Interstitial submucosal node along the anterior wall of the uterus. The development of uterine fibroids on the posterior wall of the uterus: a clinical picture of the pathology. General information and causes of pathology

Thousands of women across the country face the diagnosis of fibroids. Developing myomatous nodes at an early stage do not show symptoms and are more often detected during a routine examination, plunging the patient into shock. The features and causes of this disease are quite diverse, so every woman is obliged to take care of her health and respond in a timely manner to the early "bells" of the body.

Myoma diagnosis: what should you know about the disease?

This disease is quite common and can develop already during puberty. Therefore, the question, the myomatous node of the uterus - what is it, women ask quite often. The most active risk group are representatives of the weaker sex from 30 to 45 years. This age accounts for the highest incidence, since the body of a woman of the late reproductive and pre-menopausal period is subject to changes in hormonal levels.

Myomatous nodes themselves are benign tumor formations that develop in the myometrium - the muscular layer of the uterus. They consist of randomly arranged immature myocytes of the uterine wall. Neoplasms can be either single or multiple. Their size in most cases varies from 5-7 millimeters to 5-6 centimeters. However, in medical practice, cases have been recorded when a born myomatous node grew to a huge size, and its weight reached several tens of kilograms.

As for the treatment of the disease, a few years ago the only option was surgery. Nowadays, when medicine has taken a significant step forward, it is possible to defeat a neoplasm with more gentle methods, including with the help of drug therapy.

Reasons for the development of myomatous tumors

Despite the active development of medicine, it has not yet been possible to establish the exact causes of the development of this tumor process. Therefore, scientists tend to believe that the growth of myomatous nodes is a consequence of hormonal imbalance. But there are a lot of factors that precede such a violation of women's health. The main ones are:

genetic predisposition;
difficult childbirth;
abortions and other mechanical damage to the uterus;
a number of concomitant diseases, including diabetes mellitus, thyroid disorders, high blood pressure;
circulatory disorders in the pelvic organs, due to a sedentary lifestyle.

Types of neoplasms

The place of origin of this disease is the middle layer of the uterine wall - the myometrium. It is in it that the pathological cell, due to a number of reasons, begins to actively divide and form myomatous nodes. In medical practice, neoplasms are classified according to location and direction of growth into three main types:

The most common type of disease is the interstitial (intramural) myomatous node. According to medical statistics, its share in the total indicator of diagnosed cases is about 60%, so we will pay special attention to this type of pathology.

Features of the development of the disease

Any fibroid begins to nucleate precisely in the middle layer of the uterine wall - myometrium. A myomatous node can develop quite slowly, but only until the hormonal background fails in the body, due to natural age-related changes or external factors. The further direction of growth directly depends on the location of the pathology. If it is located on the border with the endometrium, then in the absence of timely therapy, the interstitial myomatous node can be transformed into a submucosal one. And at the location bordering on the perimetry - in the subserous.

Thus, with a diagnosed interstitial myoma, the choice of a possible method of therapy should be determined immediately. Postponing treatment can lead to further development of the disease and many negative consequences, such as infertility, anemia against the background of heavy bleeding, etc.

How to recognize the disease?

It is no secret that many women in our country ignore preventive examinations by a gynecologist, even if they require a medical examination at work. It is easier for our beautiful half of humanity to buy a document with seals from unscrupulous health workers than to think about the question, uterine myoma - what is it? But the danger of the situation lies in the fact that many diseases of the female genitourinary system in the early stages are asymptomatic, including fibroids. Symptoms appear already when the tumor has grown to a significant size and interferes with the normal functioning of the organs of the reproductive system. At the same time, clinical signs are individual in nature and depend on the location of the tumor, its size, the presence of concomitant diseases, the age of the patient, and many other factors.

Clinical picture of the disease

Possible clinical manifestations in the advanced form of fibroids are:

profuse painful menstruation;
violation of the menstrual cycle;
bleeding during the menstrual cycle;
pain syndrome in the lower abdomen and lumbar;
frequent urination;
constipation.

Myoma necrosis: symptoms and consequences

Lack of timely diagnosis and treatment of fibroids can lead to the most dangerous consequences. One of them is necrosis of the myomatous node. The death of neoplasm cells can occur due to twisting of the stem, and, consequently, blockage of the vessels that feed the tissues. With this development of events, clinical signs are not long in coming and manifest themselves in the form of:

cramping pains in the abdomen, radiating to the lower back and perineum;
difficult painful urination;
hyperthermia;
dysfunctions of the gastrointestinal tract;
symptoms of intoxication.

Over time, the symptoms become more pronounced. The lack of qualified medical care for a patient in this condition can lead to irreversible processes in the body and even death.

Modern methods of diagnosing the disease

Even in the absence of symptoms, identifying an intramural myomatous node is quite simple. To do this, you must follow the schedule of preventive visits to the gynecologist. An experienced doctor will definitely identify a neoplasm during palpation, and then, with the help of mirrors and additional tools, will assess the size of the pathological process.

When a tumor is detected, the patient is prescribed a number of additional diagnostic procedures, the first of which is ultrasound. The study is carried out using a transvaginal sensor, which allows you to clearly establish the localization and assess the degree of development of the pathology. In addition, the results of such a diagnosis give the doctor information about the state of the endometrium, because endometriosis is a frequent companion of fibroids.

