Leiomyoma of the body of the uterus is a pathological muscular growth of the walls of the organ, which leads to oncology. The tumor itself has a benign structure, but against the background of neglected treatment, it can also become malignant. In medicine, this pathology is also called fibromyoma or uterine myoma. This disease can appear in one in four women who are between the ages of thirty and forty. This disease is considered hormone-dependent, can proceed independently. But in general, pathology requires appropriate therapy.
Let's take a closer look at what it is and how to treat uterine leiomyoma.
Features of the pathology and structure of the uterus
To get a concrete idea of this tumor, you need to study the structure of the female reproductive organ. The uterus is a hollow organ capable of carrying a baby and then pushing it out during childbirth. This complex mechanism of work occurs due to the myometrium - the inner layer of the organ. Such a strong frame is formed from muscle fibers of various types in conjunction with connective tissue.
What is it - uterine leiomyoma, you can see in the photo.
Outside, the myometrium is covered with a serous membrane, which resembles the composition of the abdominal cavity. The inner layer is called the endometrium, which consists of layers of epithelium. In a certain phase of the cycle, this layer is updated, after which menstruation occurs. Any such processes are controlled by female hormones, which are produced in the ovaries.
This disease is characterized by the occurrence of a myomatous node. In the event that there are several such appearances, then this is a multiple uterine leiomyoma. Such growths are different in size, structure and type. Nodular forms very often do not manifest themselves in any way, and women do not know about the disease for years if they do not visit the gynecologist regularly.
The tumor has no special symptoms at an early stage. The clinical picture is in many ways similar to various gynecological diseases. In this regard, the most reliable method of diagnosis is ultrasound and hysteroscopy. Doctors do not always prescribe treatment for uterine leiomyoma to patients. Usually when a woman goes through menopause, the tumor, in turn, freezes and regresses. Thus, it requires simple regular monitoring.
Thisthe disease is hormone-dependent. In this regard, it is easily influenced by hormonal drugs. Small fibroids under the influence of medications can completely disappear or stop in their development. The removal operation is prescribed in situations where there is a risk of a serious complication, and the woman, in turn, feels severe pain along with impaired functioning of nearby organs. But even after surgery, this disease can return. This most often happens due to incorrect treatment tactics to eliminate the causes of the tumor.
Types of uterine leiomyoma
Now consider the classification. Depending on the location of the appearance of the myomatous node, this tumor has various names in medicine.
- Intramural leiomyoma of the body of the uterus is more common than other types. It is formed in the inner region of the muscle layer. Its formation is deep enough. Symptoms are manifested by pain in the pelvic area, an irregular cycle, and in addition, a violation of the activity of neighboring organs.
- When submucosal leiomyoma occurs, tissue grows under the lining of the uterus. Often, this type of tumor can grow inside the organ, and it is not always possible to conceive a child.
- Subserous leiomyoma is formed under the serosa, which is obvious from the name. It can be located on the outside and most often grows in the direction of the abdominal cavity. This type is characterized by the absence of symptoms. The only thing that women notice is only a slight discomfort in the lower abdomen.
- Multiple leiomyomas are the formation of several nodes that differ in volume, attachment site and tissue composition.
- Unspecified form of uterine leiomyoma refers to a hidden form of a tumor that cannot be confirmed by diagnostics. This can happen extremely rarely due to the small size of the tumor or due to its slow growth. Gynecologists can only guess about the presence of a problem. Women need to be constantly monitored by a doctor so as not to miss the onset of the disease.
Uterine nodular leiomyoma is diagnosed in many patients. This is a fairly common gynecological disease. It occurs in 30% of women of late reproductive age and patients during menopause. As for the prognosis of this disease, there are doubts. If the problem is detected in a timely manner, a comprehensive examination is carried out and therapy is prescribed, then the disease can be quickly cured. But there is a high risk of recurrence, so it is important to visit the gynecologist regularly.
When the form of nodular leiomyoma is advanced, the formation can become malignant, in connection with this, even death is possible.
Leiomyomatosis and stages of its maturation
Any leiomyomatosis forms in the myometrium and goes through some stages of maturation:
- At first, a muscle knot is formed, which grows from smooth muscle and fibrous fibers around small vessels. At this stage, clinical manifestationsmissing because the uterine leiomyoma is small.
