What is myoma is of interest to many women, especially those who have a predisposition to the onset of this disease. This is a benign neoplasm that is localized directly in the uterus 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. Myoma often forms in women aged 35-45 years. However, it happens 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.
Disease feature
Uterine fibroids - a benign tumor that develops in the uterine cavity or on its neck. Its dimensions can be small, and can reach several centimeters. The most common type are multiple tumors.
Mostly women of reproductive age suffer from it. Myoma is a neoplasm, consisting of randomly enlarged uterine fibers, forming a dense node that is densely intertwined with blood vessels. A feature of such a tumor is that its growth and development largely depends on the level of sex hormones.
It is important not only to understand what a fibroid is, but also what its manifestations are. Of great importance is the size of the tumor and its location. Upon reaching considerable size, it can provoke painful sensations, menstrual irregularities, as well as problems during pregnancy.
Classification
What is a fibroid, and what are the types of this tumor, the attending doctor can absolutely accurately tell. There are several different classifications of this tumor, depending on the location, cellular composition. There are such types as:
- subserous;
- submucous;
- 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. Submucous - the growth of a tumor inside the uterus, namely under its mucosa, passing into the lumen. Leg fibroids are not a specific group, but only a form of uterine disease that occurs with a subserous or submucous type. The difference lies in its wide or narrow leg.
Intramural fibroids are most common. This is a fairly characteristic pathology for women aged 40 years. A tumor of this kind is formed from the tissues of the muscle layer, which leads to an increase in the size of the entire organ. This cannot but affect the adjacent organs, since the neoplasm affects them and interferes with normal blood supply. The main feature of the course is a violation of the menstrual cycle, the presence of painful sensations and a feeling of pressure.
Multinodular myoma has several nodes and significantly deforms the uterus. As it grows, this neoplasm can even be visually seen, as the abdomen 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 types of hormonal disorders, therefore this is considered the main cause of the disease. Often, a tumor forms in young women and successfully resolves with the onset of menopause, as estrogen levels begin to decline by this time. In addition, there are several more main reasons, in particular, such as:
- genetic predisposition;
- inflammatory gynecological diseases;
- stress
- frequent abortions;
- obesity and a sedentary lifestyle;
- intercourse without orgasm.
This is a hormone-dependent tumor, therefore, it forms 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 once giving birth women significantly reduce the risk of developing this disease.
The main reason for the development of many diseases is nutrition. Metabolic disorders, the constant presence of refined fats and obesity lead to increased levels of estrogen.
The main symptoms
For a long time, no signs of uterine fibroids are manifested, and it is often found quite by accident during an examination with a gynecologist. Sometimes there are symptoms, but until a certain time they are somewhat blurred, which is perceived as normal. Most often, pronounced symptoms occur with tumors of the submucous type or in the presence of large nodes, regardless of their location.
Among the main symptoms of uterine fibroids can be distinguished such as:
- long and heavy menstruation;
- bleeding
- lower abdominal pain;
- violation of the functions of the pelvic organs;
- infertility;
- miscarriage.
The most basic symptom is long and very heavy menstruation, but the frequency of the cycle is not broken. This can trigger the development of anemia. In addition, bleeding in the middle of the cycle may be observed.
Among the signs of uterine fibroids, painful sensations in the lower abdomen and in the lower back can be distinguished. They have a aching character. Acute pain can occur when the legs of the myoma node are twisted, as a result of which there is a significant violation of blood circulation. When the neoplasm reaches a large size, it begins to compress the internal organs, 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 interferes with 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 myoma and make a healthy 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 location. When conducting a diagnosis, a woman initially carries out a sampling of tests. Diagnostic techniques are based on such studies as:
- gynecological examination;
- ultrasonography;
- hysteroscopy;
- laparoscopy.
When conducting a gynecological examination, you can find that the uterus is slightly enlarged. Ultrasound diagnosis allows you to evaluate the size of fibroids, the number, size, location 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 evaluate 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.
Therapy Feature
There are 3 main methods for treating uterine fibroids, in particular:
- medication;
- non-drug;
- surgical.
Another treatment regimen has not been developed, following which it would be possible to quickly and efficiently get rid of an existing tumor. Treatment is selected purely 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, with myoma, medications can be used. 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 specific drug is carried out only by a qualified doctor. In addition, it determines the dosage and duration of therapy.
