The danger of uterine fibroids. Is uterine fibroids dangerous? Tumor tissue necrosis

Why is uterine fibroids dangerous? This question is often asked by those who have experienced this disease. uterine myoma is benign tumor myometrium, which is associated with a hormonal disorder. Despite the fact that this tumor is benign, the pathology can have some complications that adversely affect the woman's health. It is worth considering the most basic ones. But before you find out if uterine fibroids are dangerous, you need to learn a little more about this disease.

The size of the formation can be from a few millimeters to 25 cm. With a small formation, medical intervention is not required. But if the tumor grows, it interferes Everyday life or the development of pregnancy, you will need to consult a specialist.

Symptoms of pathology

Myoma is quite common in women. Since the symptoms in the early stages of the disease are minor, many patients are unaware of the presence of a tumor.

As the formation of the uterus grows, the following manifestations of the disease appear:

abdominal pain;
pain in the lumbar and pelvic region;
frequent urge to urinate;
heavy bleeding during menstruation;
development of anemia;
the appearance of constipation;
infertility develops;
pathology can lead to miscarriage.

Very often, suspicions of fibroids arise if a woman has long periods of menstruation, while bleeding is profuse, and sometimes with blood clots. This condition is dangerous because anemia of the body develops. At the time of sexual intercourse, pain occurs in the pelvis and legs.

There is a certain classification of the disease:

. It is formed in the outer muscular layer of the uterus, and can subsequently grow into the pelvic area. It does not affect the menstrual cycle, but as it grows, it has Negative influence to other organs.
Intramural myoma. It develops in the middle muscle layer. This form disease is more common than others. With an increase in fibroids, the uterus also grows. This condition entails the appearance of pain in the lower back and abdomen, as well as painful and heavy menstruation.
. This is a submucosal fibroid, which is also quite common. A tumor develops inside the uterus, in its submucosal part. The symptoms are pronounced.

Causes

Hormonal disorders in the body of a woman, which is caused by an increase or decrease in the level of progesterone and estrogen.
Irregular sex life and lack of orgasm during intercourse.
Mechanical interventions: abortion, childbirth with injuries, curettage of the uterine cavity.
hereditary factor.
Diseases that contribute to the formation of uterine fibroids: this is diabetes mellitus, endocrine diseases, obesity, hypertension, sedentary image life.

Ways to treat pathology

There are not so many ways to treat fibroids. The doctor, based on the size of the tumor, the place of its formation and the effect on the body, can suggest two conservative method treatment:

Hormone therapy.
Surgery to remove the tumor.

If education does not develop rapidly, and the woman is not planning a pregnancy in the near future, then she is offered hormone therapy. Hormone therapy is selected on an individual basis, depending on these tests. Do not self-medicate, as you can harm the body and accelerate the growth of the tumor.

With the rapid growth of the formation, it is removed surgically. Currently, there are methods of removal that do not violate the integrity of the tissues of the uterus. If it is laparoscopy, then the negative consequences of the operation are minimized. Only in rare cases, fibroids may appear elsewhere.

If there is a risk of development malignant neoplasms, doctors decide on the complete removal of the uterus.

The following reasons may be indications for surgery:

The large size of fibroids and its progressive increase.
Submucosal type of tumor, regardless of size.
Severe pain that gets worse over time.
Prolonged and heavy menstruation against the background of fibroids, which threaten the development of anemia.
Pathology contributes to the dysfunction of other internal organs.
Education is in the cervix.

Threats posed by uterine fibroids

Why is uterine fibroids dangerous? This disease can pose a threat under the following circumstances:

depending on the structure of the tumor.
With necrosis (necrosis) of the tissues of the uterus.
Depending on the location of education.
In the presence of inflammation, which contributes to the growth of fibroids.

Sometimes fibroids may not be located on the uterus itself, but on the leg, which is attached with its tissue. This type is dangerous in that the leg of the fibroids can twist, while causing a painful spasm. This condition is called an acute abdomen and requires immediate surgery.

Torsion of the leg can occur at the time of any action, for example, during childbirth or during intensive exercise. This type of fibroid is called serous. Therefore, when it is detected, without waiting for complications, a planned operation to remove the tumor is prescribed.

Another danger in uterine fibroids is necrosis of the tissues of the organ. It can come on its own or in combination with pregnancy. Since the nutrition of the tumor stops, appear sharp pains in the abdomen and fever.

First of all, an examination is carried out, which includes ultrasound and tests, and only then the doctors decide on the treatment of uterine fibroids. If an operation is scheduled, it is worth considering the age of the patient, how involved in the process of tissue death of the organ, the presence or absence of peritonitis (inflammation in the abdominal cavity). If the patient is childbearing age, then during the operation, doctors try to preserve the integrity of the uterus. For women aged and with children, removal of the uterus is indicated so that there are no serious consequences.

What is dangerous uterine fibroids:

Myoma in some cases leads to infertility. Even if pregnancy has occurred, sometimes education interferes with standard childbirth, you have to resort to an operative method.
If the fibroid is formed on the anterior wall of the uterus, it is located next to the urinary tract. When the tumor begins to grow, it compresses the urinary canal, making it difficult to urinate. And this leads to chronic pyelonephritis.
If the fibroid formed on back wall uterus, it can make it difficult to pass feces. There are constipation and problems with the digestive organs.

Danger during pregnancy

If there is uterine fibroids, what is the danger of this problem during pregnancy? If a woman is expecting a child, then a number of problems and complications arise.

If the tone of the uterus is increased, then there may be a threat of termination of pregnancy. It all depends on the size of the tumor, its location and intensity of growth. When the tumor is located at the bottom of the uterus at the time of childbirth, there are problems with the expulsion of the fetus. With intramural myoma, the development of acute hypoxia in a child can also occur.

When choosing the tactics of conducting childbirth, many indicators are taken into account:

condition of the fetus at the time of birth;
the degree of impaired blood flow in the uterus, in the fetus and in the placenta;
mima node blood supply.

Why is myoma dangerous and when is urgent help needed?

Such delicate issue how uterine fibroids can be a threat to the life of a woman of any age, regardless of the onset of sexual activity or the implementation of reproductive function. Caring for women's health is extremely important not only for those who plan to have children, but for all women who want to live a healthy old age. Find out why uterine fibroids are dangerous, how to treat them in order to protect yourself and maintain your health for many years.

