The female genital organ, which is known to everyone as the uterus, sadly, is prone to the development of various diseases. There are some among them that pose a serious threat to women's he alth. But there are also neoplasms that are benign in nature. These include subserous uterine fibroids. To date, this phenomenon occurs in 20% of the fair sex.
Varieties of subserous uterine fibroids
Myoma itself in medical practice is quite common, and it is customary to divide it into several types:
- Intermuscular - the tumor is located in the thickness of the muscle fibers at the bottom of the uterus or in the area of \u200b\u200bher body.
- Submucosal - or in other words, submucosal fibroids, is a benign hormone-dependent tumor that is formed from smooth muscle cells of the myometrium of the genital organ and is located in its submucosal layer.
There is also another variety - subperitoneal fibroids,which we will touch on in more detail. Its official name is subserous. And it, in turn, is also divided into several varieties:
- intramural;
- interstitial-subserous;
- multiple.
But what, in fact, is subserous uterine fibroids? A node of this type is a benign tumor, so patients with such a diagnosis have nothing to fear.
Neoplasm is completely dependent on the hormonal background of the female body. It often forms outside the uterus and grows towards the pelvic cavity. Some neoplasms are localized directly on the wall of the reproductive organ, but there are also those that have a leg, which is a kind of "umbilical cord" for feeding the tumor.
Intramural case
The mildest form of uterine fibroids, which develops on the outside of it. At the same time, conformity does not have any effect on the size of the reproductive organ and the menstrual cycle itself. And this means that there is simply no danger for women in this case. A girl can get pregnant without any problems and calmly endure a full-fledged developed baby.
The tumor comes from smooth muscle and connective tissue. If we compare this form with the rest, then it does not degenerate into a malignant neoplasm. Tellingly, even with a simple ultrasound examination, it is not always possible to detect the development of an interstitial node, especially when it is small. To verify that thisforms of the disease, hysteroscopy will be required.
Interstitial subserous uterine fibroids
Otherwise, this form of uterine fibroids is called mixed and, unlike other types, is quite large. Growing in the wall of the uterus, the neoplasm, due to its larger volume, has a negative effect on neighboring organs by squeezing, which contributes to the inhibition of their main functions. And if the diameter of ordinary nodes is often no more than 10 cm, then the dimensions of such neoplasms are simply amazing in their dimensions - about 250 mm.
As a large tumor develops, a woman may find some tell-tale signs:
- Severe pain and heaviness in the abdomen.
- Frequent urge to urinate like during pregnancy.
- The menstrual cycle will lengthen, and blood loss will increase.
- Shortness of breath with palpitations.
- Appearance of anemia and pallor of the skin.
Typically, women between the ages of 30 and 45 and those who have had one or more pregnancies in the past are at risk for subserous uterine fibroids.
Multiple or multinodular fibroids
Among all other varieties, multiple fibroids are the most common. It is characterized by the development of several nodes, focused on different parts of the genital organ.
As medical practice shows, multinodular neoplasms occur in 12-25% of cases. The peak of the disease falls on the reproductive and premenopausal age of women. However, recently, cases of this pathology have been diagnosed in the fair sex up to 33 years old, which cannot but excite physicians. Among girls younger than 20 years of age, the risk of experiencing such a disease is from 0.9 to 1.4% of cases.
In this case, nodes can have different sizes:
- small - less than 20mm;
- medium - no more than 60 mm;
- large - from 60 mm and larger.
As for pregnancy, due to multiple neoplasms, the seminal fluid does not pass well through the fallopian tube, as a result of which the fertilization of the egg is significantly hampered, but this applies only to large subserous nodes. Smaller uterine fibroids do not have this effect. But even if the conception is still crowned with success, the node begins to actively develop, sometimes in contact with the placenta, which threatens with complications.
The course of pathology
Regardless of the type of uterine fibroids, there are three main stages in the development of neoplasms:
1 stage - first, the tumor actively grows against the background of an accelerated metabolism.
2 stage - the disease passes to a progressive stage, but at the same time it does not clearly show itself.
3 stage - neoplasms increase to diagnosable dimensions.
The development of neoplasms and an increase in their size has a detrimental effect on the contractility of the reproductive organ, as a result of which menstruation is not only accompanied by pain, but the discharge itself becomes more abundant. As a rule, this leads to chronic iron deficiency.anemia.
Moreover, due to the growth of subserous uterine fibroids, pain increases not only during menstruation, but also appear after any physical exertion, prolonged stay on the legs, or after a change in body position. The pain itself is localized in the lower third of the abdomen with a return to the groin or coccyx.
In the case when the neoplasm grows in the direction of the rectum, a woman can be overcome by constipation and pain in this area. With the development of a tumor in the direction of the abdominal region, it usually begins to compress the walls of the bladder, which causes symptoms of dysuria:
- frequent urge to urinate, and painful;
- difficulty urinating;
- bladder not emptying completely.
In addition, a subserous tumor contributes to a serious deformation of the reproductive organ, narrowing of the fallopian tubes. For this reason, if nothing is done, it inevitably threatens with infertility.
Emergency
As it is now known, there are no clearly defined symptoms of the presence of neoplasms of the genital organ, especially at an early stage of the disease. However, sometimes urgent removal of subserous uterine fibroids is indispensable. In this case, the characteristic features will be pronounced:
- In the lower third of the abdomen, pain becomes acute, intense and growing.
- Cyanosis of mucous membranes and skin, pallor.
- The abdominal muscles are in great tension.
- Increased body temperature.
- General intoxication of the body
All of these symptoms point to deep necrosis or twisting of the subserous node pedicle, resulting in extensive hemorrhage. This situation is critical, and urgent surgical intervention is required here. It is possible that the woman will experience pain shock.