In most cases, when the myomatous node is located along the back wall, such a study is sufficient to make the correct diagnosis. In particularly difficult or controversial situations, the patient is recommended to undergo other instrumental diagnostic studies: MRI or CT.

The choice of treatment is the prerogative of professionals

Even taking into account the fact that myoma is a benign tumor, it is strictly forbidden to ignore it. And if, after the next medical examination, the doctor revealed myomatous nodes, you should immediately start restoring health and immediately begin to treat the disease. There is currently no panacea that would cure fibroids like flu in a few days, so it is better to entrust the choice of the most effective method of therapy to an experienced doctor. The specialist not only knows the answer to the question, what is a myomatous node, but also has enough experience to choose the safest and most effective treatment option for each patient.

Previously, the only way to restore women's health with uterine fibroids was surgery. However, today medicine has advanced far ahead, and with small neoplasms it can solve the problem with medication.

Surgical method of treatment

Doctors recommend removing the pathological formation when the size of the diagnosed fibroids reaches 12 or more weeks of pregnancy. Also, indications for surgical intervention may be the rapid growth of the tumor, or a vivid clinical picture of the disease (severe pain, frequent heavy bleeding, etc.). But even if the doctor recommends the removal of fibroids, this is not a cause for concern. Modern surgical options are quite extensive, so the consequences of the operation will be insignificant.

Types of surgery for uterine myoma

To date, the following surgical methods of treatment are used for uterine myoma:

Laparoscopic myomectomy. It is carried out using a supersensitive apparatus (laparoscope) through small incisions on the abdominal wall. The advantages of this method include rapid recovery, preservation of the uterus and the ability to plan pregnancy after the established rehabilitation period.
Hysteroscopic myomectomy. Allows you to completely remove the myomatous node using a hysteroscope, which is inserted through the vagina into the uterine cavity. Surgery is indicated for patients with submucosal fibroids.
Laparotomy myomectomy. The tumor is removed through an incision in the abdominal wall. Nowadays, such an operation is performed only in extreme cases, since the postoperative period is quite long and difficult for the patient.
Hysterectomy. A technique involving the complete removal of the reproductive female organ. It is carried out in especially severe cases, when a large myomatous node is diagnosed, the symptoms of the tumor threaten the health and life of the patient, the localization of the fibroids does not allow for a more gentle operation.
arterial embolization. A fairly effective method of treatment, which involves blocking the blood flow in the artery that feeds the fibroids. There is a risk of developing an infection that can provoke necrosis of the myomatous node. In addition, the postoperative period is accompanied by severe pain.
FUS-ablation. It is carried out by means of hardware irradiation of the tumor process with ultrasonic waves. The method is contraindicated for multiple myomatous nodes, and is also contraindicated for women planning pregnancy in the future.

Medical therapy

With early diagnosis of neoplasms, conservative treatment allows women to take control of the pathological process in their body, and even bear the desired child. Such therapy is possible only in cases where the fibroid is localized exclusively in the myometrium, is characterized by a slow rate of development, and also has a relatively small size (up to 12 weeks of pregnancy).

This method of therapy is based on the use of hormonal drugs that allow you to restore the proper functioning of the female body. In combination with these drugs, doctors prescribe symptomatic medications in each case.

Preparations for drug therapy of fibroids

Antigonadotropins. Helps slow down and stop tumor growth. More often from this group, doctors prescribe the drug "Gestrinone" to patients. It is indicated for women who have an intramural myomatous node of medium size.
Gonadotropic releasing hormone agonists. Preparations of this group have a complex pharmacological action. They are prescribed to women to reduce the level of sex hormones, causing a condition similar to menopause. The systematic use of these drugs can significantly reduce the risk of uterine bleeding and partially relieve pain. Most often, drugs from this drug group are prescribed: Triptorelin, Goserelin, Buserelin or Zoladex. After the end of the course of therapy, the menstrual cycle quickly returns to normal.

Content

A myomatous node is a benign formation formed along the anterior or posterior wall of the uterus, in the thickness of the cervix or outside the uterus. In another way, the disease is called leiomyoma, or fibroma. Pathology is often diagnosed in women after thirty years. With the onset of menopause, the nodes on the anterior or posterior wall of the uterus usually regress.

Features of the type of uterine fibroids

Uterine fibroids include several varieties and intermediate options. The wall of the uterus consists of three layers.

Parametrium. This is the outer layer of the uterine wall, including the peritoneum and parauterine tissue.
Endometrium. This layer of the uterine wall is also called the inner layer. The endometrium is represented by a basal and functional layer. The functional layer grows and is rejected every cycle under the influence of hormones. The basal layer provides functional growth.
Myometrium. It is the source of the described tumor. Myomatous nodes are localized in the muscular layer of the uterine wall.

Myomatous nodes are represented by various types.

Interstitial or intramural myomatous node. This variety is formed in the muscular uterine wall, for example, anterior or posterior. If the tumor does not extend beyond the myometrium, such a node is called intramural.
Submucosal node located inside under the mucous membrane of the uterine wall.
subserous node localized directly under the serous membrane outside the organ.
retroperitoneal node grows from the lower sections, for example, the cervical part.
Intraligamentary node located between the leaves of the broad ligament.