What is uterine fibroids

Uterine fibroids is a benign tumor that occurs in muscle tissues in the form of nodes. This disease, depending on the location of localization, has several forms. According to the location of the neoplasm, the disease can be of several types:

Subserous - fibroids are located under the abdominal cavity or in the space of the small pelvis.
Submucosal - most of nodes is located in the uterine cavity, as a result of which deformation of the organ is possible.
Interstitial - the neoplasm is located directly in the thickness of the uterine wall inside the myometrial tissue.
Intraligamentary - the tumor grows between the ligaments.

Often the disease occurs simultaneously in several areas. All types of knots tend to increase in size. Initially, the formation reaches a size of several mm (up to 2 cm), and in advanced cases it increases to 8-10 sentiments. On the initial stages the disease does not manifest itself. Patients do not have bright severe symptoms, so many women do not even suspect that they have a problem, but with the growth of nodes and the development of the disease, a number of the following symptoms:

pulling aching pain in the lower abdomen, sometimes severe spasms;
changes in the menstrual cycle: copious discharge during periods that last longer than usual; severe pain; violation of the cycle; intermenstrual bleeding;
bloating due to an increase in the size of the uterus;
defecation disorders ( chronic constipation);
disruption of work Bladder(frequent urge, pain);
lower back pain;
a state of weakness;
nausea with uterine fibroids;
pale skin;
dizziness;
fainting;
chronic feeling of fatigue.

Causes

Knowing about the factors that contribute to the development of fibroids, it is quite possible to reduce the risk of the disease. The causes of uterine fibroids can be very diverse.

obesity;
hormonal failure (myoma in women progresses with an increase in the level of hormones progesterone, estrogen);
childbirth;
surgical intervention, various injuries genital organs, including abortion, gynecological operations;
lack of regular sex;
lack of orgasms;
genetic predisposition;
stress and depression (they affect the hormonal background and weaken the immune system);
endocrine disorders (diabetes, high blood pressure, goiter, etc.) (they disrupt the hormonal balance in the body);
genital infections, lesions and inflammation of the female genital area, especially when treatment has not been carried out.

What is dangerous myoma

myomatous tumor in early stage not dangerous to the body, but in the absence of treatment, the neoplasm increases and the disease develops. The consequences of uterine fibroids are serious and, if the tumor degenerates into a malignant one, they can even threaten life. The enlarged tumor compresses internal organs. When squeezing the bladder and urinary organs in a patient during urination, cramps, stagnation of urine, accumulation of sand, kidney stones appear. And when the rectum is compressed, it is difficult to empty the intestines, because of which the patient has constipation, hemorrhoids.

Rebirth into cancer

Despite the fact that the myomatous tumor is benign, it is hormone-dependent, so it is difficult and unreliable to predict any complications of uterine fibroids. chance of rebirth benign neoplasm in cancer is extremely high. At running treatment diseases, there is a risk of malignancy of the tumor and the development of metastases. The risk of developing cancer is increased by smoking, alcohol abuse, unhealthy diet, depression and stress.

Bleeding and anemia

With myomatous nodes, the patient often has heavy uterine bleeding during menstruation or even between them. If abnormally abundant discharge is not prevented, then post-hemorrhagic iron deficiency anemia may develop due to blood loss. At reduced concentration hemoglobin and a decrease in the number of red blood cells in a woman, her health worsens, constant dizziness, fainting, chronic headaches, and a feeling of weakness appear. In addition, if left untreated, the disease threatens the life of the patient.

Tumor tissue necrosis

A serious complication that uterine fibroids will entail is tumor necrosis. This occurs due to torsion of the legs of the myomatous node or a violation of the formation of blood vessels. Necrosis is the cessation of the vital activity of the cellular tissue of the neoplasm, which means its necrosis. At the initial stage of the disease, the blood circulation of the tumor is disturbed. Because of this, there are swelling, hemorrhages, aseptic inflammation. In some cases, fibroid rupture occurs. This is fraught with such serious complications as peritonitis, sepsis.

During pregnancy

In the presence of myomatous nodes, it is not easy to get pregnant. In neglected treatment or its absence, the disease often leads to infertility. If a woman with the presence of a fibroid tumor managed to become pregnant, then serious complications are possible during her gestation. Throughout pregnancy there is a risk of miscarriage, premature birth, placental abruption. If a pregnant woman has a uterine tumor large sizes, then at natural childbirth she may have such serious problems like fetal hypoxia, weakening labor activity.

Can fibroids resolve on their own

The appearance or disappearance of fibroids depends entirely on hormonal background. It is difficult to predict whether the disease will progress, decrease or completely resolve. Hormone fluctuations are constant. This process is almost impossible to predict or control. A fibroid tumor appears when estrogen levels rise. It may shrink or resolve during menopause. There are cases when the nodes disappear during pregnancy, after childbirth. It is important to consider that only small fibroids can resolve and in women who are not obese.

Treatment

Uterine fibroids can be treated in several ways: medical, surgical, embolization uterine arteries. Each method has advantages and disadvantages. How to treat the disease depends on the age of the woman, the location of the tumor, its size and individual features organism. The method of getting rid of the problem is chosen by the attending physician. At the initial stages of the disease, treatment with drugs is prescribed, and in advanced cases, in the presence of serious complications, necessarily surgical intervention. In some cases, the doctor combines both methods.

Medical treatment is the use of hormonal drugs that suppress the development of the tumor, contribute to its complete resorption. Effective drugs that reduce the tumor are Danazol, Gestrinone. But they need to be taken for a long time (from 6 months to 1 year). With a small node size (up to 2 cm), oral contraceptives Regulon, Yarina are effective. They stop the development of nodes and their growth. Medicines Buserelin and Zoladex reduce the level of estrogen, which helps to get rid of fibroids, but their long-term use is dangerous.
Surgical treatment is more radical. It is the removal of a benign tumor with an incision. If there are serious complications (malignant tumor) or an abnormally large tumor, doctors perform a hysterectomy and remove the uterus along with the node. Despite the fact that in modern medicine rare open operations to remove nodes, and surgeons often practice a less traumatic method, when nodes are removed through the vagina, surgery is not the most best method especially for women who want to have children.

Today, many women are faced with the diagnosis of "uterine fibroids". The reasons similar disease may be different, as well as its manifestations. According to statistics, about 35-45% of women middle age suffer from such a disease. Although in most cases fibroids are easily treatable, they can lead to a mass dangerous complications. So what is the disease and what are its causes? What are the signs to look out for? What methods of treatment does modern medicine offer? This information will be useful to every woman.

