What sizes of uterine fibroids are dangerous in weeks and centimeters? Uterine fibroids: dimensions in weeks and centimeters, causes, methods of treatment, reviews Fibroids size 10 weeks in centimeters

Middle-aged women often face a disease such as uterine fibroids. It is a benign tumor that occurs due to an excess of the female hormone estrogen. With timely diagnosis and complex therapy, the myomatous node can be cured without surgery. If the size of the fibroid can be described as large, the tumor presses on the surrounding organs and tissues. This means that conservative methods of treatment will be ineffective, and the woman will have to be operated on.

The danger of fibroids is that the tumor can develop asymptomatically for a long time. And only when bleeding starts, pain begins or discomfort is felt, the woman decides to seek medical help.

A neoplasm is diagnosed using a special mirror on a gynecological chair or with ultrasound diagnostics. Lack of treatment and medical supervision can lead to the degeneration of the node into a malignant formation and an increase in the number of tumors.

The size of fibroids and their symptoms

It is extremely important for women to understand at what sizes of uterine fibroids surgery is performed, and in which cases it is possible to confine oneself to hormone therapy and folk remedies.

When the node grows, this leads to the fact that the volume of the organ also increases, as during the development of the embryo. That is why the size of the uterus with fibroids is determined, as during pregnancy, in weeks and centimeters (millimeters). For example, a fibroid 6-7 weeks is 2.5 cm.

The size of the tumor can be divided into three categories or groups. Distinguish uterine fibroids:

• Small. The size of the uterus corresponds to 6-8 weeks of pregnancy, and does not exceed 2 cm in diameter. Such a node is usually diagnosed by chance, because it is not capable of causing pain or other signs of illness. Uterine fibroids for 7 weeks does not require prompt elimination, it will be more effective to simply treat it. The doctor will prescribe a course of hormone therapy, and with the help of a photo from an ultrasound scan, he will draw up a table (development schedule), and will also monitor the size and nature of the tumor.
• Average. This category includes fibroids 9-10, as well as 12 weeks. Such a node has pronounced symptoms and signs, a woman suffers from heavy menstruation and pain. Often women wonder, fibroids 12 weeks - how many centimeters? The size of the fibroids at 12 weeks corresponds to 7 cm.

• Big. Myoma 14-16 weeks is characterized as large. It should be understood how dangerous a large tumor is. Medical treatment in this case is powerless, surgery is required. Myoma 20 weeks - a giant tumor that requires urgent removal.

Small or medium uterine fibroids 7-8 weeks rarely cause serious complications after effective hormonal therapy. Neoplasms of 10-13 weeks, even with proper treatment, will cast doubt on the patient's fertility. There are cases when surgery is required for patients with small nodes.

Even if the tumor is not measured in centimeters, but in mm, urgent surgery may be required. The doctor makes such a decision if the nodes of 8-15 mm have legs. Tumors with this structure tend to twist and cause severe pain. Uterine fibroids 3 cm should be excised if the neoplasm is located in a dangerous or hard-to-reach place. If such a serous node reaches a size of 5-6 cm, it will be extremely difficult to remove it without damaging the organ.

• Small uterine fibroids
• Large uterine fibroids

Indications for surgery

A woman, having heard that she has been diagnosed with uterine fibroids for 8 weeks, is always trying to find out all the options and methods of treatment. Unfortunately, it is sometimes impossible to do without surgery.

Doctors have identified several indications when the neoplasm is unambiguously removed:

• Uterine fibroids 12 weeks (60 mm in diameter). Such a node endangers the health and life of the patient. Sometimes not one tumor is found, but several nodes of medium size. When diagnosing multiple uterine fibroids 6 cm, excision of the neoplasm is mandatory and urgent.
• Planning for pregnancy. Myoma 9 weeks often causes infertility or early pregnancy failure. If you want to conceive, you must first remove the node, even if it is only 4 cm. Changes in hormonal levels during childbearing can stimulate the growth of the neoplasm. If uterine fibroids were detected 5 weeks after conception, the doctor, according to indications, will recommend terminating or maintaining the pregnancy.

• risk of rebirth. If a fibroid of 7 weeks has increased to 11 weeks in a few months, this may indicate the presence of atypical cells. To prevent the node from developing into cancer, it must be removed without fail.
• Pain syndrome and dysfunction of the pelvic organs. Subserous uterine fibroids of medium or large size can put pressure on the bladder or intestines, which causes constipation, urinary incontinence, etc. Constant pain and other negative manifestations of the tumor, such as heavy bleeding, are a direct indication for surgery.

Uterine fibroids of 9 weeks deserve special attention, as well as neoplasms of a different size if the tumor develops in a woman during menopause.

During menopause, estrogen is released in a smaller volume, so doctors often decide that surgery is not necessary, preferring expectant management.

What if the observation indicates tumor growth?

If the patient is not of childbearing age, the uterus is removed along with the node.

Abdominal surgery

Subserous uterine myoma 9-10 weeks in most cases requires surgical removal, less often excision is required for smaller nodes. The traditional way of performing the operation is to remove the tumor through an incision in the abdominal wall. It is necessary to carefully prepare for the procedure, and after its completion, the patient must be in the hospital for several days under the supervision of medical personnel.

With uterine nodes, abdominal surgery can be performed in one of four classical ways, namely:

• Myomectomy or laparoscopy. Small incisions are made in the abdominal wall. An optical device, a laparoscope, is inserted into them. Indications for surgery with this method are the small size of the nodes and the increase in the volume of the uterus for no more than eight weeks. Rehabilitation after the procedure is fast and rarely accompanied by complications. The woman retains childbearing function.
• Laparotomy. It is used if the uterus has reached the size of 12-15 weeks and presses on nearby organs. After the tumor is removed, the abdominal wall is sutured. It is recommended to stay in the hospital for 5-7 days after the operation. The total rehabilitation period is about two months.

• Hysteroresectoscopy. The hysteroscope tube is inserted into the uterus through the vagina. With the help of special equipment, nodes of about 3 cm in size can be removed in the most gentle way. This method has the most positive feedback among women who have undergone the procedure.
• Hysterectomy. This is the most radical method, which involves the removal of nodes along with the uterus. It is used extremely rarely if the tumor is gigantic, grows rapidly, or is prone to degeneration.

In the postoperative period, the patient is prescribed antibiotics and restorative drugs. A course of hormones may be prescribed to stabilize the endocrine system.

A woman who had a 12-week-old tumor removed should take care of herself, be attentive to her well-being, and immediately seek medical help if alarming symptoms appear.

The size of uterine fibroids for surgery is not always of paramount importance. Each case is individual and requires a thoughtful approach.

Alternative ways to remove fibroids

Myoma is not always operated on. Medicine has stepped far forward, which means that today, loyal methods are available to women who consult a doctor in a timely manner. An effective solution would be the excision of the node with a laser.

This is the least traumatic method, characterized by many advantages, such as:

• lack of scars;
• short rehabilitation period;
• preservation of reproductive function.

The laser is successfully applied to a six to seven week old neoplasm. The procedure is carried out in modern clinics and medical centers. The price of the service varies greatly.

If there is no money for laser removal of fibroids, you can apply for a state quota.

The second loyal way to get rid of the tumor of the fifth week is UAE. Uterine artery embolization is highly effective and has no recurrence after the procedure. A catheter is inserted into the woman's femoral artery, through which a special solution will be poured into the arteries that feed the tumor. It has a clogging effect, the node ceases to receive nutrients and gradually dies.

The use of UAE is allowed with the size of the fibroids at 9 weeks. The larger the tumor has reached, the more unexpected consequences can occur after UAE is done. Cases have been noted when, after arterial embolization, a woman had no menstruation - amenorrhea.

pomiome.ru

Size of uterine fibroids in weeks

Uterine fibroids is a benign tumor that appears in the reproductive organ. Affected age - women 20-70 years. This disease occurs due to hormonal failure. At the initial stage, the disease has no symptoms, only when pain and bleeding occur, the woman decides to be examined. The size of uterine fibroids in weeks is diagnosed using ultrasound. Treatment depends on its size.

The size of a benign tumor is determined by weeks and centimeters. This completely coincides with the obstetric period (fetal growth during pregnancy). Therefore, the size of fibroids is considered to be weekly.

Divide the tumor into three types:

• A small tumor (about 2 cm), its duration is 4-6 weeks, no more. The reasons for surgery are only in case of torsion of the fibroid stem. May be removed due to profuse bleeding, leading to anemia. Also, if a woman has been diagnosed with infertility;
• Medium (from 4 to 6 cm) period 10-11 weeks. If the nodes do not grow actively and there are no pronounced symptoms, then the operation can be omitted. Formations that are located on the outside of the uterus can disrupt the functioning of organs located closest. With an average myoma, infertility or miscarriage may occur;
• A fibroid exceeding 6 cm in diameter is considered large, its term is equal to 12-16 obstetric weeks of pregnancy. Such a fibroid is removed only in an operable way and drug treatment, to eliminate neoplasms.

Size of uterine fibroids in weeks and centimeters

At an early stage, fibroids is 4 weeks. It has no symptoms and does not disturb the woman. The main thing is to determine this disease before the period of 7 weeks. It will bring much less problems than in the later stages of detection.

With its increase to 5 cm and a period of about 10 weeks of obstetric pregnancy, the first symptoms begin to appear.

• Menstruation with pain that does not help with pain medication.
• Upon reaching 12 weeks, the cervix increases, which causes bloating.
• If there is a diagnosis of fibroids on the leg, then the appearance of a sharp pain in the abdomen.
• With a large fibroid, its increase leads to squeezing of neighboring organs, which interferes with normal urination and defecation. Pain begins in the lower back and near the rectum.

Fibroids, the size of which is more than 12 weeks, entail the formation of adhesive processes in the tissues of the body and nearby organs.

When a patient complains, an ultrasound examination is performed, and appropriate tests are given. Ultrasound is the most accurate detection of this disease, as well as the timing of its occurrence. Thanks to the examination, it is possible to accurately identify a benign tumor or not. The possibility of transition of a tumor from benign to malignant depends on the time of its detection. It is necessary for every woman to take as a rule an ultrasound scan regularly.

After examination and further diagnosis, the doctor decides on the operability of this tumor. For this, the following indicators are available:

• Uterine fibroids have a size of 6 cm and its duration is more than 12 weeks. This size of the tumor is life-threatening for the patient. Fibroids that are more than 12 weeks old should be urgently removed.
• Stable intense pain. A feature inherent in medium and large fibroids. The myoma node leads to squeezing of nearby organs, and also puts pressure on the rectum. Defecation is impaired, which can lead to inflammation of the intestines and intoxication of the body.
• There was bleeding. Basically, it leads to fibroids for a period of 15 weeks or more.
• Planning for pregnancy. If a woman is unable to conceive or carry a fetus, a medium-sized fibroid is often the cause. The hormonal background during pregnancy changes, which leads to the growth of the tumor and poses a threat to the child.

If uterine fibroids are more than 12 weeks old and are located on the back wall of the uterus, then this can provoke premature birth. Oxygen starvation of the fetus may occur.