Myomatous interstitial nodes along the anterior wall of the uterus, as well as intramural neoplasms, are the most common pathology options.

Nodes can develop:

in the body of the uterus;
in the neck part.

By number and size, myomatous nodes can be:

single and multiple;
large, medium and small.

Small uterine fibroids usually progress asymptomatically, making it difficult to diagnose and treat.

The nodes are attached to the uterine wall:

on the leg;
on a broad basis.

Interstitial, located along the anterior or posterior wall of the uterus, is a hormone-dependent pathology. This species is detected in approximately 60% of cases from the total number of nodes. Only 5% of interstitial or intramural nodes are localized in the cervical part.

Interstitial nodes are presented in several forms.

Intramural fibroids do not go beyond the boundaries of the anterior or posterior wall of the uterus.
Interstitial-submucosal neoplasms grow inside the uterine cavity.
Interstitial subserous tumors progress outwards or towards the peritoneum.

Usually, the examination reveals a multiple interstitial form of fibroids, which has formations of both small and large sizes of different localization and age. A characteristic of small nodes is a latent course.

Usually, interstitial myomatous nodes on the anterior wall of the uterus develop asymptomatically. Localization of fibroids inside the uterine wall causes a violation of the contractile function, which causes a characteristic clinical picture.

Reasons for growth

Uterine fibroids of any variety progresses due to hormonal disorders. Interstitial fibroids are formed during the embryonic laying of the girl's genitals. It has been established that uterine fibroids are interconnected with an increased level of estrogen hormones, which triggers the processes of proliferation of smooth muscle cells.

However, in modern gynecology, other hypotheses are also being developed to explain the occurrence of neoplasms of the uterine body. In particular, hyperplasia of muscle cells is considered as specialists.

The etiology and pathogenesis of a disease such as uterine fibroids are not well understood. Three hypotheses are being actively developed in modern gynecology:

congenital features of the structure of the uterine wall, due to intrauterine developmental disorders;
a tumor of the muscular wall of the uterus is considered by some authors as hyperplasia, and not a tumor formation;
an acquired pathology that develops as a result of multiple surgical interventions.

Interstitial or intramural uterine fibroids go through several stages of development:

the appearance of a zone of increased growth in the area of localization of the spiral arteries of the uterus of small caliber;
progression of a microscopic nodule;
formation of a neoplasm macroscopically.

The following factors can provoke the growth of interstitial or intramural fibroids:

endocrine disorders;
multiple surgical procedures;
excess weight;
lack of physical activity;
high blood pressure in women under 30 years of age;
burdened by the disease family history;
the onset of menstruation before the age of 11;
late first birth;
stress;
venous congestion.

Interstitial and intramural myomatous tumors differ in their rate of progression. The volume of neoplasms is measured in weeks of pregnancy. Large uterine fibroids cause deformity of the uterus.

Before starting the treatment of nodes both large and small sizes, it is necessary to eliminate provoking factors.

Symptoms

Signs of intramural or interstitial fibroids depend on the location along the anterior, posterior wall of the uterus, the number and size of neoplasms. The smaller the node, the less pronounced the signs of pathology. Usually, small neoplasms are not accompanied by a clinical picture. In particular, interstitial subserous fibroids do not have severe symptoms at small volumes.

Multiple fibroids, as well as large tumors, have the following manifestations:

compression of the bladder and intestines;
discomfort or heaviness in the lower abdomen;
pelvic, aggravated on critical days;
acyclic bleeding;
increase in the amount of menstrual flow;
shortness of breath and tachycardia;
anemia;
infertility;
spontaneous abortion;
complications observed during childbirth;
growth in the size of the abdomen.

Often, an interstitial or nodule along the anterior wall causes a constant urge to urinate. Fibroids located in the cervical part can cause defecation disorders and discomfort during intercourse.

Large fibroids cause deformation of the organ, infertility and miscarriage. It has been proven that interstitial fibroids can lead to various complications in childbirth. Uterine fibroids, localized along the anterior or posterior wall, often do not prevent pregnancy.

Nodes can be located and, and on a wide base. When formed on the leg, its torsion may occur. In this case, an "acute abdomen" clinic develops with severe pain and intoxication. Treatment of this condition involves only surgical tactics, since torsion leads to further necrosis.

Since intramural fibroma in most cases, it progresses asymptomatically; in modern gynecology, timely diagnosis of the pathology is of particular importance, which makes it possible to prevent dangerous complications.

Diagnosis and treatment

It is possible to determine the pathology of the uterine body through a gynecological examination and ultrasound. These are the main research methods for this form of the disease. Ultrasound of the pelvic organs shows even small neoplasms. However, for their detection, the size of the tumor must be at least one centimeter.

Often, the detection of pathology occurs in the process of preventive examination. It is possible to identify a myomatous formation located, in particular, along the anterior wall using:

gynecological ultrasound of the pelvic organs;
examination by a doctor on a chair by palpation;
computer and magnetic resonance imaging;
hysteroscopy;
laparoscopy.

During treatment, the following types of examinations have diagnostic value:

hormone level test helping to prescribe adequate drug therapy;
dopplerography, examining blood flow in the formation before embolization of the uterine arteries;
diagnosis of tumor markers to rule out malignancy.