If the use of medications did not bring any result, then the doctor may prescribe surgery. Removal of uterine fibroids may be required in cases such as:
- a large tumor was diagnosed;
- it is rapidly increasing in size;
- exerts significant pressure on adjacent organs;
- severe bleeding occurs.
If the node is located under the outer shell of the organ, laparoscopy of the fibroids is performed. With the location of the tumor under the mucosa, a hysteroscope is used. In case of other localization, a band operation is assigned. After removal of uterine fibroids, menstruation becomes moderate and less painful.
With a benign tumor, non-pharmacological 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 is stopped and dying.
Non-surgical treatment
When a woman approaches the age of menopause, if the tumor is small and also grows slowly, conservative treatment of fibroids is allowed, the reviews which have earned quite positive. Many patients say that with complex treatment, you can achieve very good results and get rid of the neoplasm without surgery. 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 distinguish such as Novinet, Ovidon, Mercilon. Such drugs can effectively cope with lower abdominal pain and bleeding, but they do not affect the reduction in the size of fibroids, contributing only to a decrease in nodes by a few centimeters.
Hormone antagonists are for long-term use. They help to slightly reduce the tumor in size, and are also prescribed before the operation, so that blood loss is much less. Among these drugs, it is necessary to distinguish "Diferelin", "Zolodex", "Decapeptil".
Among antiprogestogens, Mifepristone should be distinguished, 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. Accurate focusing of the rays allows you to quickly cure the tumor.
Surgical intervention
It is not always possible to cure non-surgical uterine fibroids. The operation is indicated in cases such as:
- tumor size more than 12 cm;
- accelerated growth;
- severe uterine bleeding;
- necrosis of nodes;
- the formation of a submucosal node.
Based on the type of neoplasm, the location and size of the tumor, the doctor selects a method of treatment. Among the main types of surgery to remove uterine fibroids, it is necessary to distinguish the following:
- laparoscopy;
- hysterectomy;
- hysteroscopy;
- abdominal surgery.
All types of surgical interventions are divided into radical and organ-preserving. Each of the operations has its pros and cons. The most common method is the complete removal of the uterus. Such an intervention can be performed openly and laparoscopically. With all the pluses of the operation: the fibroid is completely removed, and there are no relapses, doctors distinguish a number of minuses, namely:
- complications may occur;
- the use of anesthesia is required;
- long recovery.
Such an intervention is highly undesirable for patients who do not have children and are planning a future pregnancy. 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 this, 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, a 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 embolization of the uterine artery fibroids. The operation is a violation of blood flow until it stops completely. As a result of this, there is a decrease in the 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 good reviews, as they help to somewhat inhibit the growth of the tumor. However, it is worth remembering that they can be used only with small sizes of the neoplasm with its slow growth. In addition, you must first consult with your doctor about the safety of using traditional medicine.
For the treatment, the use of various alcohol tinctures of hemlock, mistletoe, and cinquefoil is indicated. These plants are quite poisonous, which is why it is necessary to use extracts prepared on their basis very carefully, in short courses, taking special care.
Propolis helps to cope with nodes well, since it stimulates the immune system and has antitumor qualities. It is used in the form of various extracts and tinctures, as well as ointments and suppositories.
For treatment, knotweed, horsetail and medunica are used, since these herbs have the ability to regulate the formation of connective tissue. They prevent the formation of scars and adhesions.
Possible complications
With myoma, a variety of complications can occur, the most common of which are considered to be:
- malnutrition of nodes;
- necrosis;
- torsion of the legs of education;
- heavy bleeding.
In some cases, a complication such as uterine inversion can occur, which happens with a submucous node. Sometimes, fibroids may degenerate into a malignant tumor.
Myoma when carrying a child
Conducting pregnancy with myoma creates certain difficulties for doctors and patients. Absolute contraindications to the preservation of pregnancy is a suspicion of malignant degeneration of the tumor, rapid growth of nodes, cervical-isthmal localization, pinching, necrosis.
However, even if there are not all these contraindications, a miscarriage, the need for a cesarean section with the subsequent removal of the node is possible.
Myoma refers to benign neoplasms, however, in any case, timely treatment is required to prevent the development of dangerous complications.