What is myoma?

A benign formation that develops from the muscle tissues of the uterus and is mainly a collection of connective tissue elements - this is uterine fibroids. Its dimensions can be different, from a few millimeters in diameter to 10 or more centimeters. By the way, for greater convenience, doctors register not only the size of the neoplasm, but also the size of the uterus, which correspond to a particular stage of pregnancy. For example, in medical card the doctor may record the diagnosis as "uterine fibroids, dimensions - about 12 weeks of pregnancy."

The peak of the disease, according to statistical studies, falls on age group 35-50 years old. Approximately 35-45% of women of this age suffer from some form of this disease. On the other hand, over the past few years, cases of tumor formation in more early age.

Forms of the disease

It is immediately worth noting that tumors can be either single or multiple. In addition, they are classified depending on the location:

Subserous uterine fibroids grow under the peritoneum.
Interstitial tumor (sometimes called itramural) is located directly in the thickness of the uterine wall.
The submucosal form of the tumor is characterized by the fact that most of the formation protrudes into the uterine cavity, as a result of which its deformation is observed.

Uterine fibroids: causes of appearance

This problem is considered one of the most common today. Therefore, women are primarily interested in the question of why uterine fibroids develop. The causes of the disease can be different:

To begin with, it should be noted that in this case there is some genetic predisposition.
It has been proven that neoplasms can be formed as a result of hormonal imbalance, namely, when the level of estrogen and progesterone changes. That is why uterine fibroids rarely appear during menopause, and neoplasms already present can decrease in size or even disappear altogether. At the same time, tumors often form closer to the end of the reproductive age, since significant changes in the hormonal background are observed during this period.
Risk factors also include various injuries of the genital organs, including abortion, childbirth, and gynecological operations.
Uterine fibroids can develop against the background of the disease thyroid gland, diabetes, obesity, increase blood pressure etc.
Irregular sex life also increases the risk of developing such a neoplasm. By the way, statistical studies have shown that women who are unable to experience sexual satisfaction suffer from this disease much more often.
Also, sexual infections are risk factors, especially in advanced cases when treatment has not been provided.

What are the symptoms of the disease?

In most cases, this disease occurs without any symptoms, or the clinical picture is so blurred that it is perceived as a variant of the norm. For the most part, a neoplasm is discovered by chance, during scheduled inspection at the gynecologist.

Signs of a violation appear in the presence of multiple nodes, large tumors, or their rapid growth. Symptoms will depend on many factors, including the location of the fibroids.

One of the most common manifestations of the disease is heavy menstruation, in which the amount of discharge is uncharacteristically increased. Sometimes there is bleeding outside of menstruation. Constant loss of blood over time leads to the development of anemia, which in turn is accompanied by weakness, decreased performance, fatigue, pallor of the skin.

Other symptoms include pain in the lower abdomen, which often radiate to the lower back. As a rule, they are aching in nature and appear regularly. If the tumor compresses blood vessels The pain can be sharp, even cutting.

Subserous uterine fibroids, as well as other types of large tumors, can cause disruption of neighboring organs. In particular, the neoplasm can compress the bladder, urinary tract, or rectum. Patients often have problems with urination, the number of urinary tract infections increases, and chronic constipation develops. If you have these symptoms, you should immediately consult a doctor.

Modern diagnostic methods

How exactly is uterine fibroids diagnosed? Reviews of doctors indicate that the detection of such a neoplasm, as a rule, is not a problem. Since small fibroids rarely cause any disturbances, they are most often diagnosed during a preventive gynecological examination. Similar procedure allows you to note an increase in the uterus, after which the doctor prescribes additional studies.

First of all, to be carried out ultrasound procedure pelvic organs. As a rule, patients are prescribed a transvaginal examination, as it gives more accurate results. This technique allows you to identify the tumor, clarify the place of its localization, determine the shape and size. As a rule, this is enough to make a diagnosis, but sometimes additional procedures are required.

For example, a hysteroscopy may be performed, during which the doctor carefully examines the internal genital organs using a hysteroscope. This technique is more effective in the presence of interstitial and submucosal neoplasms. In addition, during the procedure, the doctor can perform a biopsy and give the collected tissue for laboratory analysis - this helps to clarify whether the tumor is really benign.

In the event that it is not possible to accurately determine whether the neoplasm is benign or malignant tumor laparoscopy is a microsurgical operation to remove uterine fibroids. After the procedure, the removed tissues are sent for analysis, where specialists can determine the exact diagnosis.

No less informative diagnostic procedures are magnetic resonance and CT scan, but these techniques are used only in the most controversial cases due to their high cost.

Conservative treatments

What therapy is indicated for the diagnosis of uterine fibroids? Treatment may be conservative. Its main goal is to stop the further growth of the tumor, prevent the development of complications and gradually reduce its size. Conservative therapy is possible only in some cases:

nodes are located in the muscle layer or under the peritoneum;
the size of the tumor does not exceed 12 weeks of pregnancy;
no pain, heavy bleeding;
The patient has contraindications for surgery.

Drug treatment includes taking various hormonal drugs.

Quite often, patients are prescribed drugs that are derivatives of androgens. Their mechanism of action is to inhibit the synthesis steroid hormones ovaries, which, accordingly, leads to a decrease in the size of the tumor. Gestrinone and Danazol are considered quite effective. The course of therapy in this case is quite long - up to about eight months.
Combined oral contraceptives, in particular, "Yarina", "Regulon". These drugs stop the growth of the tumor, but their use is advisable only if the size of the neoplasm does not exceed 2 cm. The course of admission lasts at least three months.
Also, the course of therapy may include taking medications such as Zoladex and Buserelin. They inhibit the synthesis of estrogens, which also helps to reduce the size of the tumor. Long-term use similar drugs dangerous, as it can cause menopause.
In the presence of hyperplastic processes in the endometrium (this is not uncommon with myoma), gestagens are also prescribed, in particular Norkolut, Utrozhestan, Dufaston. Sometimes these drugs contribute to the processes of tumor reduction, but they do not have a special effect in relation to myoma.

Uterine fibroids: dimensions for surgery, indications for surgery

Unfortunately, conservative treatment is not possible in every case. In the presence of large tumors, squeezing of organs, bleeding, surgical intervention is necessary. What should be in this case, uterine fibroids? The dimensions for the operation correspond to an increase in the uterus at 12 weeks and more.

