Uterine myomatosis is a fairly common and dangerous pathology in women, characterized by the appearance of a benign neoplasm. There are several different varieties of myomatous nodes, one of which is submucous myoma, it can actively develop and grow.
This disease is a benign tumor that extends beyond the uterus, formed from its muscles. There may be a multiple myoma, which consists of several nodes at once, and they are located immediately in several zones.
Features of submucous uterine fibroids
Submucous myoma is a benign neoplasm that forms in the submucous layer of the uterus. A feature of such a disease is that fibrotic nodes do not grow deep into the uterine cavity, but towards the abdominal cavity.
It has been clinically proven that such neoplasms grow much faster than all other types of fibroids, and they also have pronounced symptoms. Depending on where the myomatous node is located, it can cause some discomfort, as it puts pressure on adjacent organs.
If the submucous nodes are large, then they squeeze the ureters and intestines, which is manifested in problems with urination and defecation. In addition, such a neoplasm can lead to a frozen pregnancy or provoke a miscarriage.
Reasons for the formation of submucous fibroids
To date, doctors cannot say exactly why the submucous myoma occurs, but there are a number of factors that provoke the formation of this pathology, in particular such as:
- hormonal changes;
- frequent stress;
- physical exercise;
- obesity;
- taking oral contraceptives;
- lack of pregnancy and childbirth up to 30 years;
- hereditary factor;
- frequent abortions;
- inflammatory diseases of the genital area.
Only the doctor can determine the main reason why myomatous nodes formed. It is very important to determine what triggered the pathology, as this will eliminate its occurrence in the future.
The main signs of the disease
Submucous myoma is a very dangerous disease, since it does not manifest itself at all in the initial stages. The nodes quickly increase in size, so the symptoms appear quite brightly. In particular, signs such as:
- long and heavy menstruation;
- pain in the lower abdomen;
- the presence of blood clots in menstruation;
- severe uterine bleeding;
- bloating;
- temperature increase;
- weakness and malaise;
- infertility.
In some cases, submucous myoma does not manifest itself at all, especially in the initial stages. With the development of pathology, the symptoms begin to grow more and more. It is very important to timely diagnose to determine the presence of pathology, as this contributes to the rapid treatment and recovery.
Diagnosis of the disease
Myoma with submucous growth is diagnosed during a gynecological examination by palpation. In this case, the doctor can detect a myomatous node of dense consistency.
The diagnosis is confirmed during the examination with the help of mirrors, as you can see a whitish shade with a pronounced vascular pattern. The uterus can reach considerable size, its surface becomes tuberous, the nodes are dense, and when blood circulation is disturbed, they become painful.
To make a more accurate diagnosis, an X-ray is performed, since the image shows the expansion or curvature of the shadow of the tumor. Submucous nodes in the image are defined as clear defects with clearly visible contours.
One of the most informative methods of diagnosis, which helps to determine exactly whether there is interstitial-submucous fibroids, is considered ultrasound. The information content of this method is quite high, as newer and more modern tools and techniques have appeared. Ultrasound scanning makes it possible to detect myomatous nodes, even if they have a small diameter.
To clarify the diagnosis, an ultrasound tomogram is performed, since a three-dimensional ultrasound image can be obtained. This is a fairly informative method, as it allows you to fully evaluate the ongoing pathological process and to clarify whether there is a concomitant pathological process.
Treatment of fibroids
Submucous myoma was previously treated only by an operative method. When diagnosing the myomatous node , only the removal of the uterus was previously performed, after which the woman could no longer give birth to a child.
However, now it is possible to conduct treatment with a conservative method. At the initial stage, the tumor has small dimensions, but this type of neoplasm grows very quickly, which is why during the diagnosis it is extremely important to determine how quickly its growth will occur.
The disease is very poorly amenable to drug therapy, however, hormone-containing agents may somewhat hinder its further development. The use of hormonal drugs can provide a hormonal background in the female body that will correspond to the menopause.
If the patient has submucous fibroids, treatment with hormonal drugs can bring the desired effect if the patient is more than 40 years old and it is close to the menopause. With successful therapy, there is a high probability that the myoma will begin to decrease in size and disappear altogether after a while.
Many patients prefer to treat using traditional methods, but initially you need to consult a doctor, since an incorrectly selected treatment methodology can significantly worsen the patient's condition and provoke complications.