• There is a risk of a benign fibroid to develop into a malignant one. This possibility appears with the rapid growth of fibroids.

Small or medium fibroids can be treated without surgery, provided there are no complications. If the tumor is benign and equal to even a few millimeters, you still should not relax and start its treatment, because it can be located in a harmful area.

tumor growth

For the treatment of fibroids, it is important how quickly it grows. If within a year the uterus has increased to 5 weeks or more, then this tumor is progressing. Her growth is affected by hormonal failure of the body. There are also the following reasons for the rapid development of this disease:

• before the age of 30, a woman did not give birth
• gynecological pathologies
• a sufficient number of abortions
• taking hormonal drugs
• long-term effect of ultraviolet radiation on the body.

Sometimes uterine fibroids grow to enormous sizes, the weight can be about 5 kg and 40 cm in diameter. At the same time, it looks like a late pregnancy.

Effect of fibroid size on pregnancy

With fibroids of small or medium size, pregnancy can proceed normally. If the tumor is large, then pregnancy, as well as the bearing of the child, is not possible. Even conception does not occur due to the fact that the nodes block the fallopian tubes.

If a woman during pregnancy found out that she had a large fibroid, then complications may arise during childbirth. It can be bleeding, infections of internal organs, as well as unforeseen situations.

The most serious is considered a fibroid located in the vagina. It causes infertility, as well as spontaneous miscarriages. If the onset of pregnancy occurred with a benign tumor, then the patient is under the supervision of doctors all the time to prevent miscarriage. If the growth of the myoma node increases rapidly, then the pregnancy has to be terminated.

In some pregnant women, fibroids stop growing altogether, in 10% it decreases, and in only 20% it can begin to grow at a progressive rate.

Removal of fibroids

When examining an ultrasound, it was revealed that the nodes are increasing, the doctor prescribes a complete examination of the patient to begin with. Then the operation is performed. There are the following types of operable intervention: laparoscopy, laparotomy, strip operation, hysteroscopy, hysterectomy.

Removal of fibroids 8 weeks. If the tumor began to grow and grew from a small stage to an average one and corresponds to a period of 8-9 weeks, it is recommended to perform an operation. The type of operation used here is laparoscopy. This is the removal of fibroids through incisions made on the abdomen. After such an operation, scars do not remain. The postoperative period lasts about two weeks.

With hard-to-reach and large nodes, hysteroscopy is done - making incisions through the vagina.

Removal of fibroids 10 weeks. Deletion cannot be delayed. The operation is performed through an incision in the anterior wall of the abdominal cavity. This rather serious operation to remove a benign tumor is called a laparotomy. After it, a long rehabilitation is required.

Removal of fibroids 12 weeks. When a tumor of this size is diagnosed, surgery is performed immediately. In extreme cases, a hysterectomy is used - the complete removal of the uterus. This operation is performed if no other treatment is more effective. The rehabilitation period is about 2 months.

In a difficult case, as well as common foci of the disease, a strip operation is performed.

Complete removal of the uterus for fibroids

The entire genital organ can be removed: if the size of the tumor has reached unacceptable norms, also if the removal of the nodes is not possible. The main indicators for this are:

• late identified nodule formation,
• uterine prolapse,
• prolonged blood loss
• suspected malignancy,
• increasing anemia.

Rehabilitation after removal

To quickly return to a normal lifestyle, you must adhere to the following recommendations:

• eliminate the load on the stomach, but try to move more;
• avoid constipation;
• do not lift weights;
• eliminate stress, often they lead to changes in hormonal levels.

To plan pregnancy, you need to consult with your doctor.

Take medicine to restore the vital activity of the uterus. Also, in case of any unpleasant symptoms, consult a doctor.

Every woman should systematically visit her gynecologist, monitor her reproductive system.

onkologii.ru

Uterine fibroids: dimensions for surgery in millimeters, centimeters and weeks

A benign tumor in the uterine myometrium or fibroids is a fairly common disease for middle-aged women. If the patient monitors her health by regularly visiting a gynecologist, and the tumor process is observed by a specialist from the very beginning, non-surgical treatment of uterine fibroids is possible.

The main danger of a neoplasm lies in its potential ability to grow and degenerate into a malignant cancerous tumor, which is why it is so important to monitor the increase in the size of myoma nodules.

With the diagnosis of uterine fibroids, the dimensions for the operation to remove it are determined by a set of studies:

• visual-bimanual examination on a gynecological chair using a special mirror;
• ultrasound examination, specifying the number and size of fibroids.

In order for the doctor to prescribe the correct treatment, it is necessary to repeat the ultrasound procedure several times. This will determine the rate of tumor growth. To obtain a detailed picture of the disease, it is recommended to do an MRI.

With the growth of fibroids, the cavity of the organ itself also gradually increases - this resembles the growth of an embryo. Due to this similarity, the size of uterine fibroids is usually compared with the weeks of pregnancy. For example, uterine fibroids 7 weeks is approximately 2.5 cm.

Myoma sizes

In gynecology, it is customary to conditionally divide uterine fibroids into three types, based on the size of the neoplasm:

1. Small myoma. It is comparable to a pregnancy of 6-8 weeks and has a volume of up to 2 cm. Usually, such a tumor does not manifest itself in any way, a woman learns about the disease by accident. It is important to identify the formation during this period - a fibroid of 7 weeks in size will bring much less trouble than a neglected giant tumor.
2. Medium myoma. In terms of pregnancy, the size will be 10-12 weeks or up to 7 cm. A patient with such a tumor may complain of heavy painful menstruation that cannot be anesthetized with medications. There are small discharges of blood in the middle of the cycle, the so-called "daub".
3. Large myoma. The parameters of the neoplasm are comparable to the embryo at 12-15 weeks.

Symptoms

The presence of such uterine fibroids is manifested by severe symptoms:

• pain in the belt, heart, and with adhesions to the tissues of neighboring organs - and in other places;
• frequent numbness of the legs due to circulatory problems;
• violation of defecation or increased urge to urinate due to tumor pressure on the nearest organs - intestines, bladder;
• an increase in the lower abdomen while maintaining weight at the same level.

Small and medium fibroids in the absence of complicating factors allow conservative treatment without surgical intervention. In such cases, conception and successful delivery are possible. But large-sized fibroids will become a serious obstacle to childbearing.

Even if the tumor is very small and is measured not in centimeters, but in millimeters, you should not relax: it can be located in a dangerous area. The growth of a tumor on a stalk can cause inconvenience even with a size of 9 mm: when the stalk is twisted, the pain is unbearable.

Another mandatory characteristic of fibroids is the rate of its growth: an increase in 12 months by more than 5 or weeks or 4 cm is considered a dangerous signal and one of the indications for surgery.

Heal can't be cut

A patient with a diagnosed tumor first of all asks the question: at what size of uterine fibroids do surgery and is it possible to do without it.

Doctors distinguish several indications for surgical intervention:

1. The size of fibroids exceeds 12 weeks or 6 cm. Such myoma nodes pose a threat to a woman's life. If several medium-sized nodes are found, their urgent removal is considered strictly mandatory. At the same time, slightly smaller uterine fibroids, for example, 5 weeks, are subjected to drug treatment under the supervision of the attending physician.
2. The woman is planning a pregnancy. Medium fibroids often cause infertility or miscarriages in the early stages. A change in the hormonal level during pregnancy stimulates the growth of the tumor: it can be either a small growth or a sharp increase at times, creating a threat to the baby.
3. The risk of degeneration into sarcoma is a malignant tumor. First of all, this probability is manifested by rapid tumor growth.
4. Constant severe pain. This symptom is also characteristic of medium and large fibroids. The location of the myomatous node can cause the tumor to compress the nearest organs, causing severe pain. So with pressure on the rectum, a rare stool is observed - 1 or 2 times in 6-8 days. This situation threatens with intoxication of the body and inflammation of the intestines.
5. Heavy bleeding. Constant loss of a significant amount of blood leads to anemia. Uterine fibroids usually bleed heavily for 15 weeks or more.

Menopause stops the growth of fibroids due to a decrease in the production of estrogens - female sex hormones. Therefore, in menopause, tactics of passive observation are also acceptable. The alternative is a radical solution to the problem, removal of the uterus.

Of course, there is no need to rush to the operating table: a knowledgeable specialist uses all the possibilities to reduce myoma with medication. If the operation is the only possible way out, you should not delay it either, because delay can cost your health.

Traditional and alternative operations

Removal of uterine fibroids is an abdominal operation, but some fear of it is justified and natural. The intervention is performed under anesthesia, so you should not panic.

Modern medicine offers different options for getting rid of fibroids, let's start with gentle alternatives:. It is applied to a node no larger than 6-7 weeks. Reviews of doctors characterize the laser as the least traumatic method, which has a lot of advantages:

• does not leave ugly seams, only a small scar 1.5 - 2 cm in size, as seen in the photo;
• maintains the maximum ability to bear children;
• rehabilitation lasts only 14 days.

Given that the latest sensitive equipment is used and highly qualified doctors work, many patients prefer to clarify in advance how much the operation costs in different clinics. You can save on expensive treatment by getting a quota from the state. True, it will take some time.

Embolization of the uterine arteries. The effectiveness of UAE is 98%, while with conventional surgical removal, the risk of recurrence is 40%. Through a catheter on the femoral artery, a solution is injected that clogs the vessels that feed the myoma. As a result, the tumor gradually dries out and dies. It is best to do this intervention when the fibroid is about 9 weeks old or less. The long-term effects of the procedure are not fully understood. In some patients, after UAE, there was a lack of a menstrual cycle - amenorrhea.

How is the operation - video

Abdominal surgery

It happens that the state of fibroids does not allow using alternative methods of removal: the situation is complicated by necrotic processes in the tissues, the tumor stem is twisted, etc. Then the surgeons perform traditional abdominal operations, making incisions on the abdominal wall. After such a removal of uterine fibroids, the woman will have to spend the postoperative period in the hospital under the supervision of doctors.

There are four types of traditional abdominal operations:

Laparoscopy or myomectomy. The intervention occurs through the introduction of special equipment into the punctures on the abdominal wall - a laparoscope, therefore it does not leave large scars. The second plus is a short rehabilitation period, it will be only a week. During laparoscopy, several fibroids are usually removed, not exceeding 15 mm in diameter. The uterine cavity should be enlarged for a maximum of 15-16 weeks. For the uterus itself, the consequences of such an operation are the least severe, the risk of adhesions in the fallopian tubes is minimal.

Laparotomy or removal of fibroids through a small incision made in the abdominal wall. Indications for laparotomy:

• distortion of the shape of the uterine body caused by rapid tumor growth;
• growth of large tumors in the abdominal cavity or pelvic area;
• the size of the nodes is more than 12-15 weeks.

Hysteroscopy or resectoscopy. A special device, a hysteroscope, is inserted into the uterine cavity through the vagina. The method is applied to single nodes on the uterus 6 or more weeks in size, located on the back or front wall of the uterus. The intervention is preferably carried out in the first 7 days of the cycle. The operation is so simple that it can be performed on an outpatient basis.