There are several ways to remove such a neoplasm. Only the attending physician can choose the appropriate procedure, depending on the characteristics of the patient's condition.

Most in a safe way is the embolization of uterine fibroids, or rather, the uterine arteries. This is a minimally invasive procedure during which an embolus is introduced into the vessel. It interrupts the blood flow to the tumor, which causes its gradual necrosis. This method is suitable for young women who are planning a pregnancy in the future.

You can also save the ability to conceive and bear a child by performing a myectomy. During the procedure, the doctor removes the fibroids, leaving only healthy tissue. Access to the affected tissues is carried out either using a laparoscope or through an abdominal incision.

How else is uterine fibroids treated? Treatment may be more radical. In some cases, the only possible solution is complete removal uterus - hysterectomy. This method is used in the presence of large tumors or a large number of nodes, inconvenient localization, if it is impossible to remove all fibroids without damaging organs, and also if diagnostic procedures cannot confirm the benignity of the detected tumor.

Even if the uterine fibroids are removed, the patient is prescribed a course hormone therapy to prevent future relapses. A combination of conservative and surgical treatment today is the "gold standard".

What complications are possible?

Today, many patients are interested in questions about what is dangerous for uterine fibroids. It should immediately be said that the presence of such an education can be quite dangerous, since its growth affects the work of the entire reproductive system.

At one time, fibroids were considered a precancerous condition. Doctors said that the probability of malignant degeneration is high. To date, this topic is not so relevant, since during latest research It has been shown that the probability of a transition to oncological disease extremely low. However, in some cases without surgical removal neoplasms simply cannot be determined whether they are benign or malignant.

To possible risks can be attributed fast growth neoplasms, as a result of which it begins to put pressure on the nearby organs of the small pelvis, blocking normal blood flow interfering with the nutrition and blood supply of tissues.

There are other risks associated with uterine fibroids. The consequences of the presence of such an education are also profuse uterine bleeding, which eventually leads to the development of anemia. It is also possible to develop pyelonephritis and hydronephrosis, which is also dangerous. Pregnant women have a high probability of early spontaneous abortion, as well as hypoxia and fetal hypotrophy. Due to the loss of uterine tone, the risk of uterine bleeding is much higher.

According to research, fibroids can lead to infertility, as well as the development different forms endometrial hyperplasia. That is why in no case should you ignore the disease - follow all the recommendations of your doctor.

Are there effective methods of prevention?

Unfortunately, today there are no means that can completely protect against the appearance of such a problem. However, by following some rules, you can significantly reduce the risk of both a neoplasm and its associated complications. So how to prevent a disease called "uterine fibroids"?

The causes of the disease can be different, so in the first place it is worth avoiding risk factors. In particular, you need to adhere to the rules of rational nutrition, make sure that the body receives enough vitamins C, A and E, and minerals including iodine, zinc and selenium. It is important to practice physical activity and maintain body weight within optimal limits.

Since abortion is one of the risk factors, it is better to use high-quality methods of contraception, for example, hormonal drugs (but they should be selected by the attending physician after examination). Regular sex life (but not promiscuity) will positively affect the state of the hormonal background and the reproductive system.

It is also necessary to pass at least twice a year preventive examinations at the gynecologist, as well as once a year to conduct an ultrasound examination of the pelvic organs. The sooner a disease is detected, the easier it will be to get rid of it.

The presence of such a disease is a signal that you need to reconsider your lifestyle. Women with a similar diagnosis are advised to more carefully monitor nutrition. In particular, fatty and fried foods should be excluded from the diet, and the amount of preservatives, dyes and other substances should be minimized. At the same time, it is recommended to include in the menu fresh fruits and vegetables, foods rich in vitamins, fiber and trace elements. Fish dishes are extremely useful in such situations.

It is also worth noting that patients with diagnosed fibroids should avoid heat exposure. This means that you need to give up long sunbathing, visits to the bath, sauna and solarium, as well as a hot shower.

Compliance with these rules will not only speed up treatment, but also reduce the likelihood of relapse in the future.

Folk remedies: how effective are they?

As you can see, uterine fibroids without surgery can be treated quite often. The preparations, the scheme and the duration of their administration are determined by the doctor. But many patients are also interested in questions about whether some home remedies can be used in the fight against the disease.

Undoubtedly, folk methods treatments for fibroids exist. But it is worth saying that any prescriptions can be used with the permission of a doctor and only as auxiliary elements of therapy.

So what is effective similar illness? For example, ordinary burdock helps many patients. The root of this plant must be dried and ground to a powder. Approximately 5 g of such a powder should be poured with 400-500 ml of boiling water, covered with a lid and let it brew for 12 hours. You need to take an infusion of half a glass four times a day. The course of treatment lasts about 30 days, after which you need to take a break for at least two weeks. Mint, nettle, hawthorn and celandine tinctures are considered no less effective. But any thermal treatments(for example, hot baths, warm compresses and ointments) are categorically contraindicated, as they can accelerate the growth of the neoplasm.

And it becomes clear that the removal of the uterus cannot be considered as the optimal treatment for MM.

The possibilities of a relatively recently appeared method are wide conservative treatment. There is also a difficult method for patients to turn off the ovaries when menopausal symptoms appear. BUT!

The absence of a surgeon's knife is still better than the conditions when you have to lie down under it. This is especially true for women planning a pregnancy, since even diagnostic laparoscopy leaves a certain degree adhesive process in the pelvis.

The frequency of occurrence and detection of MM in recent years has been steadily increasing, and this disease has significantly “rejuvenated”, which limits the use surgical techniques. Of the surgery, only conservative myomectomy remains, after which, I hope you have already understood, there is a need for hormone therapy in order to avoid recurrence of tumor growth. The same is true for the combination of MM and polyps or hyperplasia (overgrowth) of the endometrium.

On the other hand, fibroids significantly aggravate the course of pregnancy, the percentage of miscarriage, premature birth, the birth of children with a deficit of weight, low birth weight is growing. From this side there is an undoubted expansion of indications for conservative myomectomy- removal of fibroids, leaving the uterus to fulfill the dream - to give birth to a child. And once again I remind you of the need to counteract the recurrent growth of myomatous nodes through hormone therapy, it is necessary to suppress the oncogenic tendency of the body - the tendency to form excess, tumor, tissues.

