Growth factors of benign uterine tumors and indications for surgical intervention. Indications for removal of uterine fibroids by size in weeks or centimeters - how the operation is performed Myoma 5 cm large

Myoma is a benign tumor, but if it is large, then the complications are very serious. The abdomen increases, as during pregnancy, the shape of the uterus is disturbed, the volume of the cavity is reduced. It is possible to block the cervical canal. Violated physiological processes occurring in the reproductive system. The general health of a woman is deteriorating. When choosing a method of treatment, various factors are taken into account, the most reliable and sparing method is selected. An assessment of the size of the fibroid is important, since there must be good reasons for the operation.

Content:

Types of fibroids

The neoplasm originates in the muscle tissue of the uterus, gradually increases in size due to abnormal cell division. Unlike a malignant tumor, fibroids do not spread to other organs, they grow much more slowly. Initially, cells develop abnormally only in muscle tissue, and then the tumor goes beyond it. Depending on the direction in which it grows, the following types of fibroids are distinguished:

1. Submucosal - it is formed in the depth of the muscle layer (myometrium), grows towards the mucous membrane of the uterine cavity, therefore it is called "submucous".
2. Subserous (subperitoneal) originates in the outer muscle layer, grows towards the serous membrane that separates the uterus from the abdominal cavity. Knots can have a wide base or a thin stem.
3. Interstitial (intramuscular) - develops in the middle of the muscle layer, without going beyond it.

When assessing the degree of danger of a tumor and choosing a method of treatment, specialists take into account its location. In most cases, myomatous nodes are located in the body of the uterus (corporal view), but sometimes they are also in the cervix (cervical fibroids).

The tumor is single or multiple, in the form of several nodes. For a specialist choosing a method of treatment, the size of uterine fibroids is of great importance.

How dimensions are determined

The growing tumor stretches the uterus, which leads to a gradual increase in the abdomen (similar to its growth during pregnancy). According to which week of pregnancy the size of the abdomen corresponds, the size of the fibroids is estimated.

The exact size of the tumor in centimeters can be determined using ultrasound. In this way, even fibroids smaller than 1 cm are detected. Ultrasound is performed either through the anterior wall of the abdominal cavity or through the vagina. This allows you to identify and measure fibroids of any localization and size.

In difficult cases, when a small tumor is located, for example, between the ligaments, the hysterography method is used (X-ray of the cavity with the introduction of a contrast fluid). To study fibroids and assess its size, hysteroscopy (examination with an endoscope inserted into the uterine cavity through the vagina), diagnostic laparoscopy (an optical device is inserted into the uterine cavity through a puncture on the anterior wall of the peritoneum) and MRI are also used.

All myomatous nodes, depending on their size, are divided into three categories:

Sometimes uterine fibroids reach a size at which the stomach is, as at 37 weeks of gestation.

In addition to size, the rate of tumor growth is also taken into account. A tumor is considered to grow rapidly if its size increases by 2-2.5 cm (or 5-6 weeks) per year. Thus, the growth of small and medium-sized fibroids is assessed. If they are small and grow slowly, then conservative treatment is possible. At sizes greater than 8 cm (or 15 weeks), the nodes are removed.

In addition to the size of the tumor and the rate of development, when prescribing treatment, the severity of the symptoms, the age of the woman, and her intention to have children are taken into account.

The danger of large fibroids

There are uncomplicated and complicated forms of the disease. Possible complications are:

• necrosis of the myomatous node - an acute painful condition in which there is a torsion of the legs, a violation of the blood supply to the fibroids;
• the formation of cystic cavities (the threat of purulent inflammatory processes);
• compression of blood vessels and nearby organs;
• malignant degeneration (into sarcoma).

Fibroids can reach a diameter of 25 cm. A large tumor located outside, on the front wall of the uterus, compresses the bladder, which leads to difficulty urinating or, conversely, can cause urinary incontinence. In addition, the appearance of fistulas connecting the cavities of the uterus and the bladder is possible.

If a large fibroid is located on the back of the uterus, then emptying the intestines is difficult, constipation occurs.

A large knot can compress the inferior vena cava, making it difficult for blood to move from the lower body to the heart. In this case, the woman has shortness of breath and palpitations even at rest. In the presence of many medium and large nodes (myomatosis), there are constant uterine bleeding that is not associated with menstruation. This leads to anemia.

