The female genital organ, which is known to everyone as the uterus, sadly, is prone to the development of a variety of diseases. Among them are those that pose a serious threat to the health of women. But also there are 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
In itself, fibroids are quite common in medical practice, and it is customary to divide them into several types:
- Intramuscular - a tumor is located in the thickness of muscle fibers at the bottom of the uterus or in the area of its body.
- Submucosal - or otherwise submucous myoma, 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 myoma, which we will touch on in more detail. Its official name is subserous. And it, in turn, is also divided into several varieties:
- intramural;
- interstitially subserous;
- plural.
But what, in essence, is a subserous uterine fibroid? A node of this type is a benign tumor, so patients have nothing to fear when making such a diagnosis.
The neoplasm is completely dependent on the hormonal background of the female body. Often formed outside the uterus and grows in the direction of the pelvic cavity. Some neoplasms are localized directly on the wall of the genital organ, but there are also those that have a leg, which is a kind of “umbilical cord” for feeding the tumor.
Intramural case
The easiest form of uterine fibroids, which develops on its outer side. In this case, co-formation does not have any effect on the size of the genital organ and the menstrual cycle itself. And this means that in this case there is simply no danger to women. A girl can easily get pregnant 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. What is characteristic, even with the help of a simple ultrasound examination, it is not always possible to detect the development of the interstitial node, especially when it is small in size. To make sure that this form of the disease is present, hysteroscopy is required.
Interstitially subserous uterine fibroids
Otherwise, this form of uterine fibroids is called mixed and, in contrast to other types, has rather large sizes. Germinating in the uterine wall, the neoplasm, due to its larger volume, has a negative effect on neighboring organs by compression, which contributes to the inhibition of their basic functions. And if the diameter of ordinary nodes is often not more than 10 cm, then the size of such neoplasms is simply amazing with its dimensions - about 250 mm.
In the course of the development of a large tumor, a woman can detect some characteristic signs:
- Severe pain and a feeling of heaviness in the abdomen.
- Frequent urination, as during pregnancy.
- The menstrual cycle lengthens, and blood loss is greater.
- Dyspnea on the background of heart palpitations.
- The appearance of anemia and pallor of the skin.
As a rule, women aged 30 to 45 years, as well as those who have already had one or more pregnancies, are at risk of subserous uterine fibroids.
Multiple or multinodular fibroids
Among all other varieties, multiple myoma is most common. It is characterized by the development of several nodes, concentrated on different parts of the genital organ.
As medical practice shows, multinodular neoplasms occur in 12-25% of cases. The peak of the disease occurs in the reproductive and premenopausal age of a woman. However, recently, cases of this pathology have been diagnosed in the fair sex up to 33 years, which can not but worry the doctors. Among girls under the age of 20, the risk of encountering such a disease ranges from 0.9 to 1.4% of cases.
In this case, the nodes can have different sizes:
- small - less than 20 mm;
- medium - no more than 60 mm;
- large - from 60 mm and larger.
As for pregnancy, due to multiple neoplasms, seminal fluid does not pass well through the fallopian tube, as a result of which fertilization of the egg is significantly difficult, but this only applies to large subserous nodes. Smaller uterine fibroids have no such effect. But even if the conception was still successful, the node begins to actively develop, sometimes in contact with the placenta, which threatens with complications.
Pathology
Regardless of the type of uterine fibroids, three main stages of the development of neoplasms can be distinguished:
Stage 1 - first, the tumor actively grows against the background of an accelerated metabolism.
Stage 2 - the disease passes to a progressive stage, but at the same time it does not make it clear about itself.
Stage 3 - neoplasms increase to diagnosed dimensions.
The development of neoplasms and an increase in their size have a detrimental effect on the contractility of the genital 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 is intensified not only during menstruation, but also appears 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 inguinal region or tailbone.
In the case when the neoplasm grows in the direction of the rectum, a woman can be overcome by constipation and pain in this zone. With the development of the tumor towards the abdominal region, it usually begins to squeeze the walls of the bladder, which causes symptoms of dysuria:
- frequent urination, and painful;
- difficulty urinating;
- the bladder is not completely empty.
In addition, a subserous tumor contributes to severe deformation of the genital organ, narrowing of the fallopian tubes. For this reason, if nothing is done, it inevitably threatens infertility.
Emergency
As it is now known, clearly expressed symptoms of the presence of neoplasms of the genital organ, especially in the early stages of the disease, do not exist. However, sometimes without urgent removal of subserous uterine fibroids can not do. In this case, the characteristic features will be pronounced:
- In the lower third of the abdomen, pain sensations become acute, intense and increasing.
- Cyanosis of the mucous membranes and skin, pallor.
- The abdominal muscles are in great tension.
- Elevated body temperature.