Now, I hope, it becomes clear that even if you were diagnosed with "MM", then this is not a sentence at all. There is different ways overcoming this disease, defeating the tumor, opening up the possibility of having children - our continuation, the preservation of the family. This is our step into the future, a life-affirmation necessary for us and for them. The main thing is to fight and not give up on the disease, and then it will not become a sentence, but will turn out to be a temporary difficulty on a long life path.

As a rule, fibroids develop in women with an "apple" figure - with the accumulation of adipose tissue in the upper body, which is not typical for a normal woman's figure. The accumulation of body fat on the torso is characteristic of men, so there is a hormonal imbalance. And in women with a pear figure, which is characterized by the distribution of fat deposits on the hips and buttocks, the risk of developing fibroids is lower. What is the meaning of violation fat metabolism for the risk of fibroid formation.

Obesity often goes hand in hand with hypertension, and if it develops before the age of 35, the risk of developing fibroids increases significantly, since hypertension causes vasospasm and a decrease in blood supply to tissues and organs, especially those that are sensitive to a decrease in blood supply - in this case we are talking about the uterus and ovaries. And the least sensitive to a reduced level of blood circulation and oxygen in the tissues connective tissue, which has a service function, strengthens muscle bundles, maintains the connection of bones and joints with muscles. In the uterus, connective and muscle tissue are closely related. And uterine fibroids develop when, under conditions of insufficient blood circulation and reduced oxygen, an increase in the amount of connective tissue occurs, and individual muscle fibers “stretch” behind it, as already mentioned, closely connected with the connective tissue fibers that engraft them. Senile sclerosis develops according to the same laws - in conditions of reduced blood circulation, the amount of oxygen, the functional elements of the brain replace the connective tissue.

Therefore, deterioration of the inhaled air, an increase in air pollution in cities, as a result of which hypoxia develops, also leads to the formation of hormonal imbalance.

The risk of fibroid formation also increases from direct damage uterus when scraping the uterus during an abortion, when a scraping sound appears, which, they say experienced doctors, a must hear for young doctors learning the technique of surgical abortion. This sound indicates that surgical instrument already damages the uterine muscle. The same damage occurs during childbirth, when it becomes necessary to manually enter the uterine cavity to separate the placenta ( children's place) or part of it, lingering in the uterus. Although this helps stop bleeding and promotes uterine contraction, the doctor's hand inadvertently damages not only inner surface uterus, but also the muscle layer. Repeated curettage with incomplete abortion, diagnostic curettage, insufficiently substantiated or due to incorrect tactics of examination and treatment, have the value of a trigger for the development of fibroids.

Of particular importance as a mechanism for the formation of myomatous nodes is intrauterine device. This method of contraception is considerably outdated. And only now the complications caused by the presence of the IUD in the uterus are realized. Due to the spiral in the slightly open uterine cavity, despite the copper-silver-gold-platinum wires, chronic inflammation is formed, which persists even after the removal of the IUD. Meaning chronic inflammation as a factor in damage to the uterus and the risk of fibroids has already been shown above. Squeezing the inner and muscular layer of the uterus under the tip of the spiral causes a decrease in blood circulation, the amount of oxygen, and the connective tissue that has already set teeth on edge develops.

The genetic factor is also important in the risk of developing uterine fibroids. It has been proven that fibroids often recur in sisters, grandmothers and granddaughters (the third generation, in which a hereditary trait is usually detected).

Please note that above all the time we were talking about a decrease in blood flow, hypoxia, oxygen starvation, tissue compression (helix ends), which also impairs blood supply. This is directly related to the predominant structure of fibroids.

Under conditions of hypoxia and reduced blood flow, the least sensitive to these adverse conditions connective tissue participating in the muscular layer of the uterus as a connecting link of individual smooth muscle fibers. Myoma is more often predominantly composed of such connective tissues. In places where the muscle is squeezed by the ends of the spiral, connective tissue arises as an element of the emerging myoma node, in which the fibers of the muscle and connective tissue are intertwined in disorder, like a ball of woolen threads.

Before that, we talked about the increased risk of uterine fibroids. Now you can imagine the factors that reduce the risk of developing uterine fibroids.

This is vegetarianism a large number of vegetable fiber and a much lower fat content in food lower the amount of ovarian hormones, which are fatty substances.

Recently discovered and positive traits nicotine, despite its huge bad influence on the human body. In particular, with regard to the development of myomas, nicotine reduces the most active form female hormone removing the risk hormonal disorder and, accordingly, uterine fibroids.

May reduce the risk of fibroids repeated pregnancies. After all, there can be no hormonal imbalance during pregnancy. If pregnancy has come, then the hormones are in order, otherwise it will not come. And the repetition of pregnancy, that is, the extension hormonal order, - prevention of the risk of developing tumors of the genital area.

Here, the termination of pregnancy, which causes a hormonal breakdown, and the continuation of pregnancy, which prevents it, are contrasted.

Let's return to the myoma itself - a tumor (excess tissue) from muscle and connective tissues, with a huge advantage of the latter. If at the beginning, when the myomatous node is just being formed, the muscle and connective tissue components participate in equal shares, then in the subsequent increase in the size of the tumor, only the connective tissue gains an advantage. The fact is that the muscle and connective tissue components in the node are located, as already mentioned, randomly, so the vessels cannot "push" into this tangle. And with reduced blood circulation, I’m already tired of reminding you that it grows well.

Therefore, with different parameters for the classification of uterine fibroids, when classified according to the type of structure of the tissues that make up the tumor, an overwhelming advantage is obtained for fibromyomas, leiomyomas. Fibros is "thread" and leios is "white". Fibrous tissues are whitish, which is why they are called white. When the tumor is removed on the cut, it is light - leiomyoma. Tumors from only one muscle tissue it simply does not happen, the muscle cannot get rid of the fibrous filaments that braid it.

Another classification parameter is the number of nodes. Fibromyomas are single, then the tendency to increase in size is more pronounced. If there are even two nodes, then this is already multiple myoma. If there are 2 or 3 small nodules, then they grow less actively, they have stages of stable size. This variant of development is present in 25-30% of patients with MM. But the presence of one or more nodes in the composition of the muscular layer of the uterus further increases the degree of hypoxia and reduced blood flow, so conditions are created for the formation of new nodes. Again, the advantage for one type of growth, and hence the formation of multiple fibroids.