Hysterectomy is the complete removal of the uterus. A radical measure used in extreme cases when other methods are no longer effective:

• with a gigantic size of the tumor;
• degeneration of a benign tumor into a sarcoma;
• the presence of many different types of nodes;
• climax.

Recovery will take 2 months. The doctor will prescribe pain medication for a few days, because. pain does not even allow you to just stand, and the implementation of the simplest movements is painful. Then you need to drink a course of antibiotics. Based on the patient's condition, general strengthening drugs are prescribed. In the postoperative period, the risk of bleeding is high. Any discharge of blood is an occasion to immediately seek medical help.

Removal of fibroids - video with Elena Malysheva

Features of rehabilitation

The operation to remove uterine fibroids is not the most difficult and dangerous, but it is still important to follow a number of rules in the postoperative period. This will help you quickly return to a normal rhythm of life and restore hormonal levels.

The advice of gynecologists is mandatory, especially since it is not difficult to follow them:

• avoid constipation, especially in the first postoperative days;
• try to move more, while eliminating any load on the stomach (slow walking will do);
• in the first six months after surgery to remove uterine fibroids, you can lift no more than 3 kg;
• eliminate stressful situations, tk. they lead to hormonal disruptions and relapse of the disease.

You can plan a pregnancy only after consulting with your doctor. The operation performed is always stressful for the reproductive organs, the recovery of which may take quite a long time.

During the rehabilitation period, it is mandatory to take medications that normalize the structure of the uterine body and the menstrual cycle. Any unpleasant symptoms should not be ignored - it is better to once again make sure that everything is fine than to allow the development of complications.

healthladies.ru

Classification of the size of fibroids in centimeters

Myoma is a benign neoplasm that grows in the muscular layer of the uterus. The main age of patients affected by this disease is 20–60 years. The main cause of cervical fibroids is hormonal failure. When diagnosing fibroids, its size is determined. Depending on how many neoplasms were found, their type and size in weeks, treatment is prescribed.

When prescribing treatment, the doctor starts from the size of the fibroid

To accurately determine the size of fibroids, it is necessary to do an ultrasound. It is generally accepted that with a large neoplasm that exceeds 60 mm or 6 cm (12–16 obstetric weeks), surgery is necessary. Benign neoplasms are dangerous for a woman's life when there are a lot of them. Fibroids 20–60 mm or 2–6 cm (10–11 weeks) are treated with medication, diet, and physical therapy. That is, conservative treatment is carried out.

Classification

The size of a benign neoplasm is determined in centimeters, weeks or mm on ultrasound. With the growth of fibroids, an increase in the uterine cavity occurs. This process is similar to the growth of a fetus. Therefore, the size of cervical fibroids is compared with the weeks of pregnancy.

Myoma is divided into 3 types:

1. Small swelling of the cervix. It does not exceed 2 cm (20 mm) - 4 obstetric weeks.
2. The average neoplasm is 10–11 weeks, varies from 2–6 cm or 20–60 mm.
3. Large myoma of the cervix. The size exceeds 6 cm (60 mm), which equates to 12-16 obstetric weeks of pregnancy.

Large fibroids can reach the size of a 4-month pregnancy

Size and symptoms

Neoplasms at an early stage (20 mm or 2 cm) do not bother a woman. But as soon as the tumor begins to grow and reaches 10-12 weeks (50 mm or 5 cm or more), the corresponding symptoms appear.

1. Menstrual bleeding accompanied by pain. Painkillers do not help relieve pain.
2. If the fibroid has reached 12 weeks (6 cm or 60 mm), then the cervix increases and bloating occurs.
3. With a diagnosis of pedunculated fibroids with torsion, sharp pains begin in the abdomen. This means that in the body of the neoplasm, the blood flow is disturbed, and entails peritonitis. You need to do an ultrasound.
4. Large fibroids (10–20 weeks) compress nearby organs, leading to improper defecation and urination. There is pain in the lower back and heart muscle. The legs begin to go numb when the nerve endings near the rectum are crushed.
5. Large fibroids (more than 12 weeks), grow on the outer part, form adhesions with nearby organs and tissue layers.

The symptoms of fibroids vary depending on its location and size.

Size diagnostics

The woman is examined bimanually to determine the size of the benign neoplasm. Further, appropriate tests are given and ultrasound is performed. Ultrasound with accuracy allows you to diagnose the size of the neoplasm.

To properly prescribe treatment, you should constantly do an ultrasound of the uterus. It will help determine how many benign formations, size and growth rate.

The faster the neoplasm grows in size, the greater the likelihood of its transition to oncology. In such situations, an ultrasound is performed to determine how many neoplasms are present and exclude cancer.

Regular ultrasound is a must. Since small fibroids (up to 12 weeks) can be localized in dangerous parts. MRI is also used to obtain detailed information about the type, structure and size of a benign neoplasm.

Ultrasound is a common way to diagnose fibroids

Pregnancy

The tumor is small (less than 1 cm), does not particularly affect the growth of the fetus in the womb. But the obligatory observation of the doctor for the condition should be.

Large nodules (12 weeks or more), which in the submucosal part of the uterus, prevent the normal development of the fetus, forming a variety of pathologies.

Neoplasm more than 12 weeks and located at the back wall, increases the likelihood of preterm labor. In some situations, oxygen starvation of the child occurs. Doctors are sure that with a small neoplasm, maintaining a pregnancy and giving birth to a baby will not be a problem.

Treatment

It is carried out using a variety of techniques. It all depends on the size in obstetric weeks and type:

hormone therapy

Assign if the size of the tumor has reached 12 weeks. Drug treatment is aimed at stopping growth and reducing size. Such treatment is carried out for women who are going to become mothers after surgery to exclude the appearance of new tumors.

Medicines reduce the size and prevent the recurrence of fibroids

Symptomatic treatment

1. antispasmodics and painkillers (tumors up to 3 weeks cause severe pain during menstruation);
2. hemostatic drugs are used for neoplasms of small sizes, if prolonged and heavy menstruation and at the time of ovulation, spotting occurs.

Surgery (fibroids more than 13 weeks old)

1. laser resection of the tumor;
2. myomectomy;
3. vascular embolization;
4. complete resection of the uterus.

Alternative treatment

1. hirudotherapy;
2. folk remedies;
3. physiotherapy procedures;
4. gymnastic exercises.

Treatment with leeches is effective for myoma

Indicators for surgical intervention

1. A benign neoplasm exceeds 12 weeks.
2. The woman is planning a pregnancy.
3. If there is a risk of developing a malignant tumor.
4. A benign formation causes severe pain. The use of painkillers does not work.
5. Myoma presses on the rectum, urinary system and nerve endings.
6. Regular severe bleeding is observed, due to which anemia develops.
7. If the tumor is located on a long thin stalk, then there is a torsion factor and the onset of peritonitis.
8. If normal urination does not occur, then there is stagnation of urine.
9. If a large myomatous node presses on the rectum, then the woman has a rare stool, which leads to intoxication of the whole organism. With intoxication, bloating occurs and severe pain is felt when pressed with fingers.

If, when contacting a doctor, a benign formation of the cervix was diagnosed, then:

1. On examination, it is determined how many neoplasms and their size.
2. Ultrasound must be done on a certain day, because cervical neoplasms change under the influence of estrogen levels.
3. A qualified doctor will never claim that the formation is of an average size and talk about the rules for determining them.
4. The gynecologist determines the stage of the disease using the ratio of size to gestational age and ultrasound results.
5. Dimensions are determined in weeks, cm, mm.
6. Full diagnosis and control of the doctor will help determine the development of cervical fibroids.

vrachlady.ru

2018 Women's Health Blog.

According to medical statistics, uterine fibroids are one of the most common gynecological pathologies among women over 35. It is at the age of 35-45 that the tumor is predominantly detected, it grows slowly and gradually leads to the appearance of severe clinical symptoms. Without treatment, fibroids can significantly disrupt the usual course of life, cause infertility and other serious health problems.

When evaluating the prognosis of the disease, special attention is paid to the size of the uterine tumor. Small nodes are easily amenable to hormonal therapy and usually do not interfere with the bearing of a child, while large formations put an end to the reproductive function of a woman. The size of uterine fibroids also matters for the operation. The choice of a method for removing a tumor will directly depend on its diameter, location, and the presence of concomitant pathology of the pelvic organs. Knowing what sizes are considered acceptable for a particular method of therapy, you can choose the best treatment tactics and achieve good results in the shortest possible time.

Classification of myoma nodes depending on their size

In gynecological practice, it is customary to divide all uterine tumors into three groups. The size of the node (in millimeters) corresponds to the size of the uterus (in weeks of pregnancy), the data are shown in the table:

For simplicity, fibroids can also be measured in centimeters. The choice of the unit of measure does not play a significant role in the diagnosis and determination of treatment tactics. Assessment of the size of the node is carried out using ultrasound.

Remote myoma nodes of various sizes (from 10 to 90 mm).

The following types of fibroids deserve special attention:

• A tumor of clinically insignificant size - up to 20 mm. Such an education does not bother, does not prevent the conception of a child and does not require treatment;
• A giant tumor - approximately 100 mm in diameter. It is distinguished by severe clinical symptoms and the development of complications. Such a neoplasm should always be removed and as soon as possible.

On a note

The shape and weight of fibroids are of purely scientific interest. The mass of the tumor is determined after it is removed and weighed in the laboratory. In the medical literature, a fibroid weighing 63 kg is described, and to date, no one has managed to break this record.

Giant uterine fibroids during surgery.

Tumor size and symptom severity: is there a link?

The size of the myomatous node affects not only the tactics of treatment, but also the condition of the woman. The severity of the symptoms of the disease depends on the size of the tumor:

• A clinically insignificant fibroid up to 2 cm in size fully justifies its name. Such an education does not hurt, does not disrupt the menstrual cycle, does not lead to the development of bleeding, does not affect the work of neighboring organs. The only exceptions are submucosal nodes, which can increase the volume of menstrual flow even at small sizes. With the cervical location of the myomatous node, there is also a rapid onset of clinical symptoms;
• Formations of small sizes (up to 2.5 cm), localized subperitoneally, do not manifest themselves in any way. Symptoms of the disease occur when the node is located in the muscular or submucosal layer of the uterus. Such formations can lead to the appearance of moderate pulling pains in the lower abdomen and increase the duration and volume of menstrual bleeding;
• A medium-sized fibroid will never go unnoticed. Reaching a value of 2.5-6 mm, the node significantly disrupts the menstrual cycle. Menstruation becomes abundant, prolonged, painful, intermenstrual discharge occurs. Pain is noted already in the lower abdomen and in the lumbar region;
• A tumor larger than 6 cm is always an indication for surgery. Such a knot leads to the appearance of constant or periodic pain in the lower abdomen, perineum and lower back. Large formations provoke the development of uterine bleeding. With a subserous location of the node, compression of the pelvic organs with a violation of their function is possible.

The main symptoms of uterine fibroids are heavy menstruation and pain in the lower abdomen.