The interstitial or intramural type of leiomyoma should be differentiated from malignant tumors and other pathologies of the organ. Interstitial or intramural myomatous nodes have a favorable prognosis. These formations have a low oncological risk, progress relatively slowly, and are not accompanied by severe manifestations at the initial stage of the disease.

Treatment of intramural fibroids includes several tactics:

expectant;
conservative;
surgical.

Expectant tactics

Expectant or observational tactics are used for small fibroids that do not cause severe symptoms. The patient systematically visits the gynecologist and undergoes an examination. With the progression of the disease, conservative or surgical treatment is performed.

Many doctors believe that expectant management is wrong. In the absence of timely therapy, interstitial or intramural myoma nodes can progress rapidly, which will lead to the need for surgical intervention.

Medical therapy

Medical or conservative treatment is used for fibroids up to 12 weeks. A prerequisite for drug therapy is the absence of violations of the functioning of neighboring organs.

The patient is prescribed to stop the progression of interstitial neoplasms, to reduce the manifestations of the disease. Drug therapy is often given before surgery to stabilize fibroma growth.

Conservative therapy is complemented by symptomatic treatment, traditional medicine. Physiotherapy methods, for example, have a good effect. Use in the framework of hirudotherapy allows you to eliminate the unpleasant manifestations of fibroids.

Surgical method

Surgery is the main type of treatment for myomatous nodes, including interstitial or intramural type. Manipulation can be carried out:

organ-preserving way through laparoscopic and laparotomic myomectomy, uterine artery embolization and FUS ablation;
radical technique with hysterectomy and hysterectomy.

Organ-preserving tactics are recommended for patients of reproductive age. It is advisable to plan pregnancy no earlier than six months after the removal of myomatous formations. Radical methods of treatment are carried out with concomitant prolapse of a muscular organ and oncological alertness.

Surgical treatment is necessarily combined with hormonal and antibacterial drug therapy, which makes it possible to prevent many complications and relapses of the pathology.

In recent years, women are increasingly faced with diseases of the reproductive system. Pathologies can have different causes of origin, ranging from poor ecology to the absence of childbirth and frequent abortions. Myomatous nodes have become a fairly common tumor. They appear most often in reproductive age. However, during this period they may simply not be detected. However, by the time of menopause and menopause, many symptoms of this disease appear.

To treat myomatous nodes or not is a matter for each woman personally. However, it is worth showing the neoplasm to the doctor. In most cases, the pathology does not develop into a malignant tumor, but there is still such a possibility. This article will tell you about what a myomatous node can be. You will find out the features of the location of the tumor. Also find out how you can cure the uterine fibroids.

The nature of the tumor process

The myomatous node, formed on the reproductive organ or in its cavity, is a benign formation. The dimensions of this pathology are calculated in weeks of pregnancy. Small myomatous nodes most often do not manifest themselves. However, with increasing size, a woman begins to notice a variety of signs. Most often these include the following:

stomach ache;
delayed menstruation or prolonged bleeding;
(with large formations);
constipation and intestinal obstruction;
pathology of the urinary tract and so on.

Myomatous nodes are usually round in shape and consist of intertwined muscle fibers. They can be single and multiple, located on a thin stalk or sit tightly on the surface of the reproductive organ.

How is uterine fibroids diagnosed?

This pathology is a common reason for visiting a gynecologist. Almost 250 out of 1000 women have fibroids at their next examination. Ways to detect a tumor can be different.

If the size of the neoplasm is less than 2 centimeters in diameter, then they can only be seen during an ultrasound examination. With the appearance of multiple foci and intensive growth, an experienced gynecologist can make a similar diagnosis by palpation. Also, uterine fibroids are often detected during computed tomography and magnetic resonance imaging.

Types of fibroids

As you already know, a tumor can be single or multiple. In addition, there is an additional classification that allows you to divide the pathology into ways of its formation. Tumor types can be as follows:

submucosal myomatous node (submucosal neoplasms with a thin stalk);
interstitial, or intramural formation (intermuscular pathologies located in the wall of the reproductive organ);
subserous appearance (located on the outer wall of the uterus and often has a leg);
intraligamentary tumor (a node located on the ligaments or between them).

In addition to those listed, cervical and birth nodes are less common. In this case, the body of the tumor is located in or simply hangs down into it.

Is it necessary to treat pathology

Myomatous node treatment may be different. It all depends on where the tumor is located. The presence of symptoms of the disease also plays an important role. If a woman does not express any complaints, then the doctor most often recommends simply observing the tumor. At the same time, regular examinations and ultrasound examinations are prescribed. When the tumor begins to gain momentum and grow, treatment is mandatory.

Correction can be done in several ways. Removal of fibroids is often recommended. However, for this there must be certain indications (increased growth, the presence of complaints, and so on). In addition, the doctor can choose conservative therapy. However, it does not always give a positive effect. Often, after hormonal correction, an increase in tumor growth begins, and it becomes even larger than at the very beginning. Consider the main methods of treatment of myomatous nodes.

Medical therapy

Most often, specialists prescribe hormonal agents containing gonadotropin-releasing hormone agonists. This group of drugs helps to reduce the production of estrogen. Due to this, tumor growth is reduced. However, after discontinuation of the drug, the opposite enhanced effect may occur. At the same time, the size of the tumor begins to increase rapidly and reaches its previous size. Often, a subserous myomatous node can enlarge its pedicle and become twisted.