This is a multiple uterine fibroids, which shows both internal, in the wall of the uterus, and external nodes, on broad base and on the leg, and intrauterine nodes on the leg, born and located in the cavity, and intramural, tending to the cavity and away from it.

Myoma is also classified according to its location in the walls of the uterus. Myoma, located under the outer cover of the uterus, is subserous, under the serous, peritoneal cover of the uterus - subperitoneal. It can distort the outer contour of the uterus. Such a fibroid can be more or less solid on the leg. The more solid, thicker the leg, the more pronounced blood flow is accompanied, therefore, it can exist for a long time. Subperitoneal fibroids are detected during a preventive gynecological examination, ultrasound, and can also be found during pregnancy, when myomatous nodes or nodules are detected on the surface of the enlarged uterus.

Cervical and isthmus fibroids deform the cervix and its canal, which leads to infertility and miscarriage (miscarriage). But if pregnancy occurs and persists, then symptoms of circulatory disorders of the pelvic organs appear. There is venous congestion.

If the leg of the node is thin, then its blood supply is not enough, a catastrophe can happen more easily in the form of a heart attack of the myomatous node, which gives pain. Torsion of the legs of the subperitoneal fibroids can also happen, when the pain becomes so intense that surgeons call it a picture of an “acute abdomen”. The body temperature rises, signs of a catastrophe appear in the abdominal cavity. An urgent operation is required.

It happens that the subperitoneal fibroids grow between the sheets of the broad ligament of the uterus, which means that the ureters can be pressed down with the development of chronic inflammation in them (pyelonephritis).

You can see that the degree of manifestation of symptoms in MM depends primarily on the position of the node in the uterine wall.

When the node is located inside the thickness of the uterine wall, it is called interstitial. Inter - inside, interstitium - the middle muscular layer of the uterus. This is an intermuscular myoma. When such a node begins to grow, then the direction of its growth may be towards the uterine cavity. Such growth is called centripetal, that is, striving towards the center.

On the contrary, growth towards the outer cover of the uterus is called centrifugal, tending from the center.

A node growing towards the uterine cavity, when its part invades the uterine cavity, distorting its outlines, deforming the cavity, from the interstitial passes into another location option - submucosal, submucosal, under the inner lining of the uterus ("mucos" - mucous membrane). This is where fibroids are often found, as symptoms appear, signs of endometrial disorders. This is spotting or bleeding that is not related to a cycle. On this occasion, an ultrasound is done, and the submucosal node is detected. There are 2 variants of submucosal nodes: it has already been described above, as a centripetal, growing towards the uterine cavity, the node becomes submucosal. In the second variant, the node is primarily formed inside the uterine cavity.

The remaining options for the location of the nodes give signs of the disease, when the violation of blood flow becomes critical, there is a heart attack (necrosis) of part of the node. This is not a myocardial infarction, it is not life threatening, but it gives pain attack in the lower abdomen or in the sacrum, depending on whether the node is located in the anterior or posterior wall of the uterus. After tissue necrosis, the immune system will take care of resolving all traces of the catastrophe. Remains small cavity filled with tissue fluid. And here ultrasound helps to detect the so-called secondary changes in the structure of the node - traces of heart attacks. This determines how long the tumor has been around. But just like with myocardial infarction, there are both small forms that disappear without treatment, and, unfortunately, extensive, catastrophic circulatory disorders of MM, requiring immediate surgical intervention.

There is also a division of node types according to their location along the length, vertical axis cervix. There is cervical (2.6%) fibroids. Such fibroids grow in the vagina, disrupting blood flow and causing infectious complications. Such a node is accompanied by discomfort in the vagina and disturbances in intimate life- dyspareunia.

It happens that the fibroid node is located in the isthmus (7.2%) - the intermediate layer between the cervix and the body of the uterus itself. This zone is depleted in blood vessels, and since the chaotic arrangement of muscle and connective tissue elements in the myomatous node makes it difficult for blood vessels to grow, this option often manifests itself as pain above the pubis and causes problems with urination - frequent and difficult urination. And frequent heart attacks and necrosis of the isthmus node provoke cystitis, inflammation of the bladder.

Article outline

Myoma (myomatosis of the uterus) is a common disease that occurs due to rapid cell division. Most often, pathology strikes in the period of 30-50 years, but now cases of the development of the disease in reproductive age. Every woman should understand what uterine fibroids are, how to treat them, and whether they are dangerous in order to quickly recognize the disorder and contact a gynecologist.

Today, there are many methods of therapy and diagnostics, so do not panic, get upset, sound the alarm. Is not malignancy, the disease responds well to therapy and is accurately determined by hardware methods. Below you will learn all about uterine fibroids, what causes it, symptoms and treatment, types and causes.

What it is

A benign tumor consists of the connective tissues of the uterine wall. Education germinates quickly, and it is extremely difficult to control the process. Multiple fibroids are often diagnosed when a woman has more than 2 nodules. Pathology develops due to an increase in the production of sex hormones - estrogens.

Usually the tumor is located inside the cervix or its cavity. Nodular formations have different sizes, reaching several centimeters. In some, the disease develops very quickly, while in others it does not make itself felt for many years, remaining on the uterus in the form of a small nodule.

Some mistakenly believe that if left untreated, malignant fibroids occur. Studies have been conducted in gynecology, the results of which refute this theory. Cancer appears only as a consequence past illness, but the phenomenon is rare.

Myoma of the body of the uterus develops different reasons: woman's age, concomitant diseases, hormonal failure. Main symptom- intermittent, severe or persistent bleeding, sometimes accompanied by pain in the uterus. In extreme cases, anemia occurs, causing increased heart rate, dryness, pallor of the skin, severe weakness.

The diagnosis is made at any age, in 20% the disease is determined at the age of 30, in 10% - in virgins, and in 50% - women over 50 years old. To avoid negative consequences It is recommended, although once a year, to undergo an examination by a gynecologist. In addition, it is important to pay attention to any menstrual irregularities - an increase in the amount of blood, lack of pregnancy and ovulation, pain, etc.

Types of uterine fibroids

Fibroids in women can be of several types and large or small sizes. The classification is determined by the number of nodes, the nature of growth, the place of origin. Based on the specific location, the following types of nodes are distinguished:

Interstitial.
Intraligamentary.

