What is fibroids - many women are interested, especially those who have a predisposition to the occurrence of this disease. This is a benign neoplasm that is localized directly in the uterus itself or on the neck of this organ. Despite the prevalence of the disease, scientists have not yet fully established the exact causes of its occurrence.
The size of the neoplasm can be very different, and it can be single or multiple. Fibroids often form in women aged 35-45 years. However, it also occurs in younger patients. It is important to understand exactly what a fibroid is and how exactly it manifests itself so that treatment can be carried out in a timely manner.
Feature of the disease
Uterine fibroids are benign tumors that develop in the uterine cavity or on its cervix. Its dimensions can be insignificant, and can reach several centimeters. The most common type is multiple tumors.
It mainly affects women of reproductiveage. Myoma is a neoplasm consisting of randomly enlarged uterine fibers, forming a dense knot, which is densely intertwined with blood vessels. A feature of such a tumor is that its growth and development largely depend on the level of sex hormones.
It is important not only to understand what a fibroid is, but also what manifestations it has. Of great importance is the size of the tumor and its location. When reaching a significant size, it can provoke pain, menstrual irregularities, and problems during pregnancy.
Classification
What is fibroids, and what types of this tumor are, the attending doctor can tell you exactly. There are several different classifications of this tumor, depending on the location, cellular composition. There are such types as:
- subserous;
- submucosal;
- intraligamentary;
- intermuscular.
Subserous is characterized by the fact that the neoplasm is located on the outer side of the surface of the uterus, near the abdominal organs. Intramuscular - located directly inside the muscle fibers. Submucosal - the growth of a tumor inside the uterus, namely under its mucosa, passing into the lumen. Stem fibroids are not a specific group, but only a form of uterine disease that occurs with a subserous or submucosal type. The difference lies in its wide or narrow stem.
Intramural fibroids are the most common. This is a fairly typical pathology for women aged 40 years. This type of tumor is made up of tissuesmuscle layer, which leads to an increase in the size of the entire organ. This cannot but affect nearby organs, since the neoplasm affects them and interferes with normal blood supply. The main feature of the flow is a violation of the menstrual cycle, the presence of pain and a feeling of pressure.
Multinodular fibroids have several nodes and significantly deform the uterus. As it grows, this neoplasm can even be visually seen, as the stomach grows sharply. Among the main signs, it is necessary to highlight prolonged and severe bleeding, a feeling of heaviness, pain, weakness.
Causes of occurrence
The development of fibroids occurs against the background of various kinds of hormonal disorders, so this is considered the main cause of the disease. Often, a tumor forms in young women and successfully resolves when menopause occurs, since by this time the level of estrogen begins to decrease. In addition, there are several more main reasons, in particular, such as:
- genetic predisposition;
- inflammatory gynecological diseases;
- stress;
- frequent abortions;
- obesity and sedentary lifestyle;
- sexual intercourse without orgasm.
This is a hormone-dependent tumor, so it is formed only in childbearing age. Its growth is activated with an increase in the level of hormones responsible for the nutrition of this organ. Pregnancy and abortion also affect the uterus. Even women who have given birth once significantly reduce the risk of developing this condition.disease.
The main reason for the development of many diseases is nutrition. Metabolic disorders, the constant presence of refined fats and obesity lead to an increase in estrogen levels.
Main symptoms
For a long time, no signs of uterine fibroids appear, and it is often found quite by accident during an examination by a gynecologist. Sometimes there are symptoms, but until a certain time they are somewhat blurred, which is perceived as the norm. Most often, pronounced signs occur with tumors of the submucosal type or in the presence of large nodes, regardless of their location.
Among the main symptoms of uterine fibroids are:
- long and heavy periods;
- bleeding;
- pain in the lower abdomen;
- impaired pelvic function;
- infertility;
- miscarriage.