- Then comes ripening. At this time, the myoma is actively growing and forms a ball of muscle fibers, which thickens over time. Adjacent tissues begin to gather around it, which form a special capsule. This process is also called tumor growth. During the diagnosis, fibroids are quite easy to detect, and the patient is already showing clinical symptoms.
- The next step is the aging of the leiomyoma. Considering that tissues degenerate due to pathological processes, the node stops growing.
In each individual case, oncology can behave differently. You should not expect the same symptoms for all women with this diagnosis.
Leiomyoma and its causes
The detected gynecological tumor directly depends on the woman's hormones. In the presence of a large amount of estrogens, cells pathologically divide, and during menopause, this process freezes. The true causes of leiomyoma are still not fully understood, but there are the following provoking factors:
- The central factor is brain injury along with vascular pathologies and psycho-emotional disorders. Pituitary and hypothalamic hormones control ovarian function. The ovaries, in turn, are responsible for the processes of maturation of follicles and ovulation. Thus, any disruption in the activity of the brain can lead to dysfunctions of the reproductive system.
- The classic factor is infectious and inflammatory diseases of the ovarieschronic, including polycystic. Against this background, an imbalance of hormones occurs, which leads to the diagnosis of leiomyomatosis. In medical practice, the classic factor is the most common.
- With the uterine factor, any mechanical injury to the reproductive organ can provoke the appearance of neoplasms. Even against the background of good functioning of the ovaries, the uterus is able not to perceive hormones due to damage to the receptors. Complicated births, along with abortions and surgeries, can cause similar trauma.
- Associated factors are disorders in the endocrine system, thyroid disease and so on. All this causes the growth of the myomatous node.
In the event that a woman knows in advance about her predisposition to at least one of these factors, she is recommended to visit a gynecologist and carefully monitor her he alth.
What are the symptoms of uterine leiomyoma?
Symptoms of disease
The clinical picture of this disease directly depends on the growth of the tumor, and in addition, on the number of nodes, their location and the progression of the pathology. Small interstitial muscle nodes are not dangerous to the body. But the submucosal leiomyoma of the uterus, even having a small size, can significantly manifest itself with the following symptoms:
- Presence of menstrual irregularities. Menses may become irregular, heavy, and longer. At an early stage, such manifestations are removed by medications, so patients do not immediatelyconsult a doctor. But gradually, blood loss becomes significant, causing discomfort with soreness. This causes anemia, and then you can’t do without the help of a doctor.
- Pain syndrome may appear due to severe contraction of the myometrium. Large fibroleiomyomas do not allow the epithelium to exfoliate, pain occurs. Severe pain can appear with subserous myoma. Directly with the intramural form, the sensations are pulling and aching. In the event that necrosis occurs in the tissues of the uterus, a sharp pain will be felt.
- Violations in the work of neighboring organs. Leiomyomatosis can cause disturbances in the functioning of the intestines and bladder. Against this background, the woman will feel frequent urge to go to the toilet. Or, on the contrary, there may be difficulties with bowel movements or the process of urination.
- The appearance of dysfunction of the reproductive organs. Against the background of leiomyoma and concomitant diseases, as well as hormonal imbalance in women, infertility develops, and in addition, ovulation is disturbed. The reason for this is the unfortunate location of the myomatous node in the cavity of the organ, which prevents the attachment of the egg. Leiomyoma during pregnancy sometimes has unpleasant consequences in the form of premature termination and miscarriage. But according to statistics, such cases are quite rare.
Diagnosis of disease
At the first appointment with the gynecologist, the uterus is examined and the patient's complaints are collected. As part of a two-handed study, the deformation of the organ and its size are determined. It is the size of the uterusgreat importance. The specialist chooses a specific day of the cycle, and during the year, at this particular time, an examination is performed. In the event that the uterus has not increased in size in a year, then doctors talk about the slow course of the disease.
Thanks to the use of a speculum, it is possible to detect submucosal nodes growing in the direction of the cervix. For more accurate results, colposcopy methods are used. Ultrasound is considered the most reliable way to diagnose oncology, with the help of which it is established:
- Total number of fibroids along with their characteristics.
