Many diseases of the organs of the female reproductive system are directly related to hormonal processes occurring in the body. Pathologies arise from an imbalance in female sex hormones, as well as the factors that cause it. Such violations can become, in particular, the cause of fibroids and other benign and even malignant neoplasms in the uterus. Symptoms of the disease may not appear immediately. The more it is started, the more difficult the treatment and the more likely complications are.

Content:

Myoma of the uterus and its types

Myoma is a benign tumor that forms from the muscle and connective tissue of the uterus. Most often it appears in women after 30-40 years. In most cases, there are no clear signs of uterine fibroids. Therefore, preventive examinations by a gynecologist play an important role. An ultrasound scan helps to notice the tumor.

This tumor is hormone-dependent, that is, under the influence of female sex hormones, its growth begins. Therefore, it begins to increase during pregnancy, when the ratio of hormones in the blood changes sharply, as well as in obesity. Adipose tissue is capable of producing estrogens, just like the ovaries. Exceeding the level of these hormones leads to abnormal development of cells, the emergence of pathological neoplasms.

Fibroids are nodes in the myometrium (muscle fibers). The formation of a tumor occurs from one atypical cell, which then begins to divide, causing the growth of the neoplasm. There are various options for the growth of a tumor in the uterus. Depending on the direction of development, the following types of fibroids are distinguished:

1. Interstitial. Formed in the thickness of the myometrium.
2. Submucous (or submucosal). It grows from the muscle towards the lining of the uterus.
3. Subserous. It grows in the direction of the abdominal cavity.
4. Intraligamentary - formed between the ligaments of the uterus.

The appearance of uterine fibroids usually occurs in her body, but in rare cases, it is also possible in the cervix. Fibroids that develop in muscle tissue are considered typical, and those that develop in the neck or ligaments are atypical.

Neoplasms that emerge on the inner or outer surface of the uterus (submucous and subserous myoma) are a thickening on the leg, pierced by blood vessels. There are single nodes that, when growing, can fill the entire uterus, even move into the peritoneal region. Most often, fibroids appear in the form of several nodes of different sizes. At the same time, the shape of the uterus changes, its weight increases.

Video: Why fibroids occur. Symptoms and Treatment

Factors contributing to tumor formation

Myoma appears as a result of the mutation of a single cell. Its further division and development of the tumor is affected by a change in the hormonal background in the body, a violation of the ratio of estrogen and progesterone. During menopause, when the production of female sex hormones decreases, the tumor may disappear on its own.

In addition, the cause of the formation of nodes in the uterus is:

1. Metabolic disorders, liver diseases, pancreas, diabetes mellitus.
2. The presence of hypertension, especially under the age of 35 years.
3. Inflammatory processes in the cervix and uterine cavity.
4. Obesity, which is promoted by unhealthy diet, insufficient physical activity. The risk of developing such a tumor is less in women whose diet is dominated by vegetables, fruits, herbs or low-calorie animal products.
5. The time of the appearance of the first menstruation, the onset of sexual activity. Early menopause also provokes the formation of this tumor.
6. The presence of pregnancies (full-term and terminated). The likelihood of fibroids is lower in women who have given birth at least once, breastfeed for more than six months.
7. The cause of uterine fibroids can be damage to the endometrium during abortion, the installation of an intrauterine device. Injury to the mucous membrane also occurs during curettage for the purpose of diagnosing and treating gynecological diseases (endometriosis, the formation of cysts, polyps).
8. Constant nervous overload and depression can contribute to the occurrence of hormonal disorders. City women live in a more intense rhythm, so they develop fibroids more often than rural women. The environmental situation in the city is also more difficult. The likelihood of the appearance of cellular mutations is increased here.
9. The most important role is played by heredity.

A warning: Myoma most often occurs against the background of other serious diseases. It can grow rapidly, which greatly complicates treatment. To avoid serious consequences, it must be diagnosed as early as possible, without delaying a visit to the doctor and without wasting time on self-healing.

Symptoms and Signs

Obvious symptoms of the disease can appear if the neoplasm is already large enough. At an early stage, when it would seem that there are no reasons for the formation of uterine fibroids, a woman may not be aware of her presence. There may be a slight feeling of heaviness in the lower abdomen, discomfort during intercourse.

As the tumor grows in size and new nodes form, the discomfort increases more and more. One of the first symptoms of trouble is a change in the nature of menstruation. Their duration increases to 8-10 days. There are significant fluctuations in the duration of the pauses between menstruation. Menstrual flow becomes profuse and contains blood clots. Spotting may occur between periods.

The growing tumor presses on the bladder, so there is a frequent urge to urinate, it becomes more difficult. Pressure on the intestines leads to constipation, bloating. Compression of the nerve endings in the pelvic organs causes pain that radiates to the back and legs.

There is a growing feeling of heaviness, the presence of something foreign in the abdomen. Sexual contact becomes painful (in the case of the location of the nodes on the side of the vagina). The belly grows, as during pregnancy. The sprain increases the pulling pain in the abdomen.

As a result of profuse blood loss, anemia occurs (a lack of hemoglobin in the blood, leading to oxygen starvation of cells). A woman develops signs such as pallor, weakness, dizziness, heart rhythm disturbances, headaches.

Myoma, in contrast to a cancerous tumor, grows slowly, so the chances of detecting it by the first signs are much greater.

Complications

The growing tumor constricts the blood vessels, which leads to a violation of its blood supply. The result is the death of tumor tissue (necrosis) or the formation of areas of suppuration. At the same time, the woman has an increase in the content of leukocytes in the blood. The body temperature rises.

A serious complication is the twisting of the leg of the superficial node. At the same time, there is a violation of blood flow and the formation of tissue necrosis. This pathology is manifested by a sharp spasmodic pain.

The degeneration of fibroids into a malignant tumor (sarcoma) is rare. The rapid growth of the tumor, especially during menopause, when it appears extremely rarely at all, may indicate a malignant transformation. Therefore, if even a small fibroid is detected, it is necessary to regularly do ultrasound, to monitor its condition.

As a result of heavy menstrual and prolonged bleeding, anemia occurs - a condition that is dangerous to health, leading to disruption of all organs and systems of the body.

Such a tumor can cause infertility or miscarriage, since the proliferation of nodes and a change in the shape of the uterus interferes with the normal movement of the fertilized egg and its attachment to the endometrium.

Myoma of the uterus during pregnancy

Pregnancy can trigger the formation of these tumors. If a woman has them earlier, then their growth during this period usually stops (the diameter reaches a maximum of 5 cm). A woman is worried about nausea, occasionally a slight increase in temperature.

However, there is a risk of the following complications:

• childbirth before 37 weeks, if the fibroid is located near the placenta, especially when there are several nodes;
• spontaneous termination of pregnancy at an early stage;
• partial detachment of the placenta, accompanied by bleeding;
• incorrect presentation of the fetus due to deformation of the uterus;
• decreased ability of the uterus to contract normally during labor.

Therefore, usually in the presence of uterine fibroids, a woman undergoes a cesarean section. In this case, it is also possible to remove nodes. After such an operation, infertility is not threatened. She may subsequently become pregnant and give birth to a healthy baby. During pregnancy, myoma does not affect the development of the fetus, cannot cause its intrauterine death.

Video: Symptoms of fibroids, complications after treatment

Treatment

The main goal of treatment is to eliminate the cause of the disease and the harmful effects of the tumor on the surrounding tissues of the uterus, reduce its size, and stop growth. Both medical and surgical methods are used.

The drugs are prescribed in accordance with the cause and manifestation of the disease. It is possible to use antibiotics (to eliminate inflammatory processes), hormonal drugs (to restore the balance of hormones, normalize the menstrual cycle). A woman is prescribed treatment with iron preparations against anemia, as well as complex vitamins (especially A, E, C), which also contain zinc, iodine, and copper. They help accelerate the regeneration of endometrial cells destroyed by the tumor, increase the body's defenses. Pain relievers and sedatives are used as needed.

Note: Hormonal drugs are selected individually after a blood test for hormones. Violation of the treatment regimen or dosage can lead to the opposite effect. Uncontrolled treatment of fibroids with herbs or herbal remedies is unacceptable.

Surgical treatment is used in cases where the node is large, fibroids are accompanied by bleeding, anemia. The operation is performed if the tumor grows rapidly, disrupts urination or bowel function, and also blocks the cervix.

The consequence of the operation can be infertility due to the formation of scars and adhesions in the uterus. Therefore, in childbearing age, medication is often used. In older women, fibroids are removed if they grow rapidly.

Methods used include myomectomy (removal of tumor nodes, preservation of the uterus) and the method of uterine artery embolization (cessation of the blood supply to the tumor by blocking the vessels, after which the myoma dries up).

Video: Principles of treatment of fibroids. Indications for surgery

One of the most pressing problems for modern women has become a disease such as fibroids.

In this article, you can find out what it is, how to treat it, and whether it is dangerous. In an accessible language, everything about uterine fibroids in women will be described in detail: symptoms and treatment, classification, causes of occurrence, complications and consequences.

Attention: at the end of the article, live photos of the formations will be provided, so viewing them is not recommended for impressionable and easily inspired people! Videos of actual operations will also be provided.

First, let's figure out the definition of the disease and its varieties.

What is fibroid

Myoma of the uterus is a disease of the female reproductive system, which is characterized by the formation and growth of a benign tumor in the uterus, namely in its muscle layer. Most often, such a disease is found in a woman of 30-40 years of age or more. But there are more and more cases when this diagnosis is made at a younger age, including virgins 20-25 years old.

Fibroid nodes can be located inside the body of the uterus, this type of localization is found in 95% of cases, and in the cervix in 5% of patients. If a tumor develops from connective tissue, it is called fibroma, and if it develops from muscle tissue, it is called leiomyoma.

The growth rate of the neoplasm depends on the hormonal background, therefore, one of the methods of treatment is hormone therapy, but surgery is a more effective option to eliminate the problem.

Views

Depending on the location relative to the myometrium, the classification of fibroids will be as follows:

• intermuscular (interstitial, intramural) - the node is located inside the muscle layer;
• subperitoneal (subserous) - the node is located near the peritoneum under the mucous membrane of the outer layer of the uterus;
• submucous (submucous) - the node is located in the uterine cavity under its inner mucous layer;
• interconnective (intraligamentary) - the tumor is located between the wide uterine ligaments.

There are also different types of nodes, they can be on a leg or on a flat base. By the number of nodes, myoma can be single or multiple, but most often the occurrence of one node entails the appearance of other neoplasms.

By size

Gynecologists indicate the size of fibroids in centimeters, meaning the size of the node itself, or in weeks. If the diagnosis says "fibroids of 13 weeks," then the uterus with the myomatous node has increased to the size that is characteristic of pregnancy at 13 weeks. Based on these criteria, the tumor can be classified into 3 types:

• small size- up to 2 cm (4 weeks);
• average- 2-6 cm (10-11 weeks);
• large sizes- more than 6 cm (12 and more weeks).

Why are uterine fibroids dangerous?

Any tumor poses a danger to the human body, since it is an abnormal neoplasm for it.

At the initial stages, some women still do not fully understand how dangerous a benign education is, but with its growth, they begin to feel the constriction of organs in the small pelvis. In the presence of fibroids, blood circulation in neighboring organs is disturbed, since the formation itself acquires its own vascular network. In addition, fibroids can be a sign of endocrine disorders, which in turn can cause additional health problems.

What will happen if you do not treat

Many women who have been diagnosed with fibroids wonder what will happen if it is not treated. We list all the consequences of indifference to this disease:

• habitual miscarriages, hypoxia, fetal malnutrition;
• infertility;
• uterine bleeding, which provoke the development of anemia;
• the neoplasm can develop into a sarcoma, from which, as a result, a woman can die;
• rapid increase in tumor size;
• torsion of the legs of the myomatous node with malnutrition in it;
• decreased uterine tone, which leads to postpartum blood loss;
• hyperplastic processes of various types;
• hydronephrosis or pyelonephritis.

What provokes the appearance of education

The exact reason due to which fibroids appears, modern medicine has not yet established, but there are a number of factors that can increase the likelihood of developing it:

• genetic predisposition;
• hormonal imbalance;
• hyperplastic processes in the endometrium;
• pregnancy, childbirth and termination;
• infectious and inflammatory diseases of the reproductive system;
• chronic stress;
• diabetes mellitus and diseases of the endocrine system, problems with excess weight;
• chronic diseases of internal organs and systems, hypertension;
• low physical activity;
• irregular sex life and lack of orgasms.

Let us consider in more detail some of the reasons due to which the appearance of fibroids is most likely:

• excess estrogen, lack of progesterone. Since myoma is a hormone-dependent neoplasm, it can develop against the background of hormonal imbalance. It is quite natural that it is most often diagnosed in women of childbearing age, usually with an imbalance of estrogen and progesterone. Obesity only exacerbates the situation, since adipose tissue is also capable of producing estrogen;
• pregnancy, childbirth and abortion. Abortion, diagnostic curettage, difficult childbirth and spontaneous abortions increase the likelihood of a neoplasm, and successful childbirth, especially with subsequent breastfeeding, on the contrary, reduces the risks;
• woman's food. Unbalanced nutrition and junk food can disrupt the hormonal balance in the female body. Refined foods, trans fats, and fiber deficiencies increase the concentration of female sex hormones. Unhealthy food can lead to obesity and, as a result, to the development of fibroids. A woman needs to eat a lot of vegetables, fruits, seafood, cereals, less fat and sugar;
• inferiority of intimate life. Due to irregular sexual intercourse and the absence of orgasms, venous blood stagnates in the pelvic organs, which can lead to hormonal disorders and the development of a tumor.

Oral contraception, mechanical trauma to the reproductive organs, prolonged exposure to ultraviolet radiation on a woman's body can also provoke the development of fibroids.

Diagnostics

The doctor may suspect the presence of fibroids during a routine gynecological examination, since the size of the uterus in this disease will be increased. Diagnosis of pathology may include the following activities:

• transvaginal ultrasound of the pelvic organs. On ultrasound, you can evaluate the size and shape of the tumor;
• hysteroscopy. During the procedure, the doctor can simultaneously biopsy the affected area and send the resulting material to the histological laboratory;
• laparoscopy. Assign in case of controversial situations when it is impossible to distinguish uterine fibroids from ovarian tumors;
• CT and MRI. Research, although informative, is expensive, and therefore rarely used.

How does the tumor manifest itself?

In the early stages, the disease may not manifest itself at all, the first ones can appear when the size of the knot reaches 2-6 cm:

• sharp pains in the lower abdomen, which are not associated with the onset of menstruation. The nature of the pain is cramping, pulling;
• painful periods, although before they did not have such a feature;
• increased menstrual flow;
• profuse intermenstrual bleeding;
• failure of the regularity of the menstrual cycle, both its lengthening and shortening;
• problems with conception.

The symptomatology of this disease depends on its obstruction, the patient's age, the size and location of the neoplasm, the rate of its growth and the presence of concomitant chronic diseases.

Very often, myoma does not make itself felt in any way, it can only be detected during the next gynecological examination. Feeling the abdomen, the doctor will find an enlarged uterus and without fail send the woman for an ultrasound scan, where the echoes of fibroids will confirm the preliminary diagnosis.

This disease has a number of characteristic symptoms, having found which, it is necessary to urgently consult a doctor:

• pain in the intermenstrual period, which are felt in the lower abdomen and radiate to the lower back and limbs;
• menstrual irregularities. The duration of the cycle changes, menstrual pain intensifies, the intensity of discharge increases during regulation, bleeding begins in the middle of the cycle;
• a woman cannot get pregnant for a long time.

If the myomatous node rapidly increases in size or already has an impressive volume, the girth of the abdomen also increases, while the body weight remains practically unchanged. Discomfort and aching pains are felt in the lower abdomen, which increase during psycho-emotional and physical exertion.

Large fibroids can press on adjacent organs, thereby provoking constipation, frequent trips to the toilet "small" and painful urination.

If the leg of the myomatous node is twisted, the body of the fibroid may necrotize, in addition, symptoms of "acute abdomen" may appear, such as sharp pain in the lower peritoneum, accelerated heartbeat, cold sweat, fainting. In such cases, an emergency removal of the fibroid is performed.

Pathology can affect other organs and systems, which provokes the appearance of such symptoms:

• with frequent bleeding, anemia develops;
• may often be ill and dizzy;
• hurts behind the breastbone;
• neuroses and neurotic states arise.

If any of the above symptoms appear, you should definitely seek medical help.

Is it being treated or not?

Patients who have not previously encountered gynecological problems, having learned about the diagnosis of "myoma", do not have an exact idea of ​​whether the pathology is cured or not.

Although uterine myoma is a tumor-like disease with a number of tumor characteristics, it still has a number of distinctive features that allow treating the ailment not only with surgical methods, but also with conservative ones.

The most pleasant feature of this neoplasm is its ability to shrink and disappear completely.

The choice of the method of treatment is carried out individually, depending on the severity of the disease and the characteristics of the organism, only in extreme cases, surgical intervention is performed.

How to treat uterine fibroids

There are 2 ways to treat fibroids:

• conservative treatment, in which the administration of drugs and non-invasive procedures is prescribed;
• surgery, at which the operation is performed.

What to do in each specific case can be determined solely by the doctor.

How the treatment of uterine fibroids will be carried out will depend on the severity of the pathology, clinical symptoms, the size of the neoplasm, the patient's age and the intention to have offspring in the future.

Treatment of fibroids with drugs will be effective only under certain conditions:

• with a small size of the node, when the uterus does not exceed 12 weeks of pregnancy in size;
• if the disease is accompanied by a small number of symptoms;
• when the node has a wide base and is located subserous or inerstitially.

Fibroids can be treated in the early stages, the longer the neoplasm is present in the woman's body, the less the possibility of using conservatism in treatment. If there are serious contraindications to the operation, drug treatment is the only way out.

Treatment without surgery includes the following set of measures:

• adherence to a diet;
• the use of immunomodulators;
• phytotherapy;
• physiotherapy procedures;
• hormonal drugs.

In the course of drug treatment, a patient with fibroids goes through the following stages:

• inflammation and infection are eliminated;
• the work of the immune system is activated with the help of special drugs;
• the diet and daily routine are adjusted;
• the work of the endocrine system is normalized;
• an even psychological background is formed;
• bleeding is eliminated and anemia caused by it is treated;
• the menstrual cycle is normalized.

Having found a fibroid in a patient, the doctor determines the rate of development of the pathology in a year. If it grows in a year to the size of a 4-week pregnancy, then it is considered fast-growing and proceeds to surgical treatment.

Now let's look at each of the treatment methods in more detail.

Medications

Conservative treatment is carried out using the following groups of drugs:

• derivatives of androgens;
• gestagens;
• combined oral contraceptives;
• analogs of gonadotropin-releasing hormone aGnRH.