In addition to gomons, it can be prescribed. It contributes to the thrombosis of some vessels. As a result, the nutrition of the tumor is disrupted. The subserous myomatous node and others may die off altogether. However, this does not guarantee that there will be no relapse.

Often drug therapy is used before surgery. In this case, the effect of the treatment will be maximum.

Arterial emmobilization

This procedure allows you to cure both the interstitial myomatous node and other types of tumors. It is performed exclusively within the walls of the hospital. It does not require the use of anesthetics and prolonged hospitalization.

The patient is introduced into the femoral artery catheter, which, under X-ray observation, penetrates into one of the uterine vessels. After that, a drug is injected that blocks the blood flow. The consequence of this is clogging of the arteries that feed the fibroids. You should not worry about the condition of the genital organ with such treatment. The flow of blood to it will be carried out through the remaining arteries and small vessels.

Ultrasonic exposure

An intramural myomatous node, like other types of a similar tumor, can be cured by exposure to ultrasonic waves. The procedure does not require anesthesia or hospitalization.

During the manipulation, the woman is located on the table, and the doctor directs the flow of waves to the pelvic area. The operation is performed under the control of an ultrasound or MRI machine. Radiation waves contribute to the heating of tumor tissues. In this case, neighboring organs are not damaged. Under such influence, the node dies, and its structure is replaced

This method of treatment is used in young women and nulliparous women. The manipulation is fairly new and costly. Unfortunately, not all medical institutions have the opportunity to provide such treatment.

removal of fibroids

Doctors recommend removing a subserous myomatous node with a surgical method. Such a formation is located on the outer wall of the genital organ. Most often, the tumor has a thin stalk that can twist. Also, this neoplasm can affect the work of neighboring organs: fallopian tubes, ovaries and intestines. The operation to remove such a tumor is performed under general anesthesia. In this case, a laparoscopic or laparotomy method can be used. With the help of special tools, the doctor excises the base of the fibroid stem and removes damaged tissue.

An interstitial myomatous node can also be removed in a similar way. However, this damages the tissues of the reproductive organ. There is a so-called resection of the mucous membranes. Such a correction can have rather disastrous consequences, especially if a woman is planning a pregnancy. That is why young patients are recommended to choose more modern methods of treatment.

Uterus removal

If a large size of myomatous nodes is found, the woman is shown the removal of the reproductive organ. However, it is worth considering the age of the patient and the presence of her children. Of course, if possible, the doctor tries to save the uterus. However, this does not always work out.

It is produced with extensive damage to the mucous membranes and the presence of symptoms that interfere with a normal life. The operation takes place under general anesthesia. In this case, the woman is hospitalized for several days.

What is the difference between subserous fibroids and interstitial nodules

These tumor formations differ in their location and influence on the work of the female body. So, the subserous node is located in the abdominal cavity. However, it does not cause frequent bleeding, unlike interstitial fibroids. Also, the tumor does not affect pregnancy and the process of conception. With such a disease, hormonal disruptions rarely occur. Whereas an interstitial tumor leads to anemia, large blood loss and frequent pain in the pelvis.

The consequences of fibroids

Most often, a pathology detected and cured in time does not cause any consequences and complications. If you have identified small nodes, then the correction can be postponed indefinitely. In this case, it is necessary to carefully monitor the growth of the tumor.

If you do not care about your health and do not pay attention to uterine fibroids, then it can quickly increase in size and lead to infertility. Also, pathology has the possibility of degeneration into a malignant form, but this happens very rarely.

Frequent bleeding and malfunctions of the body negatively affect the well-being of a woman. That is why, when a disease is detected, it is necessary to contact a gynecologist as soon as possible. Women after forty years of age should regularly visit ultrasound rooms and undergo preventive examinations. This will allow time to identify a possible neoplasm and begin treatment.

Summarizing

You now know a lot about uterine fibroids. Many women successfully become pregnant and give birth with such a pathology. However, during the bearing of the baby, the tumor can become larger and endanger the life of the fetus. Those women whose mothers and grandmothers suffered from uterine fibroids are more likely to develop such a pathology.

Take good care of your health. If you have questions or symptoms of the disease, contact your gynecologist for advice. If necessary, the doctor will prescribe additional studies and recommend treatment. Health to you!

Uterine fibroids is a benign formation of smooth muscle, randomly intertwining fibers, accounting for up to 25% of all diseases of the female genital area. The most common type is interstitial fibroids of the muscular layer of the uterus. About 35% of all diagnosed formations are subserous, submucosal is less common, very rarely - fibroids in the interligamentous space, the cervical region. Smooth muscle formations can develop by single or multiple nodes, multiple nodules are more often diagnosed.

Please note that this text was prepared without the support of our.

The disease is getting younger every year - it is found in young women, there are cases of detection of fibroids in girls. Most often, myomatous nodes are diagnosed in women over 35 years of age, as well as in menopause. The menopause is characterized by hormonal changes, during which the balance of hormones is disturbed, which becomes one of the reasons for the growth of smooth muscle nodes of the uterine wall.

Factors that influence the development of the disease are frequent abortions, trauma to the walls of the uterus, operations on the genital organ, diseases of the genital organs, the endocrine system and other factors. The real reason for the development of smooth muscle nodes has not been studied so far. Often the disease has a hereditary predisposition when it occurs in several women of the same family.