- Structure, term and type of leiomyoma.
- Pathology of the endometrium.
- The nature of the functioning of the ovaries.
In addition to ultrasound, hysteroscopy is performed, and a smear is taken for flora along with a biopsy for oncocytology.
Leiomyoma treatment
How is the diagnosis of leiomyoma, we have already studied. Next, we will find out how the treatment of this disease occurs. In medical practice, this tumor is usually treated by conservative methods. Very often, it disappears on its own or regresses during menopause. In this regard, doctors are in no hurry to carry out surgical removal of uterine leiomyoma. The choice of a suitable treatment directly depends on the result of the examination and on the general well-being of the patient. Conditions for therapy with traditional methods are the following factors:
- Tumor sizes up to three centimeters along with a slight increase in the uterus.
- Asymptomatic course of the disease.
- Women planning future pregnancy.
- Presence of intramural or subserous fibroids.
Surgery for leiomyoma
Surgical intervention doctors prescribe to patients in the following cases:
- The presence of an advanced disease, when the submucosal uterine leiomyoma is very large.
- Presence of submucosal nodes.
- Presence of torsion of the legs of the nodes along with necrosis of the walls of the uterus.
- Development of subserous fibroids with extremely severe symptoms.
- Finding a leiomyoma on the cervix.
- Presence of hyperplastic processes.
- No effect of conservative treatment.
Modern surgical techniques make it possible to preserve the reproductive organs during surgery for uterine leiomyoma, removing only the neoplasm. Such operations include myomectomy, FUS-ablation along with partial removal of the uterus through defundation. Absolute removal of the organ is carried out with the help of hysterectomy. An operation aimed at removing a tumor does not always lead to its complete disappearance. Sometimes fibroids can grow back.
What else is used in the treatment of uterine leiomyoma?
Medication use
The main thing in the treatment of this disease is to be able to stop the cause of its occurrence. Therefore, very often, hormone therapy is prescribed by specialists in order to reduce the level of estrogens and normalize their number. For this, the followingmedicines:
- Analogues of GnRH.
- Antiprogestogens.
- Progesterone analogues.
- Combined oral contraceptives.
All medicines differ in their individual contraindications for use. For example, some of them cannot be taken if a woman has a history of hemorrhagic syndrome. As part of their use, you must first read the instructions and discuss the regimen with the doctor. Treatment with hormonal drugs is always required for a long time. In parallel with this, patients are prescribed therapy with folk remedies, and in addition, it is advisable to use sedative, antianemic and vitamin preparations.
Duration of treatment is about six months or more. At this time, it is necessary to control the pathological process with the help of an ultrasound examination every three months. If necessary, the doctor will adjust the dosage or replace the medicines. Alternative medicine techniques such as hirudotherapy, homeopathy, bee products, and so on can be used as auxiliary preparations.
But it should be remembered that leiomyoma is a disease that has its own complications and danger to the body. You can not self-medicate, it is imperative to consult with a specialist. There are cases of degeneration of this tumor into cancer, such a transformation is called uterine leiomyosarcoma. Therefore, under no circumstances should thisdisease on its own.
Reviews on uterine leiomyoma
Women write about this disease that it is an extremely unpleasant pathology. Many people have to undergo surgery to remove leiomyomas. Usually, ladies write that with the removal of the tumor, all the problems associated with the unpleasant clinical manifestations of this disease go away.
But the main disadvantage of surgery is the inability to give birth to a child. Also, those who had to go for a hysterectomy report that after the operation they developed adhesions, constipation and problems in the intimate area. Women write that after undergoing a hysterectomy, they developed caries, had problems with the bones, hot flashes and dizziness appeared.
Thus, based on the reviews, we can say that a hysterectomy on the background of leiomyoma entails many negative consequences. And among the advantages of women, they name only getting rid of menstruation and preventing the possible degeneration of leiomyoma into a malignant neoplasm. Women also write that hysterectomy, despite all the disadvantages and consequences, is by far the most effective solution to such a problem as uterine leiomyoma.
What is it and how to treat the pathology is now clear.