One of the innovative medicines is Esmya, the main active ingredient of which is ulipristal acetate. This medicine for 3 months of treatment in patients who were prescribed surgery, significantly reduces the size of the neoplasm and reduces the intensity of symptoms, and in 50% of cases, the need for surgery has disappeared. The pills have no side effects, and six months after their use, the tumor does not resume its growth.

Now let's take a closer look at drugs from other groups.

Gonadotropin-releasing hormone agonists

These drugs introduce a woman into an artificial menopause, suppressing the function of the ovaries with hormones. Agonist drugs of natural gonadotropin-releasing hormones suppress the secretion of sex hormones by the pituitary gland, which affect the activity of the ovaries. The drugs in this group include:

• Buserelin;
• Triptorelin;
• Leiprorelin;
• Goserelin.

Under the influence of drugs, the ovaries suspend their activity, ovulation does not occur, the inner uterine layer does not change and menstruation stops coming. This is a reversible process, after the drug is discontinued, the ovaries resume their work. The course of treatment is six months. During this time, the size of the neoplasm should decrease by 50%, and the symptoms should decrease significantly.

These medicines have a number of disadvantages:

• fibroids can fully recover in size after stopping drugs;
• the drug should not be taken for more than six months, as the risk of osteoporosis and other complications due to estrogen deficiency increases.

Most often, agonist drugs are prescribed before surgery to reduce the size of the neoplasm.

Antigonadotropins

Most often, Danazol and Nemestran with the active substance gestrinone are prescribed from this series. These medications reduce the severity of symptoms but do not shrink the fibroids. When taking them, a number of side effects are possible:

• hair on the face and body is growing vigorously;
• the timbre of the voice changes;
• rashes appear.

These drugs are most often prescribed in the absence of the effect of hormone therapy.

Gestagens

The drugs in this series include Dyufaston, Norkolut and Utrozhestan. They normalize the growth of the endometrial layer in the presence of hyperplasia, which occurs against the background of fibroids. Fibroids are poorly treated with gestagens, they are prescribed only when the neoplasm develops simultaneously with endometrial hyperplasia. The course of treatment is 8 months.

Another means, which includes gestagen (levonorgestrel), is the Mirena intrauterine device. It is put on for 5 years and in addition to blocking the growth of the tumor, it also has a contraceptive effect.

Antiprogestogens

Operations

Unfortunately, drug treatment can not always give a good result.

If fibroids cannot be treated with conservative methods, surgery is indicated. To begin with, let's consider in what cases an operation for myoma is prescribed.

Indications for surgery

The operation is prescribed in the following conditions:

• the size of the node exceeds the uterus of the 12th week of pregnancy;
• the tumor presses on the nearest vessels and organs, interfering with their normal functioning;
• the neoplasm provokes profuse bleeding;
• there is very strong pain;
• the leg of the knot twisted, and its dying off began;
• a submucous myomatous node appeared;
• in addition to fibroids, endometriosis was diagnosed;
• there is a suspicion of malignant processes in the neoplasm;
• if the tumor grows very quickly, an operation is urgently needed.

Now let's take a closer look at the types of surgical interventions and situations in which they need to be used.

Embolization

Recently, a lot of practicing surgeons have been using the method of uterine artery embolization. This is a minimally invasive intervention, during which an embolus is injected into the uterine vessel, it blocks the arterial lumen. The blood supply to the myoma node stops, and its tissues die off.

This is the most effective method for patients with fibroids who are still planning to have children in the future.

Hysterectomy

The most radical method in which the organ is completely removed. There are 3 options for online access:

• abdominal- the most commonly used method, which involves supravaginal amputation of the uterus or its extirpation. A common negative consequence of extirpation is urinary incontinence. Supravaginal amputation is possible if the cervix is ​​healthy and the nodes between the cervix and the uterus are not large;
• laparoscopic;
• vaginal- it is used for small sizes of the myomatous node.