To inform women about the methods of diagnosis and treatment of fibroids, an expert council of doctors was created who devoted themselves to the study and development of methods for treating the disease while preserving the reproductive organ. Women with fibroids can turn to expert advice and get advice, doctors will answer all questions in time.

Knots in the body of the uterus

A healthy female reproductive organ is about 9-11 cm long in women who have given birth, the uterus is 4 to 5 cm wide. The reproductive organ has three layers - peritoneal (serous), muscular (myometrium), mucous (endometrium). The nodes in the body of the uterus consist of muscle tissue and connective tissue. The nodes of the muscular layer of the uterus are named depending on their location:

Developing in the myometrium are the interstitial nodes of the uterus.
Formations growing towards the endometrium are submucosal (submucosal) nodes.
Smooth muscle formations growing towards the abdominal cavity are called subserous fibroids.
Between the leaves of the broad ligament of the uterus - intraligamentary nodes.

The most common formation of the muscular wall (body) of the uterus, less often the cervix.

What is fibroids: subserous node

A subserous fibroid is a benign formation that has formed in the muscle layer and grows towards the abdominal cavity. It can be located on a wide base or a thin leg. The development of a smooth muscle subserous formation at the initial stage is asymptomatic, with its growth the first signs appear - pain in the lower abdomen, often radiating to the rectum, vagina, lower back. The most pronounced pain symptom is with a subserous node on a wide base. Single subserous formations are located in a dense capsule that separates them from surrounding tissues.

Subserous formation can be of several types:

Fibroid - consists of muscle fibers and a large amount of connective tissue.
Leiomyoma is bizarre - histological examination reveals giant cells with several large nuclei.
Leiomyoma - the formation consists of smooth muscle cells.
Leiomyoblastoma - the boundaries of the formation are fuzzy, the cells of the nodes have a band-forming, light eosinophilic cytoplasm.
Leiomyolipoma - in the nodular formation, degeneration processes occur and mature fat cells appear.

Reasons for development

The reasons for the development of the subserous node are not fully understood, the factors that influence its appearance and growth are known. Fibroids are sensitive to hormones - modified smooth muscle fibers have more receptors that are sensitive to hormones than healthy myometrium. The effect of steroid hormones on nodular formations leads to their rapid growth. Hormonal disruptions, imbalance of hormones is observed during pregnancy, menopause, in overweight women. Various factors contribute to the appearance and growth of nodes:

Diagnostic curettage, abortion, difficult childbirth.
hereditary predisposition.
Chronic inflammatory processes in the female genital organs.
Diseases of the ovaries.
Diseases of the endocrine system.
Infertility.

The size of the uterine node determines the stage of development of the disease:

Small - 20 (mm).
Medium - from 20 to 60 (mm).
Large - from 60 (mm) and more.

Uterine fibroids are also described in terms of weeks of pregnancy - the size of the uterus corresponds to a certain week of pregnancy.

Subserous node along the anterior and posterior wall of the uterus

A growing subserous node along the anterior wall of the uterus can lead to the development of problems with urination, squeezing of the ureter, the development of kidney disease (pyelonephritis), dysfunction of the kidneys and bladder. A growing subserous fibroid on the back wall of the uterus compresses the intestines, blood circulation in the intestines is disturbed, and constipation occurs.

Subserous node on the leg in the uterus

Subserous formation is often located not on a wide base, but on a thin stalk. The leg can be long and thin, the subserous node on the leg is located in the abdominal cavity. This arrangement is very dangerous - torsion of the leg or its injury can cause necrosis of the tissues of the myomatous formation, the development of complications. The patient has a high temperature, there is severe pain in the abdomen, weakness, if the condition worsens, the patient loses consciousness. The situation becomes dangerous for the health and life of a woman.

Diagnostics

If symptoms of fibroids appear, you should immediately undergo a diagnosis of the disease, to a gynecologist. Subserous fibroids often cause pain while walking, pain and discomfort during intercourse, the ability of the myometrium to contract is impaired, menstruation becomes profuse and painful. Early diagnosis will help preserve childbearing function, reduce the risk of complications. Small fibroids respond better to treatment than large nodules.

Diagnosis of the disease begins with an examination by a gynecologist. During the examination, the doctor determines the condition of the uterus, the presence of deformation of the organ, its size. Changes in contours, size, pain during examination become the reason for the appointment of diagnostic studies. To diagnose the disease, they are sent for ultrasound, MRI or CT, various tests. Additionally, laparoscopy or hysteroscopy may be prescribed to examine the tissues of the formation.

Histological examination will determine the type of fibroids. Due to malnutrition, the subserous node has areas of necrosis, mucoid and myxomatous dystrophy, hyalinosis, hemorrhages, and calcification. Ultrasound will help determine the localization of fibroids, its size, tissue structure, the state of organs and tissues located next to the fibroids. Magnetic resonance imaging serves to clarify the nature of the formation, helps to determine the benignity or malignancy of the formation.