Understanding when it's time to remove fibroids is quite simple. If the tumor disrupts the usual rhythm of life, creates significant discomfort and interferes with the functioning of the reproductive system, it must be disposed of. And if there are no disagreements with large-sized formations, then many questions arise regarding small fibroids. Let's answer the most popular ones:

• Is it necessary to remove a small node if it does not bother? Observation of small fibroids is allowed only if the formation does not change the menstrual cycle and does not lead to the development of bleeding;
• Is it possible to remove medium-sized fibroids (3, 4, 5 cm)? Yes, it is better to get rid of such a tumor: with the growth of the node, the likelihood of uterine bleeding and other complications increases;
• Is it possible to do without surgery? Yes, fibroids up to 30 mm respond well to hormone therapy;
• In what cases is the uterine myoma urgently excised? With the development of complications: tumor necrosis, torsion of the leg of the node, infection, heavy uterine bleeding;
• Can a tumor grow the size of a uterus? Yes, and even more. Giant nodes reach the size of a full-term baby, significantly deform the uterus and several times exceed its diameter;
• What size nodule is not considered uterine fibroids? There is no such concept in gynecology. If the formation is detected on ultrasound, the diagnosis of uterine fibroids will be in the medical history, and it does not matter what size the tumor is - 6 mm or 6 cm;
• What size should be the myomatous node for the operation? Surgical treatment is carried out with a node size of 30 mm or more, but options are possible for different tumor localizations.

Depending on the location of the fibroid and the presence of accompanying symptoms, various treatment options are possible.

It's important to know

The size of the myoma node varies depending on the phase of the cycle. A benign tumor of the myometrium slightly increases in size after ovulation, closer to the next menstruation. After menstruation, its size decreases again.

Myoma growth rate as an indication for surgery

Fibroids tend to grow slowly but steadily throughout the reproductive period. Once having arisen, the tumor will increase in size, and no medicinal herbs and other dubious methods can slow down its development. The following factors influence the growth of fibroids:

• Pregnancy. It is noticed that some nodes increase in size during this period, while others decrease or stabilize. The maximum tumor growth is noted in the first half of gestation;
• lactation period. When feeding a baby with breast milk, the tumor usually does not grow, treatment during this period is not required;
• Termination of pregnancy (spontaneous miscarriage or induced abortion) provokes active tumor growth and leads the woman to the operating table;
• Entry into menopause inhibits the development of fibroids. Normally, in menopause, the node should regress. If this does not happen, surgical treatment cannot be avoided;
• The use of hormonal drugs affects the course of the disease in different ways. Some drugs inhibit the growth of the node, others provoke tissue proliferation. It has been observed that estrogen and progesterone stimulate the development of fibroids, while gonadotropic hormone agonists lead to tumor regression.

The growth of fibroids depends on the hormonal background of the woman, and therefore taking hormonal drugs in the presence of a tumor is possible only under the supervision of a doctor.

It's important to know

The rapid growth of the node (4 weeks per year or more) is considered one of the likely signs of a malignant tumor of the uterus - sarcoma. If malignancy is suspected, fibroids are always removed with subsequent histological examination of the material.

It is not always possible to find out the exact reasons for the growth of the node. Assessment of the size of the tumor in dynamics is carried out using ultrasound. The doctor takes measurements, comparing them with the results of a previous study. A rapidly growing tumor is always an alarming symptom, and in this situation there is no need to postpone surgical treatment.

Is surgery always needed?

Gynecologists warn: in the reproductive age, fibroids will not disappear by themselves. The inevitable growth of the tumor leads to the fact that a large formation arises from a small node, threatening the development of serious complications:

• Acyclic uterine bleeding. The larger the fibroids, the more often the endometrium bleeds, which eventually leads to the development of anemia and can threaten the life of a woman;
• Compression of the pelvic organs: fallopian tubes, bladder, ureters, rectum. A tumor growing outward interferes with the functioning of neighboring structures and leads to the appearance of concomitant symptoms: impaired urination and constipation;
• Infertility. With a large size of the tumor, the conception and bearing of a child is most often impossible.

Subserous located nodes affect the functioning of neighboring organs.

If the doctor prescribes an operation to remove fibroids, there is no need to refuse treatment. The tumor will not resolve itself. Auto-training, hirudotherapy, applying lotions on the stomach, taking herbs, gymnastics or massage will not help. All these methods are good for maintaining the general tone of the body, but are useless in relation to the myomatous node of the uterus. The only guaranteed method of solving the problem is surgical treatment.

There is no maximum size for uterine fibroids. The tumor can grow indefinitely. Reaching the size of a 12-week pregnancy, fibroids extend beyond the small pelvis. The woman notes an increase in the size of the abdomen, the appearance of asymmetry on one side. Without treatment, the tumor grows up to 20 weeks or more, fills the abdominal cavity, pushing the organs of the digestive tract. With such a size of the node, an urgent operation is indicated, and often with giant tumors, removal is possible only together with the uterus.

The uterus and appendages are normal; multiple formation with one dominant submucosal node; dominant subserous node; multiple myoma removed along with the uterus.

Important aspects of the surgical treatment of fibroids

Surgery for tumors of the uterus is indicated in the following situations:

• The size of the neoplasm is more than 3 cm;
• Rapid node growth (from 4 weeks per year);
• Severe clinical symptoms: uterine bleeding, pelvic pain, not amenable to conservative therapy;
• The development of complications such as tumor necrosis or compression of the pelvic organs;
• Recurrence of uterine fibroids;
• Infertility and miscarriage against the background of myomatous nodes;
• Suspicion of sarcoma or confirmed malignancy.

On a note

Formations up to 30 mm in size are treated conservatively. In the treatment of uterine fibroids, hormonal agents are used that reduce the diameter of the tumor and eliminate the unpleasant symptoms of the disease. The effect of the use of hormones is temporary. After discontinuation of the drug, the tumor begins to grow again and gradually returns to its previous size.

The choice of method of surgical treatment depends not so much on the size of the fibroids, but on its location. The value of the node is taken into account in the second turn. In inoperable tumors, removal of the uterus is indicated.

Depending on the location of the node, different methods of surgical treatment are used.

Embolization of the uterine arteries

One of the modern methods of treatment, involving the introduction of emboli through the femoral artery. Small balls clog the lumen of the vessels that feed the myoma and lead to tumor regression. The size of the fibroids for UAE is not significant. The procedure is carried out for almost any size of the tumor and is especially effective for multiple formations. This method is considered one of the safest and is recommended for women planning a pregnancy.

UAE is usually not done for giant tumors when the uterus is 20 weeks or more in size. The procedure is not very effective for subserous formations on a thin stalk.

According to reviews, the UAE procedure is well tolerated. In the postoperative period, the appearance of cramping pains in the lower abdomen against the background of tumor regression is noted, but unpleasant symptoms are stopped by medications. After UAE, there is no scar on the uterus, there are no obstacles for conceiving and bearing a child. The procedure is considered very effective: the probability of recurrence of the disease is no more than 2%.

UAE allows to achieve reduction of myomatous nodes in the least traumatic way.

Hysteroresectoscopy

Removal of a tumor of the uterus through the vagina using an endoscopic instrument is performed in such situations:

• Submucosal pedunculated fibroids protruding entirely into the uterine cavity;
• Submucous-interstitial tumor, most of which is located in the uterine cavity.

With deeply localized formations, hysteroresectoscopy is carried out with great care, since there is a high risk of bleeding and subsequent adhesions in the uterine cavity.

The size of the myomatous node plays a role in choosing the method of hysteroresectoscopy:

• Submucosal-interstitial formations up to 50 mm in diameter are excised using an electrosurgical instrument;
• Deeply located nodes with sizes from 50 mm cannot be removed through the vagina;
• Submucosal nodules on a stalk measuring 50-100 mm are excised only mechanically (conchotome);
• For tumors larger than 100 mm, transcervical myomectomy is not performed.

The critical size of fibroids for hysteroresectoscopy is 10 cm. It is difficult to extract a larger tumor through the vagina, therefore, abdominal surgery is indicated.

Removal of submucosal pedunculated fibroids by hysteroresectoscopy.

Conservative myomectomy

Organ-preserving operations, in which only the tumor is removed, and the uterus remains, are performed by open and laparoscopic access. The possibility of myomectomy depends not only on the size of the nodes, but also on their number and location.

Surgical options:

• Laparoscopic surgery - removal of fibroids through small punctures in the abdominal wall;
• Abdominal operation (laparotomy) - excision of the node is possible only after an incision in the skin and underlying tissues.

Indications for laparoscopy:

• The size of the uterus is not more than 12 weeks;
• The number of nodes is no more than four;
• Location of fibroids in the body or bottom of the uterus;
• Subserous or interstitial localization of the node;
• Myomectomy during pregnancy.

When choosing a method of surgical treatment, gynecologists are guided not by the size of the node itself in millimeters, but by the size of the altered uterus. It is difficult to draw a parallel between the diameter of the tumor and the reproductive organ. The uterus can be enlarged both due to one node, and with multiple formations. As a rule, laparoscopy is performed when the size of the dominant node is up to 10 cm.

On a note

Modern endoscopic technologies make it possible to perform the operation with the size of the uterus up to 15 weeks.

Indications for laparotomy:

• The size of the uterus from 12-15 weeks;
• The number of nodes is more than four;
• High risk of bleeding during surgery;
• Low location of fibroids: in the cervix or isthmus.

When large or multiple nodes are located along the posterior wall of the uterus, priority is also given to abdominal surgery.

It is important to understand

The choice of treatment method is always determined individually, taking into account all the features of the course of the disease.

Removal of uterine fibroids by open access.

Hysterectomy

Removal of the uterus along with myoia is carried out with the ineffectiveness of other methods of treatment and is a last resort. The size of the tumor is not critical here. The need for a hysterectomy may arise in the following conditions:

• Heavy bleeding, not amenable to conservative therapy;
• Multiple myomatous nodes, when there are contraindications to UAE;
• Detection of uterine sarcoma;
• The presence of concomitant pathology of the genital organ;
• The development of severe complications of the disease.

Indications for hysterectomy may arise directly during the operation. Each patient must be warned that if complications develop, the doctor can remove the fibroids along with the uterus.

The photo shows the removed uterus along with interstitial and interstitial-subserous nodes. In one of the nodes, there are signs of malnutrition, which became the reason for surgical treatment.

Remote uterus with multiple myomatous nodes.

Prices for the removal of uterine fibroids differ depending on the method chosen and the location of the clinic. In Moscow, the procedure for embolization of the uterine arteries will cost 50-150 thousand rubles, myomectomy - 40-90 thousand rubles, hysterectomy - about 50 thousand rubles. Under the compulsory medical insurance policy in state gynecological departments, the operation is performed free of charge for the patient.

Removal of the tumor when planning pregnancy

When it comes to planning a child, the tactics of managing a patient change somewhat. In the presence of submucosal fibroids, its removal is indicated, regardless of the size of the node. Such a knot will prevent the bearing of the fetus and, with a high degree of probability, will provoke a miscarriage.

The most favorable prognosis is given by subserous fibroids. Even reaching a significant size, it does not interfere with the conception and bearing of the fetus. Numerous reviews show that pregnancy against the background of a subperitoneal tumor usually passes without complications and ends with the birth of a child on time.