- General intoxication of the body
All these symptoms indicate deep necrosis or twisting of the legs of the subserous node, which causes extensive hemorrhage. This situation is critical, and urgent surgery is required here. It is possible that a woman will experience pain shock.
What could be the danger?
Often, complications of this type of pathology are associated with the development of a tumor on the leg, in particular, it is a violation of its nutrition. For this reason, a woman should know that a number of procedures and exercises are contraindicated for her. Due to sharp movements, the leg of the subserous uterine fibroids can twist, thermal procedures, including massage, increase the blood supply to the node, which provokes bleeding. How all this can ultimately end is described above.
No less dangerous consequences. For example, sometimes a node can rupture and its contents fall into the abdominal cavity, against the background of which peritonitis occurs. And here it all depends on how timely assistance will be provided to the woman and the professional experience of doctors.
There is a reason for everything
Not a single disease develops from scratch, because there must be a reason for it. And the subserous form of myoma 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 26-28 years.
- Increased estrogen levels.
- Decreased progesterone.
- Violation of the functions of the hypothalamus.
- No pregnancy in women older than 28 years.
Also, the cause of an increase in the size of subserous uterine fibroids can be the hormonal imbalance of the female body. But this is not characteristic of all girls and arises only in a number of cases. Of course, most people suffer from hormonal imbalances, but those women who have never become pregnant before they reach the age of 30 or have a bad heredity are most at risk.
Many doctors also replenish the list of reasons that contribute to the development of tumors, the following factors:
- Predisposition to the disease in genetic terms.
- Removal of tumors in the past through surgery.
- Carrying out any operation on the genital organ, whether it is an abortion or laparoscopy.
- Infectious diseases of the genitourinary system in the chronic stage.
- Thyroid disease and adrenal gland dysfunction.
As a rule, these factors alone do not cause the development of fibroids, only a whole complex contributes to the emergence of a pathological process.
Pathology Diagnosis
Before proceeding with the treatment of subserous uterine fibroids, it is necessary to verify its presence, which requires a diagnosis.
To make sure that there are subserous nodes in the woman’s reproductive organ, various events are carried out:
- An initial gynecological examination may reveal this pathology. During palpation, the doctor will be able to determine the size of the tumor, the structure, and also where it is localized. The abdomen of a woman is usually enlarged.
- Sonography (or simply, ultrasound) is a more accurate tool in determining subserous fibroids of the female genital organ. Moreover, the size of the tumor will be detected with an accuracy of a millimeter, the study will show exactly where the neoplasm is located, and will assess the state of the uterine border and nearby organs. In this case, it is possible not only to observe the course of 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 characterized by a high degree of accuracy of the results. Using 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.
For everything else, a woman needs to take a blood test, which will show the degree of anemia and the presence of an inflammatory process in the genital organ.
Treatment features
A 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 recalling. To make the right decision, the specialist pays attention to a number of factors:
- tumor localization;
- the number of neoplasms;
- sizes of nodes;
- type of fibroids.
If the tumor, one or more, is small, then it is likely 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 health of a woman.
However, often treatment can not be dispensed with, and then one should choose between a conservative method and surgery. Subserous uterine fibroids, as well as virtually any other disease, do not go away on their own, with the exception of some cases.
Conservative technique
Conservative therapy is aimed at preventing the further development of the tumor and any complications. As a rule, the following medications are prescribed:
- Mixed-type 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 indicated in the presence of small nodes.
- Due to gonadoliberin agonists, the production of sex hormones is reduced, which leads to the cessation of tumor growth.
- Antigonadotropic drugs prevent the progression of the disease.
As for the duration of such conservative treatment, it is approximately 6 months. In addition to medications, your doctor may prescribe the use of certain herbs for a beneficial effect on the tumor.
The need for surgery
What should be the size of subserous uterine fibroids for surgery? This issue is of interest to many women, especially those who have already been diagnosed with this. Small neoplasms are easily treated with a number of drugs, but in the presence of a large tumor, there is nothing left but the operation. The reason for this is the unnaturally large size of the uterus in conjunction with neoplasms: 70-100 mm. In addition, the operation is prescribed for a number of other medical indications:
- Active development of the tumor against the background of intestinal and bladder dysfunction.
- Pain sensations become more acute and are not removed by traditional painkillers.
- A growing tumor provoked another pathological process.
- Long periods, because of which the woman has anemia.
In addition, a strong 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 that can be told to others. Some note that they had and had a baby without problems. For others, making such a diagnosis raises some concerns. It is understandable, because almost every girl dreams of a healthy and full-fledged child, regardless of age.
If you observe the responses to urgent questions, you can see that many women have excellent knowledge about subserous or any other fibroids. And this is not surprising, because the Internet in our time is sufficiently developed and is present in almost every family.