Subserous myomatous node of the uterus: complications

The growth of subserous formation can lead to various complications. One of the complications is the torsion of the legs of the subserous node, causing tissue necrosis, the development of the inflammatory process. A growing subserous node can compress neighboring organs, disrupt the blood circulation of tissues - this leads to the development of congestion in the bladder and intestines. A large formation can deform the uterus, cause the organ to bend, the position of the uterus will prevent conception. Fusion of myomatous formation with the peritoneum causes severe pain during movement, physical exertion. When the capsule of the subserous node is ruptured, the contents enter the abdominal cavity, peritonitis develops, which can be fatal in case of untimely assistance.

Subserous node in the uterus: to operate or not

For surgical treatment, there are certain indications - a large size of fibroids, torsion of the pedicle of the node, peritonitis, various complications that require immediate surgical intervention. To operate or not to operate on fibroids - only a doctor can answer, who will be guided by the individual characteristics of the patient's body, her state of health, and the size of the fibroids.

Subserous node of the uterus and pregnancy

This type of formation rarely affects conception and pregnancy, the course of pregnancy depends on the size and location of the node. If there is a large node, it is recommended to remove it before planning pregnancy.

Uterine fibroids, subserous node: treatment

When prescribing treatment, the doctor is guided by the age of the patient, the size of the formation, its localization, the general condition of the patient, the presence of concomitant diseases. A woman is being tested for endometriosis, tumors of the uterine appendages, cancer of the mucous layer of the uterus - the endometrium. Drug therapy is not prescribed: in the presence of large nodules, prolonged and heavy bleeding, rapid growth of the node. Young women with small nodules are prescribed oral contraceptives, the Mirena spiral with hormonal content is recommended, and hormonal therapy is carried out.

Treatment of fibroids is carried out using organ-preserving methods and radical surgery (removal of the reproductive organ), when the uterus is significantly deformed, the myomatous nodes are huge, the course of the disease is complicated.

Uterine artery embolization (UAE) is one of the organ-preserving methods. Embolization of the uterine arteries allows the treatment of all myomatous nodes during one procedure, does not require the use of general anesthesia, the procedure is bloodless and painless. The doctor performs UAE through a puncture of the femoral artery, observing the passage of special microballoons - emboli - into the vessels of the fibroids. Together with emboli, a contrast agent is used, which helps to observe the entire process of movement of polymer particles through the vessels, blocking the vessels of the nodular formation. Complete destruction of nodes occurs within a few months. After the procedure, performed by an experienced specialist, a woman can plan a pregnancy.

Treatment of fibroids should be carried out in modern, specialized in the treatment of the disease, using a variety of treatment methods, including the most modern techniques.

Bibliography

Lipsky A.A.,. Gynecology // Encyclopedic Dictionary of Brockhaus and Efron: in 86 volumes (82 volumes and 4 additional). - St. Petersburg. 1890-1907.
Bodyazhina, V.I. Textbook of gynecology / V.I. Bodyazhina, K.N. Zhmakin. - M.: State publishing house of medical literature, 2010. - 368 p.
Braude, I.L. Operative gynecology / I.L. Braude. - M.: State publishing house of medical literature, 2008. - 728 p.

It is quite common among benign formations.

It has many varieties - some tumors develop inside the uterus, others are located on the outer layer of the uterine body, and others are formed in the muscle layer of the organ. One of these varieties is subserous myomatous tumor.

What is subserous uterine fibroids?

Typically, such formations have a fairly wide base, which is connected to the uterine tissues through a thin stem. This leg is a kind of channel through which nutrition for the tumor passes. The nodule may be single, although there are also multiple formations of a small size.

Similar myomatous tumors are found more often in women of reproductive age. They grow slowly and develop latently. A subserous myomatous tumor is dangerous due to torsion of the stem, which results in necrosis of tumor tissues.

Causes

The main factor contributing to the development of benign subserous tumors in women is changes in the hormonal status in women.

According to doctors, a tumor is not able to form in a healthy body, therefore, specific prerequisites are needed for its development, such as:

Operative manipulations in the female genitourinary organs. This category includes various diagnostic curettages, abortions, laparoscopic studies, etc. These interventions injure the uterine muscle tissue, which provokes the appearance of a tumor;
Genetically determined predisposition to this pathology;
The presence in the anamnesis of operations on;
Various kinds of inflammation or infection in the urogenital area;
Long-term contraception with hormonal contraceptives;
Tumors in the appendages or mammary glands;
Functional problems in the thyroid and adrenal structures.

Usually, the causes of the disease are a group of factors that, to varying degrees, affect the formation of the myomatous process in the uterine body.

Clinical picture

Outwardly, a subserous tumor looks like a node. This type of myomatous formations is considered the safest, since it differs in outwardly uterine localization and grows towards the retroperitoneal space. Such a tumor does not provoke an increase in the uterine body and is not able to affect the menstrual cycle.

Such a formation does not harm pregnancy, which occurs without difficulties with such a disease, the subserous formation cannot damage delivery, however, it is quite capable of causing spontaneous miscarriage.

Sometimes there are reproductive difficulties if the formation is located in the immediate vicinity of the pipes and pinches them.

Since the formation grows into the abdominal space, it develops mainly without symptoms, at least during the period when the node is small. When the formation grows, it begins a compression effect on the surrounding tissues and organic systems, which leads to their functional disorders.