The most basic symptom is prolonged and very heavy menstruation, but the periodicity of the cycle is not disturbed. This can lead to the development of anemia. In addition, there may be bleeding in the middle of the cycle.
Among the signs of uterine fibroids, pain in the lower abdomen and in the lumbar region can be distinguished. They have a whining character. Acute pain can occur when the pedicle of the fibroid node is twisted, resulting in a significant circulatory disturbance. When the neoplasm reaches a large size, it begins to compress the internalorgans, and the woman begins to worry about frequent urination, chronic constipation or urinary incontinence.
One of the signs of uterine fibroids is infertility or miscarriage. The tumor prevents the normal movement of sperm through the fallopian tubes. In this case, the localization of the neoplasm plays an important role. A woman may well become pregnant with fibroids and bear a he althy child, but this requires constant medical supervision.
Diagnostics
Before prescribing treatment for uterine fibroids, you need to conduct an appropriate examination to determine its type, size and localization. During the diagnosis, initially a woman is taken for analysis. Diagnostic methods are based on such studies as:
- gynecological examination;
- ultrasound;
- hysteroscopy;
- laparoscopy.
When conducting a gynecological examination, you can find that the uterus is slightly enlarged in size. Ultrasound diagnostics allows you to assess the size of fibroids, the number, size, localization of nodes and determine the structure of the uterus.
Hysteroscopy helps to diagnose the presence of a tumor, and to obtain more accurate data, a biopsy is needed to assess its histological and cytological composition. Diagnostic laparoscopy will help not only to accurately diagnose, but also to assess the degree of damage and neglect of the disease. In addition, if necessary, you can immediately remove the nodes.
Feature of therapy
There are 3 main methods of treating uterine fibroids, in particular:
- drug;
- non-drug;
- surgical.
No other therapy regimen has been developed, following which it would be possible to quickly and effectively get rid of the existing tumor. Treatment is selected strictly individually. The doctor selects the most effective method depending on the type of tumor, its growth rate, as well as the presence of many other diseases.
In some cases, medications can be used for fibroids. A similar method is selected when the disease proceeds without severe symptoms. Its main goal is to stop the growth of the neoplasm and its complete disappearance. Progestogens, combined oral contraceptives, antigonadotropins can also be prescribed. The choice of a particular drug is carried out only by a qualified doctor. In addition, he determines the dosage and duration of therapy.
If the use of medications has not brought any result, then the doctor may prescribe a surgical intervention. Removal of uterine fibroids may be required in cases such as:
- a large tumor was diagnosed;
- she is rapidly growing in size;
- puts significant pressure on adjacent organs;
- hemorrhage occurs heavily.
If the node is located under the outer shell of the organ, then laparoscopy of the fibroid is performed. When the tumor is locateda hysteroscope is used under the mucosa. In the case of a different localization, a strip operation is assigned. After removal of uterine fibroids, periods become moderate and less painful.
With a benign tumor, non-drug treatment is possible, in particular, herbal medicine, physiotherapy, balneotherapy and spa treatment. The most common method of therapy is embolization. During this procedure, the uterine arteries that feed the neoplasm are clogged. The blood supply to the tumor is disrupted and its growth stops and dies.
Non-Surgical Treatment
When a woman approaches the age of menopause, if the tumor is small and slowly growing, conservative treatment of fibroids is allowed, which has earned quite positive reviews. Many patients say that with complex treatment, you can achieve very good results and get rid of the neoplasm without surgical intervention. Therapy is based on the use of drugs such as:
- combined oral contraceptives;
- hormone antagonists;
- antiprogestogen;
- antigonadotropins;
- gestagens.
Among oral contraceptives, it is necessary to highlight such as Novinet, Ovidon, Mercilon. Such remedies can effectively cope with pain in the lower abdomen and bleeding, but they do not affect the reduction in the size of fibroids, only contributing to a decrease in the nodes by a few centimeters.
