compresses them, which leads to difficulty urinating and constipation.

Diagnosis:

  • Gynecological consultation. During examination, the doctor discovers an enlarged uterus.
  • To determine the location and size of myomatous nodes, the pelvic organs are examined using ultrasound.
  • Hysteroscopy. This study is carried out using a special optical device, which is inserted into the uterine cavity through a channel passing through the cervix. The method allows to obtain reliable information in the presence of submucosal nodes, as well as in the intramural location of the tumor, if the uterine cavity is deformed. At the same time, during this study, a biopsy is performed (removal of a small part of the node to determine the cellular composition).
  • Computed tomography and magnetic resonance imaging. These expensive methods, despite the high information content, are rarely used for the diagnosis of fibroids. Examination of organs located in the small pelvis using an endoscope inserted through small holes on the anterior abdominal wall – laparoscopy.

Treatment:

  • Conservative treatment is based on taking the following hormonal drugs :
  • Androgens (Gestrinone).
  • Progestogenic drugs (Dufaston, Norkolut).
  • Combined oral contraceptives (Zhanin, Yarina).
  • Analogues of gonadotropin-releasing hormone (Buserelin). In cases where drug therapy does not lead to the desired effect, surgical treatment of the disease is carried out, the main methods of which are:
  • Hysteroscopic myomectomy – performed with a submucosal location of the tumor.
  • Conservative myomectomy – only myomatous nodes are removed, preserving unchanged tissues.
  • Hysterectomy – removal of the uterus. If the cervix is ​​preserved, the operation is called supravaginal amputation, and if it is removed, extirpation.
  • Embolization — with this intervention, an embolus is introduced into the lumen of the uterine arteries, which leads to the death of myomatous nodes.

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