Uterine fibroids: classification, causes, types and their localization

Uterine fibroids are a hormone-dependent benign mass that appears on the muscle layer of the uterus in girls of reproductive age.

Myoma is considered the most diagnosed tumor of the female reproductive system. A uterine tumor is very common, especially among women 30-45 years old. Is uterine fibroids dangerous? This will be discussed below.

It is a round neoplasm called myomatous nodes.

Diagnosed with uterine fibroids. What to do? Many are interested in this question. The types of uterine fibroids and their localization will be discussed in this article. What is characterized by this ailment?

Classification

Uterine fibroids are a benign enlargement of smooth muscles and connective tissue. The size of the tumor can vary from a few millimeters to half a meter in diameter. In medical practice, fibroids are registered weighing more than nine kilograms.

Under uterine myoma, non-specialist girls and doctors (to facilitate the patient's understanding of the disease) mean different benign neoplasms of the uterus. A tumor can affect different tissues of this organ. Depending on the location, the neoplasm is classified as follows:

1. Leiomyoma is a formation in the muscle layer of the uterus.
2. Fibroma - formed from fibrous connective tissue, is quite rare.
3. Rhabdomyoma is a benign neoplasm formed from striated muscle tissue.
4. Angiomyoma is a neoplasm of muscle tissue with a well-formed network of blood arteries.

According to localization, there is such a classification of uterine fibroids:

• An intramuscular or intramuscular tumor appears in the middle muscle layer.
• The subperitoneal or subserous tumor grows under the serous membrane, on the outside of the organ.
• Submucous or submucous tumor is localized inside the uterus, under the mucous membrane.

Classification of uterine fibroids by the number of neoplasms:

• A single tumor is a single myomatous site. The dimensions of such a node, as a rule, vary within a few millimeters up to 8-10 centimeters, extremely rarely more.
• Multiple or multinodular uterine myoma, consisting of two or more myomatous neoplasms, in some cases has an unusual location of "node in node".

Causes

What serves as a provocateur of the appearance of pathology? The main cause of uterine fibroids is a disorder in the hormonal function of the ovaries, producing an excess of estrogen. This is confirmed by the fact that the use of hormonal contraceptives with significant portions of estrogens contributes to an intensive increase in uterine fibroids, and, conversely, the end of the formation of estrogens in postmenopausal women leads to its regression and disappearance. But episodes of the appearance of uterine fibroids in girls with the usual hormonal background are known.

Other causes of uterine fibroids are surgical termination of pregnancy, complicated pregnancy and childbirth, adenomyosis (endometriosis) of the uterus, inflammatory diseases of the fallopian tubes and ovaries, ovarian cysts, the absence of pregnancy and childbirth in a girl over thirty years old, obesity, heredity, immune and endocrine pathologies, long-term insolation.

Symptoms

Most patients with myoma do not notice signs. The disease is detected unexpectedly during a gynecological examination or ultrasound. Symptoms directly depend on the stage of uterine fibroids. As with cancer, at the initial stage a woman may not feel any symptoms. But with the development of the disease, they are intensely manifested.

Common signs of uterine fibroids can occur:

1. Difficult and long periods. A more common symptom is prolonged and powerful bleeding during menstruation. It is due to an increase in fibroids, close to the uterine cavity. The monthly period may be even longer than usual.
2. Monthly pains. Large bleeding and clots can provoke significant cramps and pain during menstruation. Significant fibroids can provoke high pressure and pain in the abdomen or lower back, they begin in the middle of menstruation and are similar to the usual ailments in this case.
3. Difficulty urinating. A large myoma is able to press on the bladder and urinary tract, activating the frequent allocation of urine, especially at night, if the girl is in a supine position. Myoma can thus cause pressure on the ureters, which in turn can complicate or block the output of urine.
4. Constipation. The pressure of the fibroids on the rectum can provoke constipation.
5. Pain during intercourse.
6. Uterus and abdomen growth. A very significant tumor can cause abdominal growth and provoke a feeling of heaviness or pressure.

Gynecological examination and preparation of anamnesis

The doctor is able to identify certain types of fibroids at the time of the gynecological examination. At the reception questions will be asked about the patient’s intimate life, about the duration and nature of the monthly bleeding.

Ultrasound scan

Ultrasound is considered the usual way of imaging to detect uterine fibroids. Sound research can be carried out both transabdominal and transvaginal methods. With the behavior of transabdominal ultrasound, the ultrasound device moves in the region of the lower abdomen. With transvaginal ultrasound, the device is inserted into the vagina.

Hysterosonography

Along with ultrasound, hysterosonography can be performed. At the time of the examination, ultrasound is used in conjunction with a physical substance that is introduced into the organ cavity in order to improve the visualization of the organ. Such an examination provides a much more accurate picture of the uterine cavity, including patency of the fallopian tubes and the presence of pathologies.

