Uterine myomatosis is a fairly common and dangerous pathology in women, characterized by the occurrence of a benign neoplasm. There are several different types of fibroids, one of which is submucosal fibroids, which can actively develop and grow.
This disease is a benign tumor that protrudes beyond the uterus, formed from its muscles. There may be multiple myoma, which consists of several nodes at once, and they are located in several zones at once.
Features of submucosal uterine fibroids
Submucosal fibroids are benign neoplasms that form in the submucosal layer of the uterus. A feature of this disease is that the fibrous nodes do not grow deep into the uterine cavity, but towards the abdominal cavity.
Clinically proven that these neoplasms grow much faster than all other types of fibroids, and they also have pronounced symptoms. Depending on where exactly the myomatous node is located, it can cause some discomfort, as it puts pressure on nearby organs.
If the submucosal nodes are large, they compress the ureters and intestines, which manifests itself in problems with urination and defecation. In addition, such a neoplasm can lead to a missed pregnancy or provoke a miscarriage.
Causes of submucosal fibroids
Today, doctors cannot say for sure what causes submucous fibroids, but there are a number of factors that provoke the formation of this pathology, in particular, such as:
- hormonal changes;
- frequent stress;
- physical activity;
- obesity;
- taking oral contraceptives;
- no pregnancy and childbirth under 30;
- hereditary factor;
- frequent abortions;
- inflammatory diseases of the genital area.
Only a doctor can determine the main reason for the formation of myomatous nodes. It is very important to determine what provoked the pathology, as this will eliminate its occurrence in the future.
Main signs of disease
Submucosal fibroids is a very dangerous disease, as it does not manifest itself at all in the initial stages. The nodes quickly increase in size, so the symptoms appear quite clearly. In particular, signs such as:
- long and heavy periods;
- pain in the lower abdomen;
- presence of bloodclots in menses;
- heavy uterine bleeding;
- bloating;
- increase in temperature;
- weakness and malaise;
- infertility.
In some cases, submucosal fibroids do not manifest themselves at all, especially in the initial stages. With the development of pathology, the symptoms begin to grow more and more. It is very important to conduct a diagnosis in a timely manner to determine the presence of pathology, as this contributes to rapid treatment and recovery.
Diagnosis of disease
Myoma with submucosal growth is diagnosed during a gynecological examination by palpation. In this case, the doctor can detect a myomatous node of a dense consistency.
Diagnosis is confirmed by examination with mirrors, as a whitish induration with a pronounced vascular pattern can be seen. The uterus can reach a considerable size, its surface becomes bumpy, the nodes are dense, and if blood circulation is disturbed, they become painful.
For a more accurate diagnosis, an x-ray is taken, as the picture shows an expansion or curvature of the shadow of the tumor. Submucosal nodes in the picture are defined as clear defects with clearly visible contours.
One of the most informative methods of diagnostics, which accurately helps to determine whether there is an interstitial-submucosal fibroid, is echography. The information content of this method is quite high, since there appearednewer and more modern tools and techniques. Ultrasound scanning makes it possible to detect fibroids, even if they have a small diameter.
To clarify the diagnosis, an ultrasound tomogram is performed, since a three-dimensional ultrasound image can be obtained. This is a fairly informative method, as it allows you to fully assess the ongoing pathological process and clarify whether there is a concomitant pathological process.
Treatment of fibroids
Submucosal fibroids were previously treated only by the surgical method. When diagnosing a myomatous node, only the removal of the uterus was previously performed, after which the woman could no longer give birth to a child.
However, now it is possible to carry out treatment with a conservative method. At the initial stage, the tumor has a small size, but this type of neoplasm grows very quickly, which is why it is extremely important to determine how quickly its growth will occur during the diagnosis.
The disease is very difficult to treat with medications, but hormone-containing drugs can somewhat stop its further development. The use of hormonal drugs can provide such a hormonal background in the female body that will correspond to the menopause period.
If the patient has submucosal fibroids, treatment with hormonal drugs can bring the desired effect if the patient is over 40 years old and close to menopause. With successful therapy, there isthere is a high probability that the fibroids will begin to decrease in size and eventually disappear altogether.
Many patients prefer to carry out treatment using traditional methods, but initially you need to consult a doctor, as an incorrectly chosen therapy technique can significantly worsen the patient's condition and provoke complications.