Drug treatment
If the patient has a fibroid, a submucous node is larger than 5 centimeters in size, then surgery is not performed, as various complications can occur.
In this case, drug treatment is carried out and the patient is prescribed drugs, for example, Zoladex or Decapeptil-Depot, which create the optimal hormonal background. In this case, the level of estrogen is significantly reduced, which contributes to the reduction of fibroids in size.
Additionally, special preparations can be prescribed to the patient, which are administered intramuscularly or intravenously. In some cases, when the nodes are small, hormone-surgical treatment is indicated.
Women of reproductive age with a severe course of the disease are prescribed the Esmiya drug. However, it has some contraindications, namely:
- pregnancy and lactation;
- asthma;
- oncological diseases;
- vaginal bleeding.
This drug is not allowed to be used for a long time, as it can provoke serious complications.
Surgical intervention
If submucous uterine fibroids are quite large, the operation is mandatory, as it can pose a serious threat to life. Myoma can be removed using laparoscopy or hysteroscopy. Laparoscopy is performed through the front wall of the abdominal cavity, and hysteroscopy is performed through the uterine cavity.
If these methods did not bring the desired effect or there are indications, then the uterus is completely removed. Myoma can have very serious consequences, so you need to conduct a patient examination and treatment as soon as possible.
Features of hysteroresectoscopy
The procedure for conducting hysteroresectoscopy is considered one of the most sparing methods of surgical intervention and is carried out to maintain reproductive function, since this is important for subsequent planning of the birth of a child.
During surgery, an electrocoagulator with a special chamber is introduced into the uterine cavity under general anesthesia. Then, an examination of the uterine cavity and determination of the size of the nodes and their removal are performed, the uterus is not affected.
Such surgery is performed through the vagina and cervical canal. For the introduction of instruments, the cervical canal is slightly expanded. The duration of surgery is no more than sixty minutes. If submucous myoma is removed in this way , the patient reviews are only the most positive, which is very important for patients planning a pregnancy.
Mechanical myomectomy
Submucous nodes of rather large sizes are removed mechanically. Initially, the node is fixed using special tools, and then unscrewing under the control of a hysteroscope.
The capsule can be dissected using a special resector and the node removed. Removal of submucous fibroids by mechanical myomectomy has its specific advantages, namely:
- short duration;
- no need to use additional equipment;
- no complications.
After surgery, the recovery period does not take much time. In addition, there is no damage to large organs, as well as overloading of blood vessels with liquid.
Features of electrosurgical myomectomy
An electrosurgical myomectomy is performed if the node is at the 1st or 2nd stage. In addition, in this way, nodes located in the corners of the uterus that cannot be removed in any other way are removed.
Surgery can be carried out in one or several stages, it all depends on the nature of the node. When submucous uterine fibroids is at an advanced stage, the reviews of this treatment method are quite good.
Other surgical methods
Other methods of surgical intervention can be carried out at various stages of fibroids. If none of the gentle methods of surgical intervention has brought the desired result or there are certain indications, then the uterus is removed completely with the cervix.
When completely removed, vaginal, abdominal, as well as laparoscopic access is used.
Submucous myoma as a cause of infertility
Uterine fibroids are a benign tumor. Among all gynecological pathologies, it takes second place in frequency of occurrence. There may be several different types of this disease, which differ among themselves by the localization of myomatous nodes. In particular, such species as:
- submucous;
- intermuscular
- subserous.
With submucous myoma, the nodes can be both on a wide base, and on a thin leg. This leaves a definite imprint on the overall clinical picture of the disease. This is a rather complex and dangerous pathology, which poses a serious threat to the health and life of the patient and leads to infertility.
The main causes of infertility
Submucous nodes in uterine fibroids lead to infertility for several reasons. These reasons include:
- mechanical factor, as there are problems with implantation of a fertilized egg;
- hormonal disorders, which leads to problems with ovulation;
- closing the opening of the fallopian tubes, which greatly complicates the process of moving the egg to the place of implantation;
- there is a risk of developing an ectopic pregnancy;
- increased activity of the endometrium;
- Immune disorders, which negatively affects the implantation process.
In addition, this pathology can lead to miscarriages due to the fact that squeezing the uterus, internal organs and certain hormones are released that interfere with the normal bearing of the child.
Thus, uterine fibroids leaves a serious imprint on the activity of the reproductive system. That is why it is necessary to begin treatment of the disease as soon as possible.