In general, subserous myoma formation can be characterized by the following symptoms:

Frequent constipation;
Hemorrhoidal inflammation;
Difficult and frequent urination, causing pain;
Hyperthermia
hypersweating, dizziness;
Discomfort in the abdomen and lower back in a sitting or standing position;
Pain symptoms of a aching nature, localized in the area above the pubis, in the lower back, lower half of the abdominal wall.

Pain symptoms tend to occur against the background of a long stay "on the legs", long walking or heavy physical exertion. Often, the pain becomes cramping in nature, which indicates the development of an exacerbation or active growth of the tumor.

The severity of pain symptoms is usually determined by the parameters, location and development of the myomatous node. If the tumor grows together with the abdominal wall, then the patient will constantly suffer from pain.

Varieties

Subserous myomatous nodes are multiple or single.

Single ones are distinguished by the presence of a shell like a capsule.

Multiple formations are found somewhat less frequently, but they are accompanied by more pronounced painful symptoms.

If multiple myomatosis becomes large, then compression of neighboring structures occurs, which disrupts their activity. In addition, they are divided into interstitial or intramural uterine fibroids.

intramural

Intramural subserous fibroids are localized on the outer uterine layer. Such education is considered the most “safe”, because it does not affect the size of the uterine body and the menstrual cycle, and does not impair reproductive abilities.

Such a tumor is formed from smooth muscle fibers, as well as connective tissue structures. It is believed that such a fibroid occurs in a kind of lightweight version.

Interstitial subserous

The subserous-interstitial myomatous node is formed in the thickness of the wall of the uterine body, but grows towards the pelvic cavity. This formation belongs to the category of mixed tumors and is somewhat different from the traditional subserous tumor.

It develops in the muscle layer, therefore, leads to some increase in the body of the uterus. An interstitial subserous myomatous node can negatively affect the surrounding tissues, but its size rarely exceeds 10 cm.

stages

Specialists stage the development of such myomatous formations into several stages:

The first stage - active growth is observed, the tumor is distinguished by the full flow of metabolic processes and increased vascular permeability;
Second the stage is characterized by rapid progression, but it is not yet possible to detect education without microscopic examination;
On the third stage, myomatous formation is easily detected during a medical examination.

Typically, such tumors are of a multiple nature, when several formations develop simultaneously.

Why is this disease dangerous?

The danger of subserous fibroids lies in the high probability of torsion of the leg, through which the formation receives the necessary nutrition. Such a complication is usually caused by atrophic tissue changes.

As a result of such changes, necrosis of tumor tissues occurs, provoking purulent-inflammatory processes in nearby structures.

Tissue death is usually accompanied by hyperthermic symptoms, intense pain, severe tachycardia symptoms, excessive sweating, dizziness, and other intoxication symptoms.

Diagnosis and treatment

When diagnosing subserous myoma formations, more often than others, such diagnostic measures are used as:

Echography;
Magnetic resonance imaging, which allows you to get a layered image of the tumor;
Diagnostic curettage in this case is carried out to determine changes in the mucous membranes of the uterine tissues;
Hydrosonographic diagnostics - allows you to detect even the smallest tumors and determine the degree of their development;
Laparoscopic examination is used if it is impossible to differentiate the pathology.

Most often, the treatment of the subserous form of uterine fibroids is operational, especially in the presence of large formations, profuse blood loss, torsion of the leg, rapid growth and progression of the tumor.

In the photo, a removed subserous uterine myoma

For the implementation of surgical manipulations, several common techniques are used, such as laparoscopic myomectomy, which is the removal of the tumor through several punctures by exfoliation.

In addition, hysteroscopic myomectomy is also used, when the node is removed through the vagina. In difficult cases, the formation is removed along with the appendages and the uterus, i.e., a total hysterectomy is performed.

In recent years, it has been widely used, involving the removal of a tumor by means of ultrasound.

Treatment with folk remedies

Among the folk methods of treating subserous uterine fibroids, healing ointments, extracts, medicinal tinctures or vaginal suppositories are especially popular with patients. Usually, for the preparation of such drugs, raw materials are used in the form of poisonous plants that have antitumor activity.

Therefore, such drugs should be taken with the utmost caution. Experts do not exclude the presence of a therapeutic effect from such medicinal remedies of traditional medicine, however, they recommend using them as an additional therapy and in the absence of contraindications.

Forecast and prevention

Subserous forms of myomatous formations are distinguished by a high rate of goodness, therefore they do not have a tendency to malignancy. The prognosis is generally positive, however, in the presence of rapid growth and progression of the pathology, surgical intervention may be necessary.

Even benign tumors can significantly ruin a woman's life and deprive motherhood of opportunities. Therefore, it is necessary to contact a specialist when the first suspicions of a pathology appear.

An annual gynecological examination will serve as an excellent prevention of the neglect of such tumors, since it allows them to be differentiated in a timely manner.

In addition, for the prevention of myomatous formations, it is necessary to avoid abortions, give birth and breastfeed a child up to the age of 30, treat gynecological problems in a timely manner, control hormonal status, and avoid long-term hormonal contraception.

This is the only way to protect yourself from the occurrence of serous uterine myomatous formations, and, therefore, to avoid possible complications such as infertility, purulent-inflammatory processes in the uterus and total hysterectomy, which deprives the patient of the chances of successful motherhood.

The video shows the laparoscopic operation of subserous uterine fibroids: