Leiomyoma of the uterine body is a pathological muscle growth of the walls of the organ, which leads to oncology. The tumor itself has a benign structure, but against the background of advanced treatment, it can also become malignant. In medicine, this pathology is also called fibroids or uterine fibroids. This disease can occur in one of four women who are between the ages of thirty and forty years. This disease is considered hormone-dependent, can occur on its own. But basically 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 specific idea of this tumor, you need to study the structure of the female genital organ. The uterus is a hollow organ that can carry the baby, and then push it during childbirth. This complex mechanism of work occurs due to myometrium - the inner layer of the organ. Such a strong frame is formed from various types of muscle fibers 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 in its composition the abdominal cavity. The inner layer is called endometrium, which consists of layers of the epithelium. In a certain phase of the cycle, this layer is updated, after which menstruation begins. Any such processes are controlled by the female hormones that are produced in the ovaries.
For this disease, the occurrence of a myomatous node is characteristic . In the event that there are several such appearances, then this is a multiple uterine leiomyoma. Such growths vary in size, structure, and type. Nodal forms very often do not appear in any way, and women have not been aware of the disease for years if they do not visit a gynecologist regularly.
The tumor does not have special symptoms at an early stage. The clinical picture is in many ways similar to various gynecological diseases. In this regard, the most reliable diagnostic method is ultrasound and hysteroscopy. Doctors do not always prescribe treatment of uterine leiomyoma to patients. Usually, when a woman begins menopause, the tumor, in turn, freezes and regresses. Thus, it requires simple regular monitoring.
This disease is hormone-dependent in nature. In this regard, it is easily influenced by hormonal drugs. Small fibroids under the influence of drugs can completely disappear or stop in their development. The removal operation is prescribed in those situations where there is a risk of serious complications, and the woman, in turn, feels severe pain along with impaired work of close organs. But even after surgery, this disease can return. This most often happens due to improper treatment tactics to eliminate the causes of the tumor.
Types of uterine leiomyoma
Consider now the classification. Depending on the site of the appearance of the myomatous node, this tumor has different names in medicine.
- Intramural leiomyoma of the uterus is more common than other types. It is formed in the inner region of the muscle layer. Its formation takes place quite deeply. Symptoms are manifested by pain in the pelvic region, an irregular cycle, and in addition, a violation of the activity of neighboring organs.
- With submucous leiomyoma, overgrowth of tissue under the uterine mucosa occurs. Often, this type of tumor can germinate inside the body, and it is not always possible to conceive a child.
- Subserous leiomyoma forms under the serous membrane, which is obvious from the name. It can be located on the outside and most often grows in the direction of the abdominal cavity. The difference between this type is the absence of symptoms. The only thing that women notice is just a little discomfort in the lower abdomen.
- Multiple leiomyomas are the formation of several nodes that differ in volume, attachment location and tissue composition.
- An unspecified form of uterine leiomyoma means a latent form of a tumor that cannot be confirmed by diagnosis. 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.
Nodular uterine 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 you timely detect the problem, conduct a comprehensive examination and prescribe therapy, then the disease can quickly be cured. But there is a high risk of relapse, so it is important to regularly see a gynecologist.
With the advanced form of nodular leiomyoma, the formation can become malignant, in this regard, even a fatal outcome is possible.
Leiomyomatosis and stages of its maturation
Any leiomyomatosis is formed in the myometrium and goes through some stages of maturation:
- Initially, a muscle node is formed, which grows from smooth muscle and fibrous fiber around small vessels. At this stage, clinical manifestations are still absent, since the size of the uterine leiomyoma is small.
- Then comes the ripening. At this time, the myoma actively grows and forms a ball of muscle fibers, which becomes denser with time. Around it, adjacent tissues begin to collect, which form a special capsule. This process is also called tumor growth. During diagnosis, fibroids are fairly easy to detect, and the patient already has clinical symptoms.
- The next step is the aging of leiomyomas. Given that the tissues are dystrophic due to pathological processes, the node ceases to grow.
In each individual case, oncology can behave differently. Do not expect the same manifestation of symptoms in all women with this diagnosis.
Leiomyoma and the causes of its occurrence
The detected gynecological tumor directly depends on the hormones of the woman. In the presence of a large number of estrogens, the cells divide pathologically, and during menopause this process freezes. The true causes of leiomyoma are still not fully understood, but there are the following provoking factors:
- A central factor is brain injuries 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 follicular maturation and ovulation. Thus, any malfunctioning of the brain can lead to dysfunctions of the reproductive system.
- Infectious and inflammatory diseases of the ovaries of a chronic nature, including polycystic disease, are a classic factor. Against this background, an imbalance of hormones occurs, which leads to the diagnosis of "leiomyomatosis". In medical practice, the classic factor is more common than others.
- With the uterine factor, any mechanical injuries of the genital organ can provoke the appearance of neoplasms. Even with the good functioning of the ovaries, the uterus is not able to perceive hormones due to damage to the receptors. Complicated childbirth along with abortion and surgery can cause similar injuries.
- Concomitant factors are disturbances 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 advised to visit a gynecologist and carefully monitor her health.
What are the symptoms of uterine leiomyoma?
Symptoms of the 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 progression of the pathology. Small interstitial muscle nodes are not harmful to the body. But the submucous uterine leiomyoma, even having small sizes, can significantly manifest itself with the following symptoms:
- The presence of menstrual irregularities. Menstruation can become irregular, plentiful and longer. At an early stage, such manifestations relieve medications, so patients do not immediately consult a doctor. But gradually, blood loss becomes significant, causing discomfort with pain. In this case, anemia occurs, and then you can not do without the help of a doctor.
- Pain can occur due to severe contraction of the myometrium. Large fibroleiomyomas do not allow the epithelium to exfoliate, pain occurs. Strong pain can occur with subserous myoma. Immediately with the intramural form, sensations are pulling and aching. In the event that necrosis has occurred in the tissues of the uterus, 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, a woman will feel frequent urge to the toilet. Or, conversely, there may be difficulty with defecation or the process of urination.
- The appearance of reproductive organ dysfunction. Against the background of leiomyoma and with concomitant diseases, as well as with hormonal imbalance, women develop infertility, and in addition, ovulation is disturbed. The reason for this is the poor location of the myomatous node in the organ cavity, 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 occur quite rarely.
Diagnosis of the disease
At the first appointment with the gynecologist, the uterus is examined and the patient's complaints are collected. In the framework of a two-handed study, the deformation of the organ and its size are determined. It is the size of the uterus that matters. The specialist selects a specific day of the cycle, and during the year, it is at this time, an examination is performed. In the event that the uterus has not increased in size over a year, then doctors are talking about a slow course of the disease.
Thanks to the use of a gynecological mirror, it is possible to detect submucous nodes growing in the direction of the cervix. For more accurate results, colposcopy methods are used. The most reliable way to diagnose oncology is considered an ultrasound, with which it is established:
- The total number of myomatous nodes along with their characteristics.
- The 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 on the flora is taken along with a biopsy for oncocytology.
Leiomyoma Treatment
How is leiomyoma diagnosed, we have already studied. Next, find out how this disease is treated. In medical practice, this tumor is usually treated with conservative techniques. Very often, it disappears on its own or regresses during menopause. In this regard, doctors are in no hurry to perform surgical removal of uterine leiomyoma. The choice of the appropriate treatment depends on the result of the examination and on the general well-being of the patient. The following factors are a condition for therapy using traditional methods:
- The size of the tumor is up to three centimeters along with a small increase in the uterus.
- Asymptomatic course of the disease.
- Woman planning a future pregnancy.
- The presence of an intramural or subserous type of fibroids.
Surgery for Leiomyoma
Doctors prescribe surgical intervention to patients in the following cases:
- The presence of advanced disease, when the submucous uterine leiomyoma is very large.
- The presence of submucous nodes.
- The presence of torsion of the legs of the nodes along with necrosis of the walls of the uterus.
- The development of subserous fibroids with extremely severe symptoms.
- Finding leiomyomas on the cervix.
- The presence of hyperplastic processes.
- The absence of any effect from conservative treatment.
Modern surgical techniques make it possible to maintain 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 defunding. Absolute organ removal is performed using a hysterectomy. An operation aimed at removing a tumor does not always lead to its complete disappearance. Sometimes myoma can grow again.
What else is used in the treatment of uterine leiomyoma?
The use of medicines
The main thing in the treatment of this disease is to be able to stop the cause of its occurrence. Therefore, hormones are often prescribed by specialists in order to lower estrogen levels and normalize their quantity. The following medicines are used for this:
- Gonadoliberin analogues.
- Antiprogestogens.
- Progesterone analogues.
- Combined oral contraceptives.
All medicines are distinguished by 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 familiarize yourself with the instructions and discuss with the doctor the reception schedule. Treated 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, anti-anemic and vitamin preparations.
The duration of treatment is about six months or more. At this time, it is necessary to control the pathological process using ultrasound every three months. If necessary, the doctor will adjust the dosage or replace medicines. Alternative drugs can use alternative medicine techniques like hirudotherapy, homeopathy, beekeeping products, and so on.
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 mandatory to consult with a specialist. There are cases of degeneration of this tumor into cancer, such a transformation is called uterine leiomyosarcoma. Therefore, in no case should this disease be allowed to drift.
Uterine Leiomyoma Reviews
Women write about this disease that this is an extremely unpleasant pathology. Many have to go for an operation to remove leiomyoma. Ladies usually 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 surgical intervention 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 sphere. Women write that after a hysterectomy they had caries, they had problems with bones, and there were flushing and dizziness.
Thus, based on the reviews, it can be said that a hysterectomy against the background of leiomyoma entails many negative consequences. And among the pluses, women call only getting rid of menstruation and preventing the possible degeneration of leiomyoma into a malignant neoplasm. Women also write that hysterectomy, despite all the minuses and consequences, is by far the most effective solution to such a problem as uterine leiomyoma.
What it is and how to treat pathology is now clear.