Medicated treatment
If the patient has a fibroid, a submucosal node larger than 5 centimeters, then surgery is not performed, as a variety of complications can occur.
In this case, drug treatment is carried out and the patient is prescribed drugs, such as Zoladex or Dekapeptil-Depot, which allow creating an optimal hormonal background. In this case, the level of estrogen drops significantly, which helps to reduce the size of fibroids.
Additionally, the patient may be prescribed special drugs that are administered intramuscularly or intravenously. In some cases, when the nodes are small, hormonal surgical treatment is indicated.
Women of reproductive age with a severe course of the disease are prescribed the drug "Esmiya". However, it has some contraindications, namely:
- pregnancy and lactation period;
- asthma;
- oncological diseases;
- Vaginal bleeding.
This drug should not be used for a long time, as it can cause serious complications.
Surgery
If submucosal uterine fibroids are quite large, the operation is mandatory, as it can pose a serious threat to life. Fibroids can be removed using laparoscopy or hysteroscopy. Laparoscopy is performed through the anterior wall of the abdominal cavity, and hysteroscopy through the uterine cavity.
If these methods did not bring the desired effect or there are indications, then a complete removal of the uterus is performed. Fibroids can have very serious consequences, so the patient should be examined and treated as soon as possible.
Features of hysteroresectoscopy
The procedure for hysteroresectoscopy is considered one of the most sparing methods of surgical intervention and is performed to preserve reproductive function, as this is important for the subsequent planning of the birth of a child.
During surgery, an electrocoagulator with a special camera is inserted into the uterine cavity under general anesthesia. Then the uterine cavity is examined and the size of the nodes is determined and removed, the uterus is not affected.
Such surgery is carried out through the vagina and cervical canal. For the introduction of instruments, the cervical canal expands slightly. The duration of the surgical intervention is no more than sixty minutes. If submucosal fibroids are removed in this way, the patient reviews are only the most positive, which is very important for patients planningpregnancy.
Performing mechanical myomectomy
Submucosal nodes of rather large size are removed mechanically. Initially, the node is fixed with the help of special tools, and then unscrewed under the control of a hysteroscope.
The capsule can be dissected using a special resector and the node removed. Removal of submucosal fibroids by mechanical myomectomy has certain advantages, namely:
- short duration;
- no need to use additional equipment;
- no complications.
After the surgery, the recovery period does not take much time. In addition, there is no damage to large organs, as well as fluid overload of vessels.
Features of electrosurgical myomectomy
Electrosurgical myomectomy is performed if the node is in the 1st or 2nd stage. In addition, in this way, the nodes located in the corners of the uterus are removed, which cannot be removed in any other way.
Surgical intervention can be carried out in one or several stages, it all depends on the nature of the node. When submucosal uterine fibroids are at an advanced stage, this treatment method has good reviews.
Other methods of surgery
Other methods of surgical intervention can be carried out at various stages of fibroids. If none of the sparing methods of surgical intervention has brought the desired result or there are certain indications, thenthe uterus is removed completely along with the cervix.
With complete removal, vaginal, abdominal, and laparoscopic access is used.
Submucosal fibroids as a cause of infertility
Uterine fibroids are benign tumors. Among all gynecological pathologies, it ranks second in frequency of occurrence. There may be several different types of this disease, which differ in the localization of myomatous nodes. In particular, there are such types as:
- submucosal;
- intermuscular;
- subserous.
With submucosal myoma, the nodes can be either on a wide base or on a thin stalk. This leaves a certain imprint on the overall clinical picture of the disease. This is a rather complex and dangerous pathology that poses a serious threat to the he alth and life of the patient and leads to infertility.
Main causes of infertility
Submucosal nodes in uterine fibroids lead to infertility for several reasons. These reasons include:
- mechanical factor, as there are problems with the implantation of a fertilized egg;
- hormonal imbalance leading to ovulation problems;
- closing the opening of the fallopian tubes, which greatly complicates the process of moving the egg to the place of its implantation;
- there is a risk of ectopic pregnancy;
- increased endometrial activity;
- impaired immunity, which negatively affects the processimplantation.
In addition, this pathology can lead to miscarriages due to the fact that the uterus and internal organs are squeezed and certain hormones are released that interfere with the normal bearing of the child.
Thus, uterine fibroids leave a serious imprint on the activity of the reproductive system. That is why it is necessary to start treatment of the disease as early as possible.