There are times when a woman finds 2-3 species at once. In addition, in medicine there is a fibroid "on the leg", which is connected to the walls of the organ. Complications and consequences of this kind are sad, in cases where torsion occurs. Depending on the classification of fibroids, the doctor decides what to do and what treatment to choose.

Interstitial

Occurs most often. Usually affects the uterus, but may develop in the cervix. It grows inside the organ, towards the abdominal cavity, protrudes outward or develops in the myometrium. The disease is diagnosed at 30-45 years of age. Nodes can be single or multiple. Some formations reach more than 10 cm and are removed surgically.

While the node is small, the woman does not feel much discomfort. At the beginning inflammatory process there is pain in the lower abdomen and mucous discharge in copious amounts. When the size of the formation goes beyond 4 cm, the bladder and intestines are squeezed, resulting in symptoms such as frequent hikes to the toilet, urination with pain, dyspeptic disorder.

Intraligamentary

The internal organs of the small pelvis are held with the help of ligaments, which are responsible for their normal position. In the presence of fibroids, there may be serious violations, characterized by a change anatomical structure organs. Intraligamentary fibroids are usually not accompanied by disruptions in menstruation, but cause problems with conception and pregnancy.

This type of disease is accompanied by pain in the abdomen or back, impaired urination, enlargement of the kidneys and ureter. The nature of the manifestations is affected by the size of the node, their location, number. Interligamentous fibroids are rare. To determine, ultrasound of the uterine cavity is used, then tomography or magnetic resonance imaging. Optimal treatment- removal of fibroid tissue, if the nodes are actively growing.

subserous

A benign tumor is located outside the uterus, grows into abdominal cavity. Large nodes are easy to identify during the examination, small ones are detected using ultrasound. During the period active growth pathology is accompanied frequent constipation, frequent urination, hemorrhoids.

After the onset of menopause, the tumor can independently decrease in size (more details in). Under other circumstances, it is removed surgically. Most often subserous myoma the uterus in women is activated after a miscarriage or spontaneous abortion.

Submucosal

The nodes are located in the endometrium. Formations progress rapidly, germinate outside the neck, causing severe grasping pain. During the period of active growth, the nodes cause such complications:

Miscarriage;
Inability to bear a child;
Profuse bleeding;
Severe pain, spasms.

The submucosal type of fibroids can be caused by an excess of estrogen, frequent abortions, difficult births, inflammatory diseases etc. Treatment occurs surgically after hormone therapy.

What is dangerous uterine fibroids

Hearing terrible diagnosis, the girl begins to panic and find out how dangerous fibroids can be for a woman's life. Immediately it should be noted that the occurrence of cancer is minimal.

The main risk lies in the subsequent development of complications, but compliance with the doctor's recommendations and constant monitoring exclude adverse reactions.

If you do not treat myoma, the following consequences occur:

Severe uterine bleeding - the process is dangerous for the development of anemia, it can threaten the patient's life.
Purulent inflammation in the nodes and adjacent tissues - without modern treatment septic complications occur.
Torsion of the node "on the leg" - a rupture of the leg is possible, the occurrence internal bleeding or "acute abdomen" syndrome.
Inability to have children - pregnancy outside the uterus, miscarriage, infertility, difficult childbirth may develop.
Necrosis is the death of nodes.
The birth of education with eversion of the uterus.
Malignancy - when a benign tumor turns into a malignant one. The phenomenon is extremely rare, but not worth the risk.

The development of pathology is accompanied by severe, sometimes unbearable pain. The main danger of uterine fibroids is possible complications up to and including death.

Causes

The appearance of pathology is due various circumstances, have not yet been fully explored. The main factor is hormonal imbalance that occurs against the background of diseases, stress, malnutrition, etc. From what myoma appears, consider below:

hereditary causes;
Hormonal imbalance - that is, a violation of the amount of estrogen and progesterone;
Lack of orgasm;
Adenomyosis;
Diabetes, hypertension;
Gynecological diseases, inflammation, diabetes, slow metabolism;
Frequent abortions - the probability increases by 2 times;
Stresses that have a bad effect on the thyroid gland, adrenal glands, etc.;
obesity, lack of movement;
Installed intrauterine device.

Doctors have proven that women who have given birth are less susceptible to the development of fibroids. Often the disease appears during pregnancy, in particular, if it is late.

Too much estrogen and too much progesterone

Fibroma is considered hormonal disease, since growths are formed during violations hormonal balance. That is why neoplasms do not occur in girls who are not of childbearing age.

For problems with menstrual cycle there is an imbalance in the production of progesterone and the hormone estrogen. Hormonal disruptions provoke the growth of tumors, so the suspicion of fibroids (first of all) must be confirmed by a study of the hormonal status.

Diabetes and hypertension

Women suffering from such diseases are prone to developing fibroids at an early age. If there is a strong accumulation of fat deposits in the waist area, this indicates a tendency to growth of formations. Girls living in cities get sick more often. They have a metabolic disorder due to stress or wrong image life, which provokes the occurrence of gynecological pathologies.

woman nutrition

An important role is played by the diet. Excessive consumption of trans fats or refined foods, as well as a lack of fiber, provokes an imbalance of sex hormones. Poor nutrition causes obesity.

If a woman eats a balanced diet, eats cereals, marine and vegetable products, avoids sugars and fats, the risk of fibroids is minimal. A person who eats right looks young and healthy.

Pregnancies, childbirth and interruptions

Abortion, miscarriage, difficult birth with trauma, curettage - common causes gynecological diseases. A woman who has given birth is less prone to the appearance of fibroids.

Lack of orgasm

Rare, irregular sex, as well as the lack of orgasm leads to stagnation in the pelvis. Chronic stagnation is the cause of hormonal imbalance, and as a result, the development of fibroids.

Diagnostics

In modern medicine, the diagnosis of pathology is not difficult. A recently appeared tumor is determined during examination by a gynecologist. The patient has an increased size of the uterus, there is deformation of the walls and thickening.

To confirm the diagnosis, the following additional studies are carried out:

MRI, CT - rarely used.
Hysteroscopy is the extraction of uterine tissue in order to subsequently transfer the resulting material for examination.
Laparoscopy.

The scope of research is determined individually for each woman. Usually, an examination and an ultrasound check are sufficient.

Fibroids symptoms

The early stages go unnoticed. You can detect the formation of tumors as they grow.