Pregnancy with subserous myomatous node.

Interstitial uterine fibroids behave differently. Knots of small size (no more than 2.5 cm) are not dangerous for a woman, but observation does not hurt. Large formations can lead to spontaneous miscarriage, cause bleeding during childbirth and anomalies in labor.

If a woman plans IVF, the doctor may insist on excision of small fibroids, although such nodes are usually treated with hormonal drugs. With in vitro fertilization, they try to eliminate any risks for the woman and the fetus and remove all factors that can cause failure.

A planned operation for fibroids is done 6-18 months before pregnancy. Terms depend on the chosen method of treatment:

• After hysteroresectoscopy (removal of the tumor through the vagina without incision of the uterus), the conception of a child is possible after 6 months;
• Laparoscopic myomectomy requires recovery within 6-12 months. A full-fledged scar is formed no earlier than six months later;
• After abdominal surgery, a long recovery is required. Planning a pregnancy is recommended after 1-2 years;
• Embolization of the uterine arteries leads to a gradual regression of fibroids. Conception of a child is possible in 6-12 months.

Treatment of uterine fibroids with UAE

Interesting video: laparoscopic surgery to remove the myomatous node

in diameter. In this case, an operation was performed, which consists in the complete amputation of the uterus (hysterectomy).

Today, doctors have a huge number of different methods of treating fibromyomas in their arsenal: from therapy with medications and minimally invasive methods of removing tumors, to safe and gentle surgical methods designed to preserve the reproductive function and health of women.

What

Myoma is a benign neoplasm in the uterus, which is formed primarily as a result of improper functioning of the hormonal system of a woman. Uterine fibroids may appear one or several at once. Most often, it has a regular rounded or oval shape, and sometimes a knot develops on the leg.

The size of fibroids can be both very small (only a few millimeters) and very impressive (up to 20 cm in diameter). It is customary to use the circumference of the uterus when determining its parameters, which, with an increase in fibroids, grows as during pregnancy. Thus, in the card, the doctor will write down the “age of the mime” in the number of weeks corresponding to the increase in the uterus during pregnancy.

"Age" of fibroids and symptoms

Most often, a small fibroid is found at a routine examination by a gynecologist or on an ultrasound examination of the pelvic organs. In this case, she does not bring any discomfort to the woman, because her size will be no more than three cm (8 weeks). Small neoplasms do not manifest themselves in any way and, most often, do not require urgent surgery.

A medium-sized fibroid, equal to about five cm (11-12 weeks), a woman can even find herself. Suggest some symptoms of the disease:

• an increase in the abdomen with a negative pregnancy test;
• pain in the lower abdomen and sacrum;
• menstrual irregularities (failures, lack of menstruation, bleeding lasting more than six days);
• acyclic spotting or breakthrough bleeding;
• infertility;
• miscarriages;
• pain when urinating;
• constipation.

If there are still no symptoms of the disease, you can try to treat the middle myoma node in a conservative way. This is especially true in the period before the onset of menopause, when there are still chances for an independent regression of the disease.

A large fibroid, larger than 8 cm (weeks of pregnancy) is simply impossible not to notice. Such a fibroid always brings discomfort to the patient, and an increase in the abdomen due to its growth is already noticeable even with the naked eye.

Large fibroids, larger than 12 weeks, require mandatory urgent minimally invasive or full surgical intervention.

When do you need surgery for uterine fibroids 12 weeks (8 cm)

The main treatment for a large myomatous node or multiple neoplasms is a surgical operation - myomectomy. Myomectomy is performed in several ways.

• Laparotomy is a full abdominal surgical operation, which is performed through a fairly long incision on the lower part of the abdominal wall. Indications for laparotomy will be: large nodes, severe deformation of the walls of the uterus, multiple formations. During laparotomy, doctors, most often, manage to avoid bleeding, completely remove all diseased tissue areas and make the correct suture on the uterus, which will not interfere with the normal development of pregnancy and natural childbirth.
• Laparoscopy is a minimally invasive surgical procedure in which nodes are removed through several small incisions in the abdominal wall. Laparoscopy is performed if the formation is not more than 6 cm in diameter and only on nodes accessible to the laparoscope. Carrying out this type of operation in hard-to-reach areas is dangerous, since the uterus is densely supplied with blood vessels, and any damage to them can lead to extensive bleeding.
• Hysteroscopy is a method of removing fibroids without incisions. A thin tube is inserted through the vagina and cervical canal into its cavity, and under the control of a miniature video camera, neoplasms are removed.
• Hysterectomy is the complete or partial removal of the uterus. This is an extreme measure that doctors take in the most advanced cases of the disease, with severe tissue damage that cannot be restored, with severe concomitant diseases.

myomectomy

There are a number of absolutely clear indications when surgical treatment is necessary:

• when the size of the fibroids is more than 8 cm (12 weeks of pregnancy), surgery is the only way out;
• too rapid growth of fibroids (by 2-3 cm in 12 months);
• the appearance of multiple nodes;
• uterine bleeding (spotting or breakthrough);
• anemia;
• pain in the region of the lower back and lower back;
• uterine fibroids on the leg;
• "Birth" of fibroids (its germination outside the cervical canal).
• death of neoplasm tissues;
• infertility;
• miscarriage;
• violation of the functions of organs associated with the growth of the myomatous node (constipation, frequent or painful urination, impaired blood supply to neighboring organs);
• the danger of degeneration of fibromyoma into a cancerous tumor (sarcoma).

The operation for these manifestations is performed regardless of the age of the patient.

Treatment of fibroids measuring 5 centimeters

For fibroids measuring 4.5.6 cm (age 8-12 weeks), there is an alternative treatment.

• Laser treatment (FUS-ablation) - elimination or reduction of fibroids without incisions and damage to healthy tissues. The procedure consists in “burning out” the tumor with a laser beam. The operation is carried out under the control of a magnetic resonance imaging device, which allows you to perform manipulations as accurately as possible and completely eliminate injury to the pelvic organs, and preserve reproductive function.
• The method of embolization of the uterine arteries is to block the blood flow to the fibromyoma. A small incision is made in the region of the right femoral artery, through which a catheter is inserted into the artery up to the very vessels of the uterus. With the help of a specially designed drug, the vessels are blocked, after which the blood supply to the neoplasm stops and its gradual death occurs. The uterine fibroids are then excreted from the body during menstrual bleeding.

How to treat fibroids 9 weeks

Most fibroids up to 12 weeks can be treated with medication.

• Analogues of gonadotropin-releasing hormone provoke the drug-induced onset of menopause by reducing the production of estrogen. Treatment can greatly reduce education, however, it is more appropriate to use it in women after 45 years, when it is not very long before the real menopause.
• Combined oral contraceptives are used in young women when fibromyomas up to two centimeters in diameter are detected. It is good to carry out such treatment in the period of preparation for pregnancy.
• The intrauterine hormonal coil helps with small and medium formations in the subserous (outer) layer of the uterus.
• Antiprogestin is the newest drug (synthetic steroid) to reduce knots.

The doctor should decide on the method of treating fibroids. If you doubt your doctor's competence, consult with several specialists and listen carefully to why each of them recommends a particular treatment. Remember that the gynecologist always evaluates the situation as a whole: collects an anamnesis, studies the medical history and test results. Therefore, if several doctors recommend surgery, do not delay it. Timely treatment will protect you from complications.

At what size of uterine fibroids do surgery?

One of the unpleasant pathological conditions of the female body is cervical fibroids, the progression of which can lead to the development of a malignant neoplasm. To date, the treatment of this disease is carried out in various ways, but the most effective of them is surgical intervention.

Uterine fibroids: features of the disease and methods of treatment

Fibrous formations occupy a dominant place among gynecological diseases.

Throughout her life, almost every woman is faced with pathologies of a gynecological nature, one of which is considered to be uterine fibroids. This disease is a neoplasm of a benign nature, the shape of which is a ball of various sizes, and the muscular layer of the uterus becomes its place of localization. Reviews about the effectiveness of a particular treatment method are quite diverse and are most often determined by the timeliness of the treatment started and the experience of the specialist.

Features of the development of pathology

Uterine fibroids is considered a benign tumor, the cause of which is hormonal changes in the female body. In this disease, the size of the tumor can be different and sometimes reach quite large sizes. The photo shows that sometimes the size of uterine fibroids can exceed cm.

In this case, the only sure way to get rid of such a pathology is surgical intervention to remove fibroids.

Most often, at the very beginning of the development of pathology, the formation of small fibroid nodes is observed. Medical practice shows that the development of single formations is quite rare and most often a woman is diagnosed with multiple fibroids. The development of the tumor occurs from the smooth muscle layers of the cells of the uterus and the risk group includes mainly women of reproductive age. The risk of developing the disease increases with the active production of such a female hormone as estrogen.

Uterine fibroids are not such a terrible diagnosis and many women feel calm throughout their lives. However, in the event that a benign neoplasm begins to cause discomfort and pain to a woman, and is also the cause of infertility, then it is necessary to carry out its intensive treatment.

Causes of pathology

Provoke the development of uterine fibroids in the female body can be various changes that cause increased division of uterine cells. Most often, the diagnosis is "multiple myoma", that is, in the female body there is an enhanced process of formation of myoma nodes as a result of the division of several cells at once.

The following reasons for the formation of uterine fibroids can be distinguished:

• performing an abortion;
• a genetic factor, that is, a woman has a hereditary predisposition to the development of this pathology;
• being overweight or obese;
• the absence of a permanent sexual partner, which causes an irregular sex life;
• problems with metabolic processes in the female body;
• diseases of the cardiovascular system;
• hormonal imbalance
• various types of gynecological diseases.

Symptoms of the disease

This pathology is characterized by the absence of any signs indicating the progression of uterine fibroids in a woman's body.

In the event that the myoma nodes reach a significant size, or the muscular layer of the uterus becomes the place of their localization, the following signs of the disease may appear:

• menstruation becomes prolonged and becomes painful;
• in the lower back and pelvis periodically there are painful sensations of a aching nature;
• frequent urge to urinate;
• the stomach becomes impressive in size;
• sexual intercourse is accompanied by the occurrence of painful sensations;
• in the discharge during menstruation there are blood clots.

Only a specialist is able to make an accurate diagnosis, since such signs can also appear with the progression of other gynecological diseases in a woman's body.

Treatment of the pathology will depend on the size of the benign tumor, as well as on the degree of damage to the uterine cavity.

Fibroids classification

To date, the following types of uterine fibroids are distinguished, which are determined by the place of its localization:

1. Subserous myoma - this type of tumor begins its development on the outside of the poppy, gradually directing its growth into the lower pelvic cavity. Most often, such a fibroid does not violate the menstrual cycle, and only in some cases it is possible to develop such side effects as increased pressure of uterine fibroids on nearby tissues.
2. Intramural myoma is one of the most common pathologies, the location of which is the middle muscular layer of the uterus. The progression in the female body of this type of tumor leads to the fact that there is a significant increase in the size of the uterus. In addition, the menstrual cycle is disturbed, the woman complains of severe pain and a feeling of pressure in the pelvic region.
3. Submucous myoma is quite rare and the main place of its development is the deep layers of the uterine mucosa. In addition, there is the formation of submucosal nodes on the leg, the removal of which requires surgical intervention.