Hysteroscopy

Hysteroscopy of uterine fibroids is considered an operation that is used to establish the presence of fibroids, polyps or other bleeding factors. It is also used in the process of surgical operations to remove fibroids. During the operation, a large elastic tube is used, which is called a hysteroscope. It is inserted into the vagina through the cervix and reaches the organ itself. Thanks to this, the specialist has the opportunity to examine the cavities in detail. Hysteroscopy is considered a non-invasive operation and does not require incisions at all, but certain girls in their reviews inform about severe pain during its action, for this reason local or general anesthesia is used.

Laparoscopy

In certain embodiments, a laparoscopic procedure is performed as a diagnostic operation. Through a small hole in the peritoneum, the doctor can examine the cavity from the inside of the uterus, and also examines it outside, for example, the ovaries, fallopian tubes and pelvic organs. Monitoring is carried out using ultrasound or a video camera.

Biopsy

In some cases, an endometrial biopsy may be necessary in order to establish the presence of unnatural cells in the uterine mucosa. Cancer cells can signal the presence of oncology.

Treatment

The age of the woman and the severity of symptoms are the main factors in choosing a method for treating uterine fibroids (signs indicating the disease were discussed above). Many women decide not to treat the disease until menopause occurs. The tumor grows slowly, and its development stops after menopause. However, if the neoplasm causes pain, bleeding or instantly increases, there is no way to do without treatment. The treatment of fibroids covers a variety of medications and surgical methods.

In current medical practice, there are three treatments.

Expectant Strategy

This aspect does not require treatment, especially if the lady is close to the onset of menopause or the tumor is not activated. Periodic gynecological examinations and ultrasound will help determine whether the disease is progressing or not.

Drug treatment

Therapy includes the following drugs for uterine fibroids:

• Anti-inflammatory and analgesic.
• Hormonal contraceptives. Continuous use of oral contraceptives can restore the menstrual cycle and reduce bleeding. The drugs are used to control heavy monthly bleeding associated with myoma, however, unfortunately, they do not reduce the increase in fibroids. Not so long ago, new types of continuous oral contraceptives have emerged that can reduce the amount of blood. They suppress estrogen or progesterone, or two of these hormones at the same time.
• Intrauterine device

Surgery

How to remove uterine fibroids? Surgical methods include several surgical methods. This includes endometrial myomectomy (endometrial removal), uterine fibroid embolization, as well as hysterectomy (organ removal).

Women are required to discuss each type of surgery with a personal doctor. Decisions on a specific surgical procedure depend on the location, size and number of sites of fibroids. Certain operations have a great influence on the possibility of becoming pregnant, therefore they are recommended only for women who have come out of childbearing age, or for those who are not going to become pregnant. Below are ways to remove uterine fibroids.

Myomectomy

Myomectomy - this surgery is aimed at the surgical removal of only fibroids. The uterus is not affected, as a result of which it turns out to preserve the reproductive function of the girl. This procedure is able to correct painful uterine bleeding initiated by myoma. If the fibroids are multiple and large, they can provoke a large loss of blood.

To perform myomectomy, the surgeon is able to use the usual "open" surgical method (laparotomy) or less invasive methods (hysteroscopy and laparoscopy).

Laparotomy is performed by cutting an abdominal wall. It is used for subserous myomas, which are considered very large, multiple. Recovery from normal abdominal myomectomy is possible after one to two months. Open surgery can cause scarring and large blood loss. A threat of relapse of new myomatous nodes is also possible.

A hysteroscopic myomectomy can be prescribed for submucosal or submucous fibroids in the uterine cavity. During the operation, fibroids are removed using a device called a hysteroscopic resectoscope, which is inserted into the uterine cavity through the vagina and the cervix, and then the doctor uses electrosurgical devices to remove the tumor.

Uterine Artery Embolization

Uterine artery embolization (EMA), which is called uterine fibroid embolization, is a relatively new method of curing pathology. Embolization of uterine fibroids deprives her of blood supply, forcing the neoplasm to decrease. EMA is considered the least invasive method and technically non-surgical therapy. The procedure is not as difficult for the patient as a hysterectomy and myomectomy, and is distinguished by a shorter recovery period than other operations. During the operation, the patient remains conscious, despite anesthesia. The duration of the procedure is about one hour, less often - one and a half.

Treatment with folk remedies

In case of an ailment, it is important to contact a qualified specialist in time. With uterine myoma, it is very important to carry out a competent examination of the body, correctly diagnose, form an individual treatment program. What to do with uterine myoma, the classification of which is presented above?

Traditional medicine does not have the necessary properties to implement a whole special complex for the treatment of such a serious ailment. Moreover, “home medicines” can harm, contribute to tumor growth. When a neoplasm is formed, the body feels stress: immunity worsens, difficulties with emptying the intestines and bladder are likely. The disease must be treated with proven and effective methods of traditional medicine.

However, it is known that herbal medicine can be effective, since numerous plants include elements similar to hormones or antitumor drugs. But their independent use can very negatively affect the state of health, cause a rapid complication or increase in the tumor. Therefore, before starting treatment with traditional medicine, it is worth consulting with a specialist. The effectiveness of treatment with folk remedies has been scientifically proven, but it is advisable to combine this type of therapy with the recommendations and appointments of a certified medical specialist.