First signs:

Violation of menstruation;
Bleeding;
constipation, frequent urination;
miscarriages;
Infertility;
Anemia;
Sudden increase in the abdomen is not justified;
Bloody discharge during sex;
Pain in the lower abdomen and lower back, heaviness;

During growth, there are persistent bleeding, cramping pains, anemia, big belly. The growth of fibroids during pregnancy is dangerous with premature, prolonged labor, fetal hypoxia, and delayed development.

For the doctor, echoes of uterine fibroids are important. With their help, the location, type of build-up is calculated.

The nature of pain in various forms

With the development of pathology, the pain becomes stronger and more unbearable. In the interstitial form, the tumor exerts pressure on the surrounding organs, which causes a feeling of heaviness and pressure. The subserous form is accompanied by exhausting back pain, the submucous form is cramping, which is permanent.

Bleeding and the menstrual cycle

The submucosal form, developing, causes constant, incessant bleeding, which provokes the occurrence iron deficiency anemia and other complications. The woman quickly gets tired, headaches and weakness appear, as well as dystrophic changes in the myocardium.

Treated or not

Since the disease is common, new treatments are being actively developed around the world. There are a lot of them, ranging from taking hormonal drugs to surgery. After the diagnosis is made, the woman does not know what to do with uterine fibroids.

First of all, you need to visit good gynecologist who will tell you exactly whether there is a disease or not, and how it is cured. Then an individual treatment is prescribed, which differs depending on the size and location of the tumor, as well as the age of the woman.

Node dimensions

Myoma nodes are both small and large, reaching sizes greater than 10 centimeters. Small education - up to 2.5 cm, medium - up to 13 weeks, large - more than 12-15 weeks of pregnancy. The larger the nodes, the greater the risk of complications and bleeding.

How to treat uterine fibroids

There are 2 main types of therapy:

Conservative treatment of uterine fibroids - mandatory application hormonal drugs, symptomatic treatment with painkillers.
The main one is surgical intervention, which is effective in severe stages.

The method is prescribed based on the symptoms, the size of the tumor, the age of the patient, the intention to give birth and the growth rate of uterine fibroids. It is best to treat early dates when no operation is needed. Conservatism is most effective in reproductive age.

Having found a tumor during menopause, the doctor restrains its development until it is completely resorbed or reduced in size.

Gonadotropin-releasing hormone agonists

This method initiates a temporary menopause, which leads to a decrease in the size of the neoplasm by 52%. The group includes preparations containing triptorelin, goserelin, busererelin and leuprorelin. The course of therapy is 4-6 months. The size of the nodes is reduced by 50%, but the risk of recurrence is not excluded. this group is often used before surgery to reduce bleeding by reducing the growth.

Antigonadotropins

Drugs are rarely used, as they cause some side reactions. It should be taken only when other methods are powerless even with prolonged use. The group consists of such active substances as Gestrinone and Danazol. The remedy eliminates the symptoms, but does not affect the size of the fibroids, therefore it is often prescribed in the preoperative period.

Gestagens

Effective, inexpensive drugs that block estrogen synthesis. Unfortunately, with the use of the drug, fibroids are not completely cured. There were cases when the patient's condition worsened. Usually, drugs in this group are prescribed for concomitant diseases, for example, endometrial hyperplasia, since hormonal disorders can be the cause of pathologies.

Antiprogestogens

Mifepristone - binds gestogen receptors, blocking the effect of progesterone. Substances reduce the size of the tumor, reducing symptoms. The drug is available in the form of tablets of 3-6 pieces, and is often used before surgery.

Operations

The operation of uterine fibroids is carried out in several ways. The most popular are hysteroscopy and laparoscopy. This is due to the absence of scars, the preservation of reproduction, fast recovery. The doctor focuses on the age of the woman, the size of the formation, its location and quantity.

A laser is mainly used, which cuts off the tumor without causing bleeding and does not leave deep scars. Today, the UAE method is actively used - embolization of the uterine arteries. During the procedure, the doctor injects a special drug into the vessels that stops the flow of blood to the affected tissues.

They begin to die off, as they are deprived of oxygen, gradually decreasing. The method is used for any number of nodes and their location. Sparing surgery is powerless in cases where it is impossible to stop the growth of the tumor. Then the doctor removes the uterus completely.

When is surgery indicated

The operation is prescribed in several cases:

The nodes are more than 12 weeks old and put pressure on the internal organs;
The combination of fibroids with other gynecological diseases;
Severe uterine bleeding;
Active growth of nodes or their necrosis;
Birth of a node or necrosis.

Also, intervention is necessary (an operation is needed) for suppuration in the area of \u200b\u200bmyoma.

Popular methods of treating uterine fibroids surgically will be described below.

Embolization

is a unique method used to cut off the blood supply to fibroids. After the operation, the growth decreases and resolves, as blood stops flowing into it. Doctors give positive forecasts, some are sure that the operated woman remains able to endure and give birth healthy child. It depends on the size and type of fibroids, as well as the correctness of the operation.

Advantages of the operation:

Normalization of menstruation.
The disappearance of problems with urination.
No risk. The operation does not require anesthesia, takes no more than 15 minutes, rehabilitation is up to 7 days.
Good efficiency.

The method excludes relapses and additional treatment, it is enough to perform the operation once, and the pathology disappears forever. If the rules of rehabilitation or prevention are not followed, sometimes the disease manifests itself again.

Hysteroscopy

A popular method that is carried out through the vagina, removing the growth with a special tool. As a rule, after removal of adverse reactions and complications do not occur, the risk of recurrence is minimal, and the woman can give birth.

Often, before the operation, the doctor prescribes preoperative preparation, which consists in taking hormonal drugs. The method is more necessary to normalize the size of the uterus, but there is also a decrease in the tumor.

Myomectomy

The laparoscopic method is performed using special punctures on the abdomen. Removal of fibroids by myomectomy is less traumatic; after extraction, the material is sent for examination. With myomectomy, uterine fibroids can be cured, while maintaining the woman's ability to give birth to a healthy child, and leaving no visible marks on the body. The disadvantages of the method include a possible recurrence and the need for repeated intervention.

Fuzz ablation

The nodes are removed under MRI control, the procedure is safe and convenient for the doctor. The cells are heated by an ultrasonic pulse until destroyed. The whole process can take 4 hours, as it consists of several stages. After the operation, the symptoms of the pathology disappear, relapses are excluded, and the size of the growth decreases. Unfortunately, the method is not suitable for all women and is selected individually.