Depending on the size of the nodes, fibroids are divided into:

• small uterine fibroids, when the size of the nodes does not exceed 20 mm in diameter;
• medium fibromyoma, the dimensions of which reach 40-60 mm;
• large myoma, with the development of which the nodes reach more than 60 mm.

Features of the treatment of pathology

• manifestation of symptoms of the disease;
• the presence of concomitant pathologies in the female body;
• the size of the neoplasm, which can be several weeks of pregnancy.

In the event that the fibroid reaches a small size, then most often the treatment of the disease involves drug therapy or a periodic visit to a specialist in order to control the growth of the tumor. Multiple myoma significantly complicates the treatment, since in such a situation it is necessary to observe several cells at once, which have transformed into myoma nodes.

Medical therapy

Such treatment is not able to completely rid women of the pathology, but only allows to slow down the further growth of the neoplasm. Many women try to get rid of fibroids once and for all using this method of treatment, so their negative feedback is understandable if the desired result is not achieved. There are cases when an independent disappearance of fibroids is observed, but most often this is possible after the age of 50 with a decrease in the amount of estrogen formation.

Drug treatment involves taking the following medications:

1. Hemostatic agents are able to stop the flow of blood to the resulting tumor, since blood clots form in the vessels. As a result of the cessation of blood supply to the myoma node, its gradual withering and complete death are observed.

Hemostatic effect has such drugs as:

2. Hormonal drugs, the main component of which is progesterone. To cure uterine fibroids in this case is obtained with the help of artificial preparations, however, the reviews about this method of treatment are rather contradictory.

Some experts believe that taking additional doses of hormones can cause the growth of a benign formation and lead to the development of a number of complications. Reviews of other specialists about the use of such therapy are completely opposite and speak of the high efficiency of the use of hormonal drugs.

Treatment of uterine fibroids is most often carried out with the help of drugs such as:

Reviews about the use of this group of hormonal agents are mostly positive, since their effect can slow down the growth of fibroids.

3. Agonists - medicinal substances, the action of which is aimed at suppressing the production of such female hormones as estrogens and androgens. The prescribed surgical intervention requires such treatment, since the effect of these drugs reduces the supply of nutrients to the myoma nodes. Reviews on the use of such drugs both for the treatment of fibroids and for preparation for surgery are predominantly positive.

Surgical intervention

Such treatment for the removal of fibroids is used in cases where the size of the uterus reaches a fairly large size, and the woman begins to be disturbed by various signs of the disease. The choice of one or the type of operation is determined by the location of the nodes and the size of their sizes. Most often, the indications for the operation are the size of the uterus with nodes exceeding mm.

Indications for the operation

The decision to carry out the operation by specialists is made when there are certain indications for this:

• uterine fibroids reach large sizes that exceed weeks of pregnancy;
• active growth of myoma nodes leads to disruption of the normal functioning of the bladder and intestines;
• persistently expressed pain syndrome, from which it is not possible to get rid of with the help of medications;
• parallel progression in the body of a woman of uterine fibroids and other gynecological pathologies;
• heavy menstruation, which can provoke the development of anemia;
• intensive growth of fibroids, when there is an increase in the tumor for several weeks of pregnancy.
• the development of a persistent pain syndrome as a result of the necrosis of the node;
• twisting of the long night of the knot, which leads to painful sensations.

Types of surgical interventions

Treatment of uterine fibroids with the help of surgery is determined by the size of the uterus and myoma node.

Hysterectomy

Such treatment, which involves the removal of the uterus, is carried out when there is no possibility to perform another type of operation. It is important to know what are the indications for this type of surgery to remove fibroids:

• large fibroids that exceed weeks of pregnancy;
• progression in the female body of such a concomitant disease as endometriosis;
• detection of a large number of nodes in the uterine cavity;
• the presence of suspicions of the formation of malignant neoplasms in the uterine cavity;

Hysterectomy, which involves the removal of the uterus, is performed for all women who are in a state of menopause and have a predisposition to the development of malignant neoplasms.

Myomectomy for fibromatosis

Such treatment involves the removal of only fibroids, while the uterus remains intact. Most often, such an operation is indicated in the following cases:

• the presence in young women of small nodes in the uterine cavity before weeks of pregnancy, the removal of which will not cause injury to her;
• development of subserous nodes on long legs, located outside the thickness of the uterus;
• formation and intensive growth in the uterine cavity of multiple subserous nodes.

Laparotomy

Such a surgical intervention to remove fibroids involves carrying out all manipulations through a specially made incision on the abdominal wall.

Laparotomy in medical practice is extremely rare and is used in the presence of large fibroid nodes in the uterine cavity in large numbers, the intensive growth of which is accompanied by deformation of the penis. In addition, such an operation is performed if the size of a benign tumor exceeds weeks of pregnancy, which is accompanied by their increased growth.

The recovery period after laparotomy lasts for two weeks, but only after a month is it allowed to engage in physical activity.

Laparoscopy

Laparoscopy of uterine fibroids is a minimally invasive type of surgery to remove fibroids, when all the necessary manipulations are performed through the largest punctures in the abdominal cavity. It is possible to cure fibroids using laparoscopy without the formation of scars, and it is carried out without taking into account the nature of the node.

Laparoscopy of uterine fibroids is performed using a special device - a laparoscope, which is inserted into the uterine cavity through small incisions approximately 1 mm in size.

Laparoscopy is done in the following cases:

The recovery period after such an operation lasts for several days, and a woman can start working within a few weeks after the operation.

Reviews about the use of a particular method of treatment are negative and positive. Negative reviews about the treatment done are most often observed in women who turned to a specialist for help late, which led to the development of a number of complications.

Indications for removal of uterine fibroids by size in weeks or centimeters - how the operation is performed

Benign neoplasms are removed by conservative methods, and their treatment proceeds under medical supervision. If the tumor grows, puts pressure on neighboring organs, then it must be removed immediately. Specialists clinically determine at what size of uterine fibroids surgery is performed in order to avoid complications.

Dimensions for the operation of uterine fibroids in millimeters

The absolute indication for surgical intervention is the rapid growth of a benign neoplasm. In the advanced stage of the disease, there is a pain syndrome, and it is important not to ignore such complaints of the patient. The operation is not done for all women with a characteristic tumor, the doctor individually determines the acceptable dimensions for the operation of uterine fibroids in millimeters. The parameters are as follows:

1. Small fibroids in size can be either 6 mm or 14 mm or more, corresponding to a pregnancy period of 4-5 weeks. The limit of this stage of the disease is the tumor parameter of 20 mm in diameter.
2. The average mime is mm in size, which corresponds to a gestational age of 5-11 obstetric weeks.
3. Large fibroids - from 60 mm in diameter, which corresponds to the beginning of the second trimester.

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Fibroids size in weeks and centimeters

It is possible to determine the parameters of a benign tumor clinically by performing an ultrasound scan. The size of the neoplasm is set by weeks and centimeters, and doctors in this matter adhere to the standard classification. If the focus of pathology in the female body reaches a large size, an operation is necessary. Approximate sizes of fibroids in weeks and centimeters for reliable diagnosis are presented below:

• 5 obstetric weeks - up to 5 cm;
• 7-week obstetric period - from 6 cm;
• 10-13 week obstetric period - 10 cm;
• 18-19 week obstetric period - cm;
• 24-25 - week obstetric period - cm;
• 30-32 obstetric week -cm;
• 40-41 - week obstetric period - see.

How are myomas operated on?

If there is an active growth of myoma nodes, a diagnostic procedure is necessary - ultrasound. If there is a small fibroid, the doctor suggests a minimally invasive type of surgery with minimal health complications. A large neoplasm is subject to immediate excision, so doctors urgently operate on uterine myoma. Before doing this, the patient is recommended to undergo a complete examination, to determine the features of the clinical picture. If the focus of the pathology grows, doctors operate, while choosing one of the following surgical interventions:

Indications for surgery for myoma

In practice, cases are different, but large neoplasms are subject to mandatory excision. Indications for surgery for uterine myoma are voiced by the doctor. Leaves small cysts under observation, the patient is registered with a gynecologist. The answer to the main question, whether it is necessary to remove uterine fibroids, depends on the size of the neoplasm and growth characteristics. If uterine fibroids develop, the dimensions for the operation determine the clinical picture:

• severe pain syndrome;
• heavy menstruation of various etiologies;
• uterine bleeding;
• necrosis of the myoma node;
• subserous and submucous myoma on the leg,
• twisting the long leg of the knot;
• deformation of an organ or group of neighboring organs;
• intramural myoma;
• not carrying a pregnancy, infertility;
• violation of the functions of neighboring organs, for example, intestinal obstruction;
• the appearance of symptoms and signs of degeneration into cancer.

Myoma surgery 8-9 weeks

If the tumor has acquired characteristics of the middle stage, while continuing to grow, doctors recommend surgery. The best option for fibroid surgery at 8-9 weeks is laparoscopic myomectomy, which involves removal through small punctures on the abdominal wall. Scars on the skin do not remain, however, after such a surgical intervention, a woman needs a two-week rehabilitation.

With this surgical method, it is appropriate to safely remove 3-4 pathogenic nodules with a joint diameter of not more than 1.5 cm. For hard-to-reach nodes, in complicated clinical pictures and with large formations, it is better to choose another method of treatment, which already involves making incisions, access to the focus of pathology through the vagina . An alternative is hysteroscopy, which is more considered a diagnostic procedure.

Fibroids surgery 10 weeks

If an average fibromyoma develops, and a violation of the functioning of the bladder is not ruled out, doctors recommend a laparotomy. This is a serious operation, appropriate for large fibroids corresponding to the obstetric period of weeks of pregnancy. Surgical manipulations are performed through an incision in the anterior wall of the peritoneum. The operation is appropriate if ultrasound shows the deformation of the uterine body against the background of pathogenic growth of a benign neoplasm. Delaying the procedure is dangerous. Fibroids surgery 10 weeks requires long-term rehabilitation.

Myoma surgery 12 weeks

If the tumor is large and growing, it is important to act immediately. If there is one node in the neck, anterior or posterior wall of the uterine body, a hysterectomy is recommended. This radical method of treatment involves the complete removal of the reproductive organ. Such an operation for fibroids at 12 weeks is performed if other methods of treatment are not suitable or are ineffective. In complicated clinical pictures, doctors do not exclude the possibility of abdominal surgery with a solid size of the pathology focus.

Indications for removal of the uterus with myoma

If it is not possible to remove the tumor, or if its size exceeds the permissible parameters for surgical manipulations, the reproductive organ will have to be completely removed. After the operation, the development of anemia and other complications in the body is not excluded. The patient needs long-term rehabilitation therapy. The main indications for removal of the uterus in fibroids are presented below:

• prolapse or prolapse of the reproductive organ;
• suspected cancer;
• late diagnosis of a characteristic neoplasm;
• prolonged bleeding;
• intensive growth of fibroids;
• progressive anemia.