What could be the danger
Complications of this type of pathology are often associated with the development of a tumor on the leg, in particular, we are talking about malnutrition. For this reason, a woman should know that a number of procedures and exercises are contraindicated for her. Due to sudden movements, the leg of subserous uterine fibroids can twist, thermal procedures, including massage, increase the blood supply to the node, which provokes bleeding. How all this may eventually end is described above.
The consequences are no less dangerous. For example, sometimes a knot can rupture and its contents enter the abdominal cavity, against which peritonitis occurs. And here it all depends on how timely assistance will be provided to the woman and the professional experience of doctors.
Everything has a reason
No disease develops from scratch, because there must be a reason for this. And the subserous form of fibroids of the genital organ is no exception. True, the main reasons for this phenomenon have not yet been fully studied, but work in this direction is underway. Among them are:
- Irregular sex life or its onset in women later than 26-28years.
- Elevated estrogen levels.
- Decrease in progesterone.
- Hypothalamus dysfunction.
- No pregnancy in women over 28.
Also, the reason for the increase in the size of subserous uterine fibroids can be a hormonal imbalance in the female body. But this is not characteristic of all girls and occurs only in a number of cases. Of course, most people suffer from hormonal disorders, but those women who have never become pregnant before reaching the age of 30 or have poor heredity are at the highest risk.
Many doctors also add to the list of causes that contribute to the development of neoplasms, the following factors:
- Predisposition to the disease in genetic terms.
- Removal of past tumors through surgery.
- Performing any operation on the reproductive organ, whether it's an abortion or laparoscopy.
- Infectious diseases of the genitourinary system in the chronic stage.
- Thyroid and adrenal dysfunction.
As a rule, such factors alone do not cause the development of fibroids, only the whole complex contributes to the emergence of the pathological process.
Diagnosis of pathology
Before starting treatment of subserous uterine fibroids, it is necessary to verify its presence, which requires a diagnosis.
To verify the presence of subserous nodes in the reproductive organ of a woman, various activities are carried out:
- Primary gynecological examination can reveal this pathology. During palpation, the doctor will be able to determine the size of the tumor, the structure, and also where exactly it is localized. The woman's belly is usually enlarged.
- Sonography (or simply, ultrasound) is a more accurate tool in determining subserous fibroids of the female reproductive organ. Moreover, the size of the tumor will be revealed to the nearest millimeter, the study will show exactly where the neoplasm is located, and will allow you to assess the state of the uterine border and nearby organs. In this case, it is possible not only to observe the course of changes, but also to timely identify the stage of transformation of the node into a malignant tumor.
- X-ray of the uterus can also provide a complete picture in the presence of any deformities.
- CT and MRI are also highly accurate. With the help of these studies, it is possible to determine the signs of subserous uterine fibroids and the features of its development, if any.
- Laparoscopy allows you to determine not only the nature, but also the composition of the node. But since this is a type of surgical intervention, albeit less traumatic, the study is carried out only during the period of taking a tumor biopsy.
In addition, a woman needs to take a blood test, which will show the degree of anemia and the presence of an inflammatory process in the reproductive organ.
Features of treatment
The method of treating pathology is the prerogative of the attending physician and no one else. Self-medication is contraindicated here, which is not even worth mentioning. To acceptthe right decision, the specialist pays attention to a number of factors:
- localization of the tumor;
- number of neoplasms;
- knot sizes;
- type of fibroids.
If the tumor, one or more, is small, then there is a chance that treatment will not be required, but the woman will be under vigilant control. In some cases, neoplasms grow very slowly, which does not pose any threat to the woman's he alth.
However, often treatment is indispensable, and then one should choose between a conservative method and an operation. Subserous uterine fibroids, as well as almost any other disease, does not go away by itself, with the exception of some cases.
Conservative method
Conservative therapy is aimed at preventing further development of the tumor and any complications. As a rule, the following medications are prescribed:
- Mixed oral contraceptives - contain hormones such as estrogen and progestogen. Preparations of this group contribute to the normalization of the hormonal background of the female body, weakening the development of the disease.
- Gestagens - in their pure form, they are shown in the presence of small nodes.
- Due to GnRH agonists, the production of sex hormones is reduced, which leads to the cessation of tumor growth.
- Antigonadotropins help prevent disease progression.
As for the duration of thisconservative treatment, then it is approximately 6 months. In addition to medications, your doctor may prescribe certain herbs to help treat the tumor.
Need for surgery
What should be the size of subserous uterine fibroids for surgery? This question is of interest to many women, especially those who have already been diagnosed with a similar diagnosis. Small neoplasms are easily treated with a number of drugs, but in the presence of a large tumor, there is nothing left but surgery. The reason for this is the unnaturally large size of the uterus in combination with neoplasms: 70-100 mm. In addition, the operation is prescribed for a number of other medical indications:
- Active tumor development against the background of bowel and bladder dysfunction.
- Pain becomes more acute and is not relieved by traditional painkillers.
- The growing tumor provoked another pathological process.
- Long periods that make a woman anemic.
In addition, a significant reason for the operation is a strong pain syndrome, heavy bleeding, as well as the rapid development of the tumor.
What women think
On the Internet you can find different reviews about subserous uterine fibroids. And judging by them, many women have already encountered such a pathology and know a lot about it, which can be told to others. Some say that they carried and gave birth to a child without problems. For others, however, such a diagnosis raises some concerns. It andunderstandable, because almost every girl dreams of a he althy and full-fledged child, regardless of age.
If you watch the responses to pressing questions, you will notice that many women have excellent knowledge about subserous or any other fibroids. And this is not surprising, because the Internet is sufficiently developed in our time and is present in almost every family.