Hormone antagonists are designed for long-term use. They help to somewhat reduce the tumor in size, and are also prescribed before the operation, so that the blood loss is much less. Among these drugs, it is necessary to highlight "Diferelin", "Zolodex", "Decapeptyl".
Among the antiprogestogens, Mifepristone should be singled out, which helps to eliminate the existing symptoms and reduce the size of the nodes. In some cases, FUS-ablation is performed, as this is the most modern method based on ultrasound exposure to fibroids. Precise focusing of the beams allows you to quickly cure the neoplasm.
Surgery
It is not always possible to cure non-surgical uterine fibroids. Operation is shown in cases such as:
- tumor size over 12 cm;
- accelerated growth;
- heavy uterine bleeding;
- death of knots;
- formation of a submucosal node.
Based on the type of neoplasm, location and size of the tumor, the doctor selects a method of treatment. Among the main types of surgery to remove uterine fibroids, the following should be distinguished:
- laparoscopy;
- hysterectomy;
- hysteroscopy;
- open surgery.
All types of surgical interventions are divided into radical and organ-preserving. Each of the operations carried out has its pros and cons. The most common method is the complete removal of the uterus. Such an intervention can be carried out openly andlaparoscopically. With all the advantages of the operation: the fibroids are removed completely, and there are no relapses, doctors also highlight a number of disadvantages, namely:
- complications may occur;
- anesthesia required;
- long recovery.
Such an intervention is highly undesirable for patients who do not have children and who plan to become pregnant in the future. Myomectomy is an organ-preserving operation, consisting in the removal of only nodes. It has a number of advantages, since the recovery period takes 2-3 weeks. In addition, in the future it is quite possible to plan a pregnancy. After that, there is no subsequent formation of uterine fibroids. The operation is mostly successful, but much depends on the experience of the surgeon, the size, location and number of nodes.
In addition, hysteroscopic myomectomy can be prescribed, which is performed with a submucosal location of the neoplasm that grows into the lumen of the uterus. Surgical intervention is performed using a hysteroscope inserted into the uterine cavity through the vagina.
Another type of surgical intervention is the embolization of the uterine artery of fibroids. The operation is to disrupt the blood flow until it stops completely. As a result, there is a decrease in nodes, their replacement with connective tissue or complete disappearance.
Treatment with folk remedies
Quite often, folk methods are used to treat uterine fibroids, they deserve quite good reviews, as they help to somewhat slow down the growth of the tumor. However, it is worth remembering that they can only be used for small neoplasms with slow growth. In addition, you must first consult with your doctor regarding the safety of using traditional medicine.
For treatment, the use of various alcohol tinctures of hemlock, mistletoe, cinquefoil is shown. These plants are quite poisonous, which is why it is necessary to use extracts prepared on their basis very carefully, in short courses, with special care.
Propolis helps to cope with knots, as it stimulates the immune system and has antitumor properties. It is used in the form of various extracts and tinctures, as well as ointments and suppositories.
Knotweed, horsetail and lungwort are used for treatment, as these herbs have the ability to regulate the formation of connective tissue. They prevent the formation of scars and adhesions.
Possible Complications
A variety of complications can occur with fibroids, the most common of which are:
- no power failure;
- necrosis;
- twisted legs of education;
- heavy bleeding.
In some cases, there may be a complication such as uterine eversion, which happens with a submucosal node. Sometimes there may be a degeneration of fibroids into a malignant tumor.
Myoma while carrying a child
Management of pregnancy with fibroids creates certain difficulties for doctors and patients. Absolute contraindications for maintaining pregnancy are the suspicion of malignant degeneration of the tumor, the rapid growth of nodes, their cervical-isthmus localization, infringement, necrosis.
However, even if all these contraindications are not present, a miscarriage is possible, the need for a caesarean section with subsequent removal of the node.
Myoma is a benign neoplasm, but in any case, timely treatment is required to prevent the development of dangerous complications.