Video: Complications with large nodes. When and how is surgical removal performed?

When is surgical treatment used?

Surgery for uterine fibroids is mandatory in cases where it grows rapidly - up to 2 cm (4 weeks) in diameter during the year, and also if the tumor has a stalk and there is a risk of its twisting.

An unconditional indication for surgical removal of fibroids is the appearance of uterine bleeding and severe anemia in a woman. This is possible due to a violation of muscle elasticity during the development of large myomatous nodes in it, deterioration of contractility.

Myoma must be removed surgically if it is the cause of infertility or miscarriages. The operation is also prescribed if a woman has severe pain in the abdomen, rectum, bladder, as they are squeezed, blood circulation is disturbed.

Video: Treatment of fibroids with hysterectomy and uterine artery embolization

What types of operations exist

When choosing a method for the operation, the size of the uterine fibroids and its localization are of primary importance. In each case, the doctor decides on the method of removing the tumor, the possibility of preserving organs and menstrual function.

Myomectomy

This is an operation in which only the tumor is removed, the uterus is preserved. Most often, this method is used to treat women under 40 who would like to maintain the ability to give birth to a child.

Removal of the tumor is carried out in this case in various ways.

Laparotomy- this is the removal of fibroids located deep in the muscle tissue or under the outer shell of the uterus by cutting the abdomen above the pubis. The tumor is excised. The risk of infection and complications is minimal. This method is especially effective when there are many nodes, there is an increased likelihood of damage to large vessels. It is much easier to prevent bleeding during open surgery. In addition, the removal of fibroids can be done quickly.

Laparoscopy– removal of fibroids through 3 small openings in the abdomen using optical instruments. Carbon dioxide is first introduced into the uterus to create conditions for more free manipulation of instruments and avoid cuts. The image is displayed on the screen, which allows you to control the process.

The advantage of the method is that the wound heals quickly, the operation is less traumatic, and there is no suture left after it. It is carried out under general anesthesia. The disadvantage is that there is still a minimal chance of internal cuts, so the woman is under the supervision of doctors for 3-4 days. Sometimes, if the myomatous node is located on the posterior or lateral outer surface of the uterus, it is removed through a puncture in the posterior wall of the vagina.

Addition: If necessary, this method can remove large myoma nodes in pregnant women. In this case, the fetus is not injured, the pregnancy proceeds normally.

Hysteroscopic myomectomy. A method that is used to remove fibroids in the cavity itself. It is carried out using an optical instrument (resectoscope) through the vagina. The method is not used if a woman has inflammatory diseases of the genital organs or cervical defects.

Hysterectomy

Removal of the uterus completely or with preservation of the cervix. Such an operation is performed in the most severe cases, when there are many large nodes, the fibroids occupy the entire cavity, there is severe bleeding. At the same time, the level of hemoglobin is critically low, the probability of tumor degeneration into sarcoma is high. Most often, such operations are performed on women after 45 years.

Removal of the uterus is performed in several ways: through an incision in the lower abdomen, through punctures in the abdominal wall (laparoscopic method), through the vagina. After the operation, a woman cannot have a period. But if the ovaries are not removed, then the rest of the symptoms of menopause may be absent. The possibility of sexual activity after the operation is preserved.

Video: Methods for removing fibroids while preserving the uterus

Minimally invasive methods for treating fibroids

When treating fibroids with these methods, no incisions or punctures are required.

Embolization of the uterine arteries. The method consists in the fact that through the inguinal artery with the help of a catheter, "plugs" made of plastic or gelatin are brought to the vessels of the fibroids, which block the flow of blood. Due to lack of nutrition, the tumor gradually decreases. The procedure is performed under local anesthesia.

FUS ablation(focused ultrasound). Removal of fibroid nodes is carried out using a directed ultrasonic flow, which causes heating and evaporation of the nodes located in the muscle. The process is controlled using a magnetic resonance tomograph. In this case, anesthesia is not required, the functions of the uterus are fully preserved. The method is effective even in the presence of large nodes.

Video: Evaporation of fibroids by FUS ablation

The possibility of pregnancy with myoma

Large fibroids (greater than 15 weeks) are the cause of infertility if they block the tubes or cervix, creating obstacles to the movement of sperm. In the presence of nodes no larger than 3 cm in diameter (that is, less than 8 weeks), pregnancy is possible. If the nodes do not increase, then their existence does not affect the course of pregnancy and the development of the fetus. Complications arise when the tumor grows in the uterine cavity, fills it, making it difficult for the fetus to develop. Often this ends in a miscarriage.

Sometimes, if the fetus is already large enough and begins to lack nutrition due to the pressure of the fibroids on the vessels, a caesarean section is performed and the subsequent removal of the uterus. A caesarean section has to be done even if the fibroid occurs in the cervix or overlaps it.

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.

Myoma of the uterus is called a benign formation, consisting from 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 hormonal imbalance, the tumor growing 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 by ultrasound, the tumor is measured in millimeters and centimeters. During a clinical examination in the gynecologist's office, the size of the fibroids is determined according to the degree of uterus enlargement characteristic of the period of pregnancy.

According to these parameters, small fibroids include tumor no more than 2 cm in which the uterus enlarges according to 5-12 weeks of pregnancy. The main sign of a small tumor size is small, firm myomatous nodule, which constitutes the center of a future major sprawl.

On palpation, the node is found tight stable core. 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, along the edges of the node, peripheral growing volume. But, as a rule, a pronounced increase is characteristic of tumors of medium and large size.

A small tumor is a fibroid that has not yet acquired an independent growth mechanism.

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

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

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, it is most often prescribed conservative therapy with the use of special medications and means, 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. Hormonal regulation, 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 lesions on abnormal areas, by reducing their sensitivity to estrogens.

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

In fact, the drugs used have antihormonal action, in which the cycle of menstruation stops, and all the signs of menopause appear. Through this action, it is observed complete regression of fibroids.

For the procedure, the drug is used Decapeptyl 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 1 to 5 days of the menstrual cycle, 3.75 mg, then take a break of 28 days and repeat the course. Depending on the characteristics of the tumor, treatment can last from 3 to 6 months.

Usually, after 4 months of therapy, tumor volume 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 disadvantage, with irregular use or incorrect dosage, after treatment, there is renewal growth of fibroids, only in a more active form.

Embolization

Embolization is a technique indicated for the removal of fibroids by stopping her blood supply. This technique is applied with formations up to 5 cm.

The procedure is minimally invasive surgery o, which is carried out with the help of 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 field of benign education, 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, into these vessels a special drug is delivered blocking the cavity of the artery, and thereby not allowing blood to flow to 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, neoplasm cells perish, and the myoma resolves. During this period, the patient does not need to be in the hospital.

In place of the destroyed fibroids, a scar is formed, which completely disappears after 3–5 months.

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.

In two weeks noted after treatment tumor reduction by 74%. In 5% of patients a few months after therapy completely disbanded central node.

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, it is observed death of healthy epithelium, which can provoke inflammation of the uterus, or the occurrence of a new fibroid.

Progestin

When a tumor is formed no more than 1.5 cm, is prescribed by the use of drugs based on progestin. Most often, it is prescribed as a contraceptive pill, which is taken once a day.

They aim to fix the problem by normalization of ovarian function, which begin to actively produce progesterone, which inhibits 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, duration of six months, fibroids reduced by 55%.

This technique has few side effects and high efficiency. But with prolonged use, it should be borne in mind that drugs can lead to liver dysfunction.

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 blocking estrogen production and the pathological cells die.

The spiral is thin T-frame which contains the hormone levonorgestrel. Throughout the treatment, spiral produces this hormone, throwing it into the blood in small quantities. This type of treatment is used only at reproductive age. Additionally, the tool cannot be installed for chronic inflammation 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, most often prescribed warfarin which is taken once a day. To enhance the effect of the drug, it is combined with antiplatelet agent. In this case, preference is given Heparin.

Both drugs should 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 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 degeneration into cancer;
• submucosal type of fibroids interstitial and centripetal development;
• the presence of persistent heavy bleeding;
• excessively active the growth of education;
• infertility;
• necrosis central node.

Article plan

Uterine fibroids is a benign neoplasm that is found most often in patients aged twenty to forty years.