Video: operation of large uterine fibroids

The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment based on the individual characteristics of a particular patient.

How small uterine fibroids are diagnosed and treated

Uterine fibroids is one of the most common pathologies of the female genital organs. Formed from a small nodule, it can grow to a large size, causing complications.

Timely relief of small fibroids will avoid complications and fully restore the functionality of the female reproductive system.

Definition

Uterine fibroids is a benign formation consisting of endometrial cells and vascular tissue, which is localized in the walls of the uterus. Vascular tissue provides nutrition to fibroids and the active growth of its cells.

In the absence of treatment and a violation of the hormonal balance, the tumor grows rapidly, increasing in size, and can form new pathological foci.

Options

For the diagnosis of fibroids, two options are used to indicate its size. When diagnosed using ultrasound, the tumor is measured in millimeters and centimeters. During a clinical examination in the office of a gynecologist, the size of the fibroids is determined by the degree of enlargement of the uterus, characteristic of the period of pregnancy.

According to these parameters, a small fibroid is a tumor of no more than 2 cm, in which the uterus increases in accordance with 5-12 weeks of pregnancy. The main sign of the small size of the tumor is a small dense myomatous node, which is the center of the future large growth.

On palpation, a hard, stable nucleus is found in the node. It persists even in the absence of blood supply to the fibroids or an unfavorable hormonal background.

With the initial development of fibroids and its small size, a peripheral growing volume can be observed along the edges of the node. But, as a rule, a pronounced increase is characteristic of tumors of medium and large size.

A small fibroid is accompanied by the appearance of some symptoms:

• increase in the volume of menstruation;
• cycle reduction;
• an increase in the intensity of pain manifestations during menstruation;
• the appearance of smearing brown discharge;
• discomfort or pain of a pulling nature in the lower abdomen.

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Therapy and prognosis

When the first signs of a small fibroid appear, it is necessary to contact a gynecologist who will conduct a detailed diagnosis and prescribe treatment. For the treatment of small fibroids, conservative therapy is most often prescribed with the use of special medications and agents, hormonal and symptomatic action.

There are several techniques that allow you to get a positive therapeutic effect in the treatment of small fibroids.

Course of antigonadotropins and synthetic agonists of gonadotropic releasing hormones

To date, this method is considered the most effective and gentle in the treatment of small fibroids. This hormonal treatment has several goals:

1. Regulation of the hormonal background, by reducing the hormonal activity of the ovaries, to a level that allows you to stop the development of fibroid cells.
2. Stopping the spread of benign foci to abnormal areas, by reducing their sensitivity to estrogens.

The method is used for tumors from 0.5 to 2 cm in diameter. This method is the use of drugs based on antigonadotropins and gonadotropic agonists of releasing hormones, which inhibit the growth of gonadotropic hormones in the pituitary gland, by acting through the hypothalamus.

In fact, the drugs used have an antihormonal effect, in which the menstruation cycle stops, and all the signs of menopause appear. Due to this action, a complete regression of fibroids is observed.

For the procedure, the drug Decapeptyl is used, which is intended for intramuscular and subcutaneous administration. The most preferred option is subcutaneous administration in the form of depot forms.

The procedure is carried out according to a certain scheme: the drug is administered from the 1st to the 5th day of the menstrual cycle at 3.75 mg, then a break is taken for 28 days and the course is repeated. Depending on the characteristics of the tumor, treatment can last from 3 to 6 months.

As a rule, after 4 months of therapy, the volume of the tumor is reduced by 70%. In addition to the therapeutic effect on benign tumors, the drug helps restore the cycle and eliminates pain during menstruation.

But in addition to the positive properties, this method has one significant drawback, with irregular use or an incorrect dosage, after treatment, the growth of fibroids is observed, only in a more active form.

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Embolization

Embolization is a technique indicated for removing fibroids by cutting off their blood supply. This technique is used for formations up to 5 cm.

The procedure is a minimally invasive surgical intervention that is performed using small punctures in the groin area. All manipulations are carried out under local anesthesia, so the patient does not feel pain at all, and the point effect of surgical needles practically does not require rehabilitation.

During the procedure, the doctor, using several needles, makes punctures in the area of ​​​​a benign formation, penetrating into the uterine artery and vessels up to 0.9 mm framing the tumor. These vessels are located on the border between healthy and pathological tissues.

Through needles no larger than 1.5 mm, a special preparation is delivered to these vessels, blocking the cavity of the artery, and thereby preventing blood from flowing to the myoma. The drug is a mass of organic matter in the form of microparticles of irregular shape, or small balls.

To obtain a positive effect in the treatment of a small tumor, as a rule, one procedure is enough. Within 7 or 10 days after surgery, the tumor cells die and the fibroids resolve. During this period, the patient does not need to be in the hospital.

This method is popular and widespread in European countries. This is due to the minimal side effects and trauma. After the treatment, there is no uterine bleeding and in 97% of cases, there is a normalization of the cycle and blood loss during menstruation.

Two weeks after treatment, there is a 74% reduction in the tumor. In 5% of patients, a few months after therapy, the central node was completely disbanded.

The disadvantage of this technique is that when the drug is injected into the vessels, not only pathological tissue, but also healthy tissue can be covered. As a result of this, there is a death of a healthy epithelium, which can provoke inflammation of the uterus, or the appearance of a new fibroid.

Progestin

When a tumor is formed no larger than 1.5 cm, it is prescribed using progestin-based drugs. Most often, it is prescribed as a contraceptive pill, which is taken once a day.

They are aimed at eliminating the problem by normalizing the function of the ovaries, which begin to actively produce progesterone, which suppresses the growth of fibroid cells. To obtain a positive result, treatment should be carried out strictly according to the scheme prescribed by the developer of the drug or compiled by the doctor.

The treatment period, on average, is 6 months, after which an additional examination will be scheduled and, if necessary, treatment can be continued. As a rule, after a full course, lasting six months, fibroids are reduced by 55%.

Levonorgestrel-containing hormonal coil Mirena

It is used to treat small tumors of the uterus, which are localized in it for a long period of time. This remedy is able to cope with fibroids that have existed for about 5 years. This type of spiral combines therapeutic and contraceptive action.

The spiral has a depressing effect on the pituitary-hypothalamic regulation, as a result of which the production of estrogen is blocked, and pathological cells die.

The spiral is a thin T-shaped frame, which contains the hormone levonorgestrel. Throughout the treatment, the spiral produces this hormone, throwing it into the blood in small quantities. This type of treatment is used only in reproductive age. In addition, the remedy cannot be installed in chronic inflammation of the endometrium.

Antiplatelet agents and anticoagulants

These drugs are prescribed to improve the circulation of blood flow, during the recovery period after treatment. As an anticoagulant, warfarin is most often prescribed, which is taken 1 time per day. To enhance the effect of the drug, it is combined with an antiplatelet agent. In this case, preference is given to Heparin.

Both drugs must be used at the same time. During the treatment period, it is not recommended to change the dosage, since a lower dose will not have the necessary therapeutic effect, and too high a volume of the drug used will lead to the development of bleeding and prolonged healing of the endometrium.

Symptomatic therapy

In addition to the main treatment, during the period of relief of a small fibroid, therapy is additionally prescribed aimed at eliminating the symptoms associated with the disease. For this, the following means are used:

• hemostatics. Designed to reduce the severity of bleeding during hormonal treatment. For this, the reception of Etamzilat, an extract of water pepper and a decoction based on a shepherd's purse is shown;
• antispasmodics. Indicated to eliminate pain caused by spasm of the muscles of the uterus. Spasmalgon is most effective in this case;
• painkillers. During the treatment of fibroids, painkillers of the non-steroidal group are prescribed, which are aimed at stopping pain and reducing the symptoms of inflammation. These drugs include Naproxen and Ibuprofen;
• antidepressants. They allow to improve the psycho-emotional state of the patient, which can be observed at the first time of treatment with hormonal agents.

Indications for surgery

In addition to conservative methods, surgical methods are also used to treat fibroids. Although, in general, small benign tumors are not operated on, there are exceptions in some situations. Surgical treatment is indicated in the presence of the following factors:

• submucosal location of the tumor;
• high probability of degeneration into cancer;
• submucosal type of fibroids with interstitial and centripetal development;
• the presence of persistent heavy bleeding;
• excessively active growth of education;
• infertility;
• necrosis of the central node.

Uterine fibroids is a benign formation that is detected in every fifth woman. The size of the fibroids may increase, which may affect the ability to have children. Usually, regular visits to the gynecologist are enough to maintain the state of health at the right level. But sometimes the size of uterine fibroids exceeds the allowable, then a surgical operation is indicated.

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What determines the size of the neoplasm

Myoma appears for the following reasons:

• Excessive physical activity;
• Constant presence in a state of stress;
• Pathology of the ovaries, because of which the work of the genital organs is disrupted;
• Problems with the endocrine system;
• The presence of chronic infectious diseases;
• genetic predisposition;
• Overweight problems, obesity. In the photo you can see the degree of obesity, which can provoke pathology.

The size of uterine fibroids can be within the normal range, then a woman needs only constant monitoring by a gynecologist. But there are provoking factors that lead to an increase in neoplasm. These include:

• Frequent abortions. Sometimes one abortion can provoke the development of a tumor, but this is extremely rare;
• Absence of pregnancy and childbirth up to 30 years. The same applies to lactation;
• The constant presence of inflammation in the reproductive system of the body;
• The constant use of contraceptives that affect the hormonal background. What does it mean? Drugs that prevent pregnancy, work with the hormonal state of a woman. With the abuse of such drugs, the hormonal background can change forever;
• Abuse of the solarium or constant prolonged exposure to the sun. This is especially true for women with sensitive skin.

Uterine fibroids 38 mm on ultrasound

To understand how high the risk of surgery is, you need to calculate at what stage the pathology is.

Classification of fibroids by size

The size of the fibroid is determined by ultrasound. It is described in weeks and in centimeters. As the neoplasm grows, the uterus increases in the same way as during pregnancy. That is, in the case of an increase in the uterus at the 10th week of pregnancy, a woman is diagnosed with a “myoma of 10 weeks”. The measurements in weeks and cm are as follows:

Fibroids in the uterus

• Small - up to 2 cm or 20 mm. This usually corresponds to the 4th or 5th week of pregnancy;
• Medium - up to 6 cm or 60 mm. This indicator is considered normal for 6-11 weeks of pregnancy;
• Large - from 60 in mm or 6 in cm or more. Usually relevant at 12 weeks of gestation and beyond.

When education corresponds to 20 weeks of pregnancy, it can greatly affect the work of neighboring organs. Myoma is also dangerous because it can disrupt the work of neighboring organs without provoking pronounced symptoms. But most often, minor symptoms are still present.

You can see a photo of myomas in size below.

How to determine the size of the neoplasm in weeks

What to do when making an appropriate diagnosis? How do you know if you are being treated correctly? There is a table that shows the size of the fibroids by week and what method of treatment is used (a table of correspondence between the height of the uterine fundus and the term):

Depending on the stage of development of the pathology, the symptoms inherent in it make themselves felt.

Usually, critical days inhibit tumor growth. During this period, the doctor only monitors her condition. If a woman no longer plans to have children, then a complete removal of the uterus may be an alternative.

What happens without surgery

If the patient is shown an operation to remove the fibroid, it is necessary to adhere to this appointment, otherwise the outcome may be unpredictable. What does it mean? Possible consequences:

• If the inflammation spreads to a great extent, severe kidney disease will result;
• A benign tumor will become malignant within a short amount of time;
• The growth of fibroids will continue, which will lead to even greater pressure on neighboring organs, the outcome of this process can be unpredictable, even fatal;
• Anemia will develop quickly;
• There is a risk of infertility.

If you regularly visit a gynecologist, follow all his requirements, then the consequences of the problem will not affect you. Today, there are many modern techniques that allow you to remove the tumor quickly and without consequences. Therefore, do not be afraid of doctors, this pathology can be eliminated by living a full and eventful life.

Myoma is a benign formation that is diagnosed more often in the fair sex of childbearing age due to changes in hormone levels. Disregard for one's health, refusal of treatment can provoke disastrous consequences, including the degeneration of a neoplasm into a cancerous tumor. Let us consider in more detail the symptoms and causes of the appearance of neoplasms in the uterus, a table of sizes of uterine fibroids in mm and weeks will help to better understand the disease, to understand when surgery is needed.

Why and how is measured in weeks and centimeters

When fibroids appear, the uterus, as when carrying a child, reacts with growth, therefore, its dimensions are measured in weeks and centimeters, and the tumors are measured in millimeters. The doctor needs to know exactly all the data in order to decide on the treatment: conservative or surgical. As a rule, a small tumor is amenable to conservative treatment - hormonal and drug therapy, a large one - necessarily requires surgical intervention.

How to determine the size of the tumor

To make the correct diagnosis, a competent specialist will not only conduct a traditional examination, but also send the patient for an ultrasound scan. The diagnosed tumor will be described in centimeters and weeks. Its dimensions and the height of the bottom of the uterus at the same time correspond to the obstetric terms of pregnancy. For convenience, we offer you a detailed table that combines data on the size of fibroids, uterus, duration in weeks, type of treatment.

*this type of treatment is most often prescribed, but in individual cases a different approach is possible to get rid of the disease.

If you refuse treatment and start the disease, the tumor can outgrow a full-term fetus in size and be up to 6 kg in weight, and 40 centimeters in diameter and cause unbearable pain to its “mistress”!

Causes of the appearance and growth of the tumor

There can be several reasons for the appearance of a neoplasm in the uterus: the main ones are hormonal changes, ovarian pathologies, heredity, excessive weight, constant stress and stress, chronic infectious diseases, excessive physical activity.

Fibroids that appear in the uterus do not necessarily continue to grow. If their sizes are small and correspond to the norms, regular observation by a specialist and prescribed treatment will be enough. There is also a danger of increasing the size of fibroids.

Can provoke tumor growth:

• the use of hormonal contraceptives without a doctor's prescription;
• abuse of ultraviolet (including tanning in a solarium);
• absence of pregnancy, childbirth, lactation up to 30 years;
• a large number of abortions;
• diseases of the reproductive system.

Perhaps the appearance of not one, but several nodes of fibroids at once, doctors call such a tumor multiple.

More about symptoms

The manifestation of symptoms of a neoplasm in the uterus depends on the size and location of the tumor. Myoma can grow:

• in the uterine cavity;
• on the cervix;
• under the mucous tissue of the uterus (submucosal);
• in the myometrium of the uterus;
• on the uterus from the side of the abdominal cavity (subserous).

In addition, submucosal and subserous tumors can grow on the so-called stalk. Often, tumors on the leg, regardless of size, twist and cause unbearable pain to the patient.

Depending on the "composition" of fibroids is called leiomyoma - it consists mostly of muscle tissue or fibromyoma - includes fibrous tissue. In the first case, the formation has only some of the properties of the tumor, but, in fact, it is not, it can “resolve” without treatment. The second case is more dangerous - for the most part, fibromyoma grows against the background of negative processes in the endometrium and can be a precursor to oncology.

Fibroids of small size from 3–4 weeks to 2 cm, as a rule, do not cause any inconvenience, their appearance is asymptomatic for the patient. It is very important for every woman to visit a gynecologist regularly, this will allow, if a tumor has appeared, to start its treatment at a very early stage.

Medium-sized formations, for example, with a diameter of about 4 cm or more, are manifested by painful menstrual bleeding, causeless "daubs" in the middle of the cycle. At the same time, the use of analgesics does not stop the problem.

Large fibroids affect the frequency of urination and defecation. The volume of the abdomen increases, but the weight of the patient remains the same. Tumors growing outside the body of the uterus are able to form adhesions with other organs and tissues in the abdominal cavity. In addition, large uterine fibroids compress neighboring organs and nerve endings, leading to pain during movement.

Pregnancy and fibroids

According to the observations of obstetricians, small fibroids located outside the uterus or in its muscle tissue do not affect the carrying of pregnancy and the development of the baby. Small fibroids also do not prevent the patient from becoming pregnant, tumors of large sizes and located directly in the uterine cavity can prevent conception. A node larger than 10 mm in diameter will block the way for spermatozoa, and when pregnancy occurs, it will interfere with the normal development of the fetus and create a threat of miscarriage or premature birth.

If it turned out to become pregnant, a patient with a myomatous node will be under the close supervision of doctors for the entire period of gestation, because due to changes in hormone levels, the tumor may begin to grow. Its growth will interfere with the normal development of the fetus and delivery. And also the drug treatment of the disease, shown throughout the entire period of pregnancy, can negatively affect the unborn child.

According to statistics, in 10% of pregnant women, fibroids stop growing. In 20% of patients, there is a progressive growth rate of uterine fibroids.

Treatment Methods

Not always the size of the fibroid is an indicator for the appointment of surgical intervention. The doctor makes a decision on the method of treatment based on the individual characteristics of the patient's health, his age and even lifestyle, of course, the "composition" of the neoplasm, its location and influence on the patient's well-being are also taken into account.

For example, a 7–10 mm fibroid is considered small and subject to medical and hormonal treatment, but if it is pedunculated and has grown in the submucosal or subserous area, immediate surgical removal is required!

Tumors smaller than 2 cm can be treated conservatively, but if they are located in a dangerous area or lead to severe bleeding, which also require surgery. The patient will also be scheduled for surgery if the tumor grows and has increased in a year to an obstetric period of 5 weeks.

The appointment of treatment at the onset of menopause has its own characteristics, which reduces the production of estrogen, the culprit in the appearance of tumors. Doctors can take a wait-and-see attitude and observe the behavior of fibroids, in this case, a radical solution is possible - removal of the uterus.

Unambiguous indications for the surgical solution of the problem are:

1. Bleeding - severe and regular blood loss due to a tumor can cause severe anemia.
2. Upcoming pregnancy - medium and large fibroids provoke miscarriages or infertility. In the event of pregnancy, they can begin to grow and threaten the development of the fetus.
3. A large tumor size is a fibroid with a diameter of more than 6 cm, which corresponds to a 12-week gestation period.
4. The risk of degeneration - the tumor can become malignant.
5. Pain - fibroids cause severe pain, and analgesics do not help.
6. The peculiarity of the shape of the tumor - due to the danger of twisting or peritonitis, pedunculated fibroids, even with a small size, must be removed.
7. Violations in the work of the body - problems with urination or defecation, squeezing neighboring organs or nerve endings.

In addition to surgery, fibroids are treated with hormonal therapy. Symptomatic treatment and the appointment of antispasmodics and analgesics is indicated for pain during menstrual bleeding. Hemostatic agents are prescribed to patients with heavy menstruation and uterine bleeding in the middle of the cycle. Experts are negative about traditional methods of treatment: non-traditional methods bring little effect and can lead to negative consequences, especially when self-medicating.

If conservative methods of treatment do not give a positive result, the doctor may prescribe a so-called uterine scraping - diagnostic curettage. This will help to give a complete picture and clarify the diagnosis. In addition, during the scraping process, all nodes and formations will be removed.

Types of surgical treatment of fibroids

Surgical treatment of fibroids can be divided into minimally invasive types and abdominal operations. The former are characterized by less intervention in the patient's body and a faster recovery period.

Minimally invasive treatments for fibroids

Laparoscopy - is prescribed for small fibroids, for example, 8–20 mm in size, located on the surface of the uterus. The operation is performed through small punctures on the patient's abdomen, which heal quickly and leave behind scars no longer than 1.5 cm. Complications are unlikely, childbearing function is preserved.

Hysteroscopy - preserves the ability to conceive and bear children, is indicated for submucosal fibroids and uterine bleeding. The tumor in this type of surgery is removed through the cervix. Contraindicated in patients with enlarged uterine cavity, other types of uterine tumors or endometrial cancer.

Abdominal types of treatment of fibroids

Despite the high morbidity and long rehabilitation period, such surgeries are highly effective and are often the only way to save the life and health of the patient.

Laparotomy - the operation is performed through an incision in the middle of the abdomen. The surgeon carefully examines the uterus, removes all tumors, if necessary, from the uterine cavity. After the operation, the patient remains fertile.

Hysterectomy is partial or complete removal of the uterus. It is used for large sizes, rapid growth, necrosis of fibroids. It is indicated for severe pain or serious blood loss due to a tumor, multiple nodes, relapses or the futility of another type of treatment. Endometriosis and ovarian pathology are additional reasons for hysterectomy. It is not prescribed for women who have not given birth, with cancer with grade 4 metastases, chronic pathologies and infectious diseases in the acute stage.

Alternative treatment for fibroids

Modern medicine offers new methods and methods for treating tumors, so uterine fibroids can be eliminated for 5-6 weeks using laser excision. The advantages of this type of treatment are obvious - there will be no scars on the body, the rehabilitation period takes a short period, and the childbearing function is preserved.

Another alternative is uterine artery embolization. It is allowed with a tumor up to 7-8 weeks. A catheter is inserted through the femoral artery, through which a special solution will enter the uterine arteries that feed the fibroids. This will clog the arteries, the fibroids will stop feeding and they will die.

Embolization, according to medical statistics, helped to get rid of fibroids in 98% of patients, and amenorrhea was recorded in some patients with tumor sizes over 9 weeks.

Recovery after deletion

For a quick recovery after an operation to remove a neoplasm, a number of rules must be observed:

• do not lift weight heavier than 3 kg;
• avoid stress and nervous strain;
• make sure that constipation does not occur;
• move more walk as often as possible;
• take medication prescribed by a doctor;
• if you have any unexplained symptoms, go to the hospital.

Conclusion

Regular examinations at the local gynecologist are mandatory for all women: those who have undergone surgery to remove uterine fibroids, and those who have never undergone such an operation. Needless to say, women of childbearing age should consult a doctor when planning a pregnancy after tumor removal?! Take care of yourself and your health, regularly visit a gynecologist so as not to face the negative consequences of this disease.