In this article, we will describe in detail what symptoms accompany the development of the tumor by weeks, at what sizes of uterine fibroids surgery is performed, and also what are the indications and contraindications for certain methods of curing this disease.

Features of the pathology

Most often, nodular fibroids are detected, it does not pose a threat to life and cannot degenerate into a malignant oncological tumor. The formation consists of smooth muscle cells and differs in volume, number of nodes and localization. A feature of the pathology is its susceptibility to changes in the hormonal balance in the fair sex. So with small formations, you can cope with the disease with hormone therapy, or simply wait for the onset of menopause, then there is a high probability that the tumor will resolve itself. And such expectant tactics are the norm for small fibroids.

But if gynecologists talk about the size that needs surgery, then its value has already reached critical volumes, and in order to normalize the condition, mandatory surgical removal of the formation is required.

What kind of disease

This is a formation that is found in 95% of cases in the uterus itself and in 5% in its neck. It can develop in the form of knots in the musculature or connective tissue. The magnitude of education is measured in centimeters, millimeters or weeks. If the gynecologist speaks of a value of 16 weeks, then he means that the organ with has become the same as during pregnancy at 16 weeks.

Symptoms

With a small size of the formation, it is almost impossible to determine its presence symptomatically. By ultrasound, the doctor can see a nodular tumor when its volume becomes from 7 mm. Symptoms of fibroids will appear with a submucous type of neoplasm, even if its size has not yet reached 15 mm. The disease is characterized by the following manifestations:

• pain in the lower back, heart muscle, if there are adhesions, then it can be localized in the area of ​​\u200b\u200bthe nearest organs;
• limbs may become numb if there are problems with blood flow;
• the process of defecation is disturbed and trips to the toilet “in a small way” become more frequent, the reason is the pressure of the neoplasm on the internal organs;
• the lower abdomen may increase in volume while the patient's weight remains the same.

Some can be confused with symptoms of other diseases:

• pain in the lower abdomen, radiating to the sacrum and leg;
• bleeding between periods;
• anemia due to massive blood loss;
• problems with conception, miscarriages.

Classification

Classification of education is carried out according to different criteria. Depending on the location in relation to the uterine cavity, the tumor is submucosal, and subserous. is diagnosed most often, progresses rapidly, and its nodes grow to a size of 11 weeks (4-5 cm).

Usually fibroids are formed in the body of the uterus, 5-8% of cases occur in the cervical location. Posterior cervical, near and precervical, interligamentous and retroperitoneal localizations are rare.

By size

It is also very important to know how many weeks in size the tumor has developed. It can be measured in mm and cm. There are such types of fibroids:

• small. The size of the nodules is a maximum of 30 mm, while the uterine myoma is 6 weeks, a maximum of 8;
• medium. The size of education from 40 mm to 70 mm (or 4-7 cm), is equal to 12 weeks;
• large. It grows more than 8 cm, while the size of the uterus starts from 13 weeks.

Is there a danger

Any disease that causes profuse blood loss is life-threatening for the patient, and intense bleeding characterizes the presence of fibroids. There are a number of other reasons why this disease should be taken very seriously:

• if the nodes are on thin legs, this can cause torsion and the need for an instant operation;
• necrosis of the tissues of the myoma node. This phenomenon is possible with a sharp contraction of the uterus, for example, after childbirth. In this case, the patient must be operated on;
• delay in the treatment of fibroids contributes to the development of a malignant neoplasm, such an outcome is possible in 1.5-3% of cases;
• ectopic pregnancy, spontaneous abortions, complex and premature births, infertility may develop;
• inflammatory and putrefactive processes in the formation itself and in the tissues of nearby organs.

Diagnostics

The first stage of diagnosis is a bimanual examination, in which the doctor visually and manually, using special equipment for examination, assesses the size of the uterine fibroids. Then he sends for the delivery of tests and ultrasound examination. It can accurately determine the magnitude of education. It is best when the examination is carried out in dynamics, in order to know the rate of growth or regression of the disease. This diagnostic method allows you to determine not only the size of the nodes by weeks in millimeters, but also the speed and their development. If in a year from ten weeks the fibroid has grown to 14 weeks or more, then such growth may indicate the degeneration of the tumor into cancer. To clarify the diagnosis, MRI and transvaginal examination are prescribed.

Forecast

It doesn’t matter if surgery is needed to treat fibroids or hormone therapy is enough, the prognosis for life is favorable. When the nodes are small and appeared before menopause, it is highly likely that they regress on their own during the menopause.

If the tumor was removed along with the uterus, then the patient is removed from the register no earlier than after 5 years. After laparoscopy, observation is carried out for life, since there is a possibility of resumption of growth of myomatous nodes. The possibility of recurrence after UAE is 50%.

Leakage during gestation

During pregnancy, nodes with a diameter of 9 mm, 10 mm, a maximum of 11 mm do not pose a danger to either the mother or the fetus, but require constant monitoring by the gynecologist. If their sizes in weeks exceed 12, and at the same time they are localized in the submucosal region of the uterus, they can cause various pathologies in the fetus.

If the tumors are in the region of the posterior wall of the uterus and are larger than 12 weeks, then there is a high probability of early birth, as well as oxygen starvation of the baby.

Prevention

In the body of a woman, everything is subject to the hormonal background, therefore, when it changes, various diseases of the uterus, including fibroids, can develop. The nature of the occurrence of these formations has not been fully studied, but statistics show that women who have given birth and breast-fed are twice as likely to suffer from this disease. Also, to reduce the likelihood of getting sick with fibroids, you need to refuse abortions, treat diseases of the genitourinary system in time and not expose yourself to stress.

What is the treatment depending on the size

What to do with a benign education, only a doctor can decide. Depending on the size of the formation and plans for pregnancy, both conservative and surgical treatment can be used. In turn, the operation can be low-traumatic or abdominal, if, for example, it is necessary to remove a completely affected organ. Consider which method is used depending on the size of the tumor.

conservative technique

If the fibroid is miniature in size, then drugs such as combined oral contraception () are used. With sizes up to 2 cm, hormonal therapy is most effective, with fibroids reaching a diameter of three centimeters, gonadotropin-releasing hormone agonists or antigonadotropins should be used initially. These medications are used throughout the year. Then maintenance therapy is prescribed, but if the nodes do not decrease in size, the doctor may again prescribe hormonal drugs.

Laparotomy

If the neoplasm in the uterus has grown to a size of 12, a maximum of 15 weeks and presses on the nearest organs, a cavity laparotomy is performed, after which sutures are applied to the abdominal wall. After the intervention, the patient must stay in the hospital for about a week, and the rehabilitation period will take about 2 months.

Embolization

Myoma does not always need to be operated on, one of the new loyal methods is or UAE. This technique is characterized by high efficiency and low recurrence rate. A catheter is inserted into the patient's femoral artery, and a special solution is injected through it into the arteries that feed the fibroids. The embolizing substance clogs the vessel, the node stops feeding and eventually dies.

Uterine fibroids at 7, 8 and 9 weeks allow for UAE.

Hysterectomy

This is a cardinal way to remove the formation along with the uterus. Hysterectomy is used only when the tumor is huge, grows rapidly and has a tendency to degenerate. After the operation, a woman can be prescribed antibiotics and drugs for general strengthening of the body, then hormone therapy is possible for the stable functioning of the endocrine system.

Hysteroresectoscopy

The procedure is performed using a hysteroscope, the tube of which enters the uterus through the vagina. With such a device, uterine fibroids 3 cm in diameter are removed as sparingly as possible. Most patients respond positively to this procedure.

Myomectomy

Another name is laparoscopy. During the manipulation, small incisions are made, a laparoscope (optical device) is inserted into them. Elimination of nodes using laparoscopy is carried out if the tumor is 8 weeks old, no more. After manipulation, there are rarely complications, and the rehabilitation period proceeds easily and quickly. The possibility of having a child remains.

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.

• 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.

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.

Uterine fibroids in the size of 10 weeks of pregnancy, according to the classification, refer to benign neoplasms of the female reproductive organ of medium size. What size uterine fibroids are considered large? This is the size of the neoplasm, exceeding 12 weeks. Uterine fibroids (sizes in weeks) have a fairly clear gradation of treatment tactics depending on its size.

Therefore, such a pathological condition has a chance for conservative treatment. That is why, with any symptomatology of an unknown nature, it is necessary to seek medical gynecological help from your obstetrician-gynecologist in order to start treatment on time and limit yourself to non-surgical methods of treatment. Symptoms of uterine fibroids in the size of 10 weeks 1 scheme may be slight pulling pains in the lower abdomen of a different nature and frequency. Minor dysuric phenomena may occur, such as frequent urination due to the pressure of this fibroid on the bladder. In some cases, when the fibroid is localized along the posterior wall of the uterus, the nodes are subserous, and can cause constipation. Submucosally located nodes deform the uterine cavity, prevent its physiological contraction, thereby causing profuse bleeding on the days of endometrial desquamation, as well as in the intermenstrual period. The volume of blood loss exceeding physiological is 80 ml of blood per day or more.

If a woman notices the filling of a medium-capacity pad more than 1 per hour, then it is possible to ascertain the presence of bleeding and immediately consult a doctor.

Diagnostics. Diagnosis of such fibroids is no different from those of a smaller size. A bimanual examination of the uterus is performed on a gynecological chair, ultrasound diagnostics, if necessary, magnetic resonance imaging or CT, as well as hysteroscopic or laparoscopic diagnostics. Such uterine fibroids without symptoms can be treated conservatively with the use of hormonal drugs in the form of combined oral contraceptives, progesterone drugs, and gonadotropin-releasing hormone agonists. Mandatory in the treatment of such neoplasms is the dynamic control of the growth of nodes.

Uterine fibroids 11 weeks: what to do?

Uterine fibroids in the size of 11 weeks does not have significant differences from that in the size of a 10-week pregnant uterus. The clinical symptoms will also not be any different, causing slight pulling pains in the lower abdomen, an increase in the volume of menstrual flow. Gynecological examination, ultrasound diagnostics, CT, MRI are also used in diagnostics. Special therapy for such fibroids is also aimed at non-surgical treatment with hormonal drugs, an intrauterine hormonal system such as Mirena can be used.

Hormonal drugs for the treatment of fibroids are also no exception.

Uterine fibroids 12 weeks: is surgery necessary?

Uterine fibroids in the size of 12 weeks is the borderline size, 12 weeks and beyond, the fibroids are considered large and the intended remedy is surgical treatment. Uterine fibroids 12 weeks, the dimensions in centimeters are, that is, more than six centimeters.

How to remove uterine fibroids 12 weeks?

Conservative therapy with such a size of myomatous formation is ineffective, it is considered a means by which precious time is lost for the use of a surgical method of treatment with a fairly high efficiency. With such sizes of myomatous formations, intermediate methods of surgical treatment can be used, such as ablation of the myomatous node, as well as embolization uterine arteries yet. The essence of these two techniques lies in their low invasiveness, which does not allow them to be attributed to the full-fledged surgical treatment of this formation. Scientists have proven their high efficiency in relation to benign neoplasms of the female reproductive organ

Uterine fibroids 14 weeks, uterine fibroids 15 weeks: tactics

Uterine fibroids 14-15 weeks is already a large neoplasm. The tactics of treating this tumor is only surgical, because of the size of the fibroids, the symptoms of this disease become brighter and more colorful: the pains are intense and constant. An increase in the abdomen is observed in most cases, 14-15-week-old fibroids protrude above the pubic symphysis. The uterus can be palpated even through the anterior abdominal wall. Diagnostics is no different from the previously stated. Treatment of these sizes of myomatous formations is surgical, which includes ultrasonic ablation, embolization of the uterine arteries, conservative myomectomy is also used, the operation is the removal of only a pathological formation without the introduction and removal of the reproductive organ itself. This operation is of great importance for the subsequent reproductive history of the woman. If a conservative myomectomy is performed without suturing the bed of the node, then such a woman during pregnancy needs an operative delivery, a caesarean section. If the knot bed has been sutured, the pregnant woman can give birth on her own through the natural birth canal.

When a woman is in the perimenopausal period, fibroids can be removed along with the uterus and appendages.

Uterine fibroids 16 weeks: what to do?

The method of therapy for such catches also remains unchanged in comparison with the previous size of myomatous formations. Only surgical treatment with the solution of the issue of removing the uterus itself with appendages, depending on the age of the patient and reproductive plans. These surgical procedures can be performed both laparoscopically and laparotomically.