Before the operation or during it, the surgeon determines the advisability of removing together with the uterus and ovaries. The decision is made individually in each case, taking into account the age of the patient and the presence or absence of neoplasms on the ovaries.

This method is prescribed in such cases:

• fibroids are larger than 13 weeks of gestation;
• drug treatment is ineffective;
• the tumor is growing rapidly;
• the ovaries are swollen;
• acute bleeding began.

Myomectomy

Women who are of reproductive age and still want to have children are initially given recommendations on how to cure fibroids with medication, if they do not help, then a conservative myomectomy can be prescribed. During this intervention, the myomatous node is exfoliated to healthy tissue. The intervention is performed laparoscopically or abdominal.

Fuzz ablation

This is a non-invasive method of treating pathology, which is carried out under the supervision of MRI. During the procedure, the cells of the myomatous node are heated by an ultrasonic pulse until they are completely destroyed.

The process is carried out in several stages. Initially, the doctor examines the tumor and plans the operation using an MRI. At the second stage, under the control of an MRI machine, the doctor begins to heat the cells of the node to a certain temperature with ultrasound pulses. After cell death, the specialist cools the tissue. Depending on the size of the tumor, there can be several such sessions. The procedure itself takes about 4 hours. Control MRI is done using contrast.

Since FUS ablation is a non-invasive technique, it has many positive aspects:

• no need for anesthesia and postoperative care;
• no complications and side reactions, such as bleeding, fever and intoxication;
• both the uterus and the woman's reproductive function are preserved;
• rehabilitation passes quickly;
• no relapses;
• the method is also effective in treating large nodes;
• myoma decreases in size immediately after the session;
• you can quickly get rid of uncomfortable symptoms.

During the procedure, the patient lies motionless on her stomach. In case of any discomfort, she immediately informs the attending physician about it. The procedure should not cause burning, stabbing or shooting pain, therefore, the appearance of such symptoms should be immediately reported to the medical staff conducting the treatment.

Folk remedies to help

Traditional methods of treatment are reduced only to the use of tampons and douching with herbal infusions and decoctions at home.

No such method will help get rid of the deep internal causes that provoked the development of fibroids. The use of any alternative methods of treatment for this disease should be discussed with the attending physician without fail.

Prophylaxis

If you belong to the beautiful half of humanity, then no preventive measures can 100% protect you from the occurrence of fibroids. The only thing that may be in your power is to reduce the factors that provoke the growth of fibroids. There are several basic recommendations for women who do not want to deal with this disease:

• make annual visits to the gynecologist regular, it is better to visit a specialist 2 times a year;
• annually do an ultrasound of the organs of the reproductive system;
• regularly have sex and achieve orgasm at the same time;
• prevent abortions, and the use of hormonal contraceptives will help to protect against unwanted pregnancy;
• control weight, lead an active lifestyle and play sports;
• take vitamin and mineral complexes with an antioxidant effect, which include vitamins A, E, C, iron, zinc, iodine, selenium.

A few words about pregnancy

Women of reproductive age who are diagnosed with fibroids always have a number of questions regarding the compatibility of this disease with the ability to have children. We will provide answers to the most popular ones.

Is it possible to get pregnant?

You can get pregnant if you have fibroids in the uterus.

Everything will depend on the size of the tumor and its location. If it does not prevent the fertilized egg from passing through the fallopian tube and fixing itself in the uterine wall, then conception will occur. It is important that the entire process of carrying a child is under strict medical supervision.

During the first 2 trimesters, due to hormonal changes in a woman's body, a slight growth of the myomatous node may occur, but in the last months of pregnancy, myoma does not grow, but only lends itself to destructive changes.

What are the risks to fetal health

Fibroids can disrupt blood circulation and nutrition of the walls of the uterus, which affects the ability of the myometrium to contract correctly, so the presence of a neoplasm in the uterus increases the risk of miscarriage.

Premature termination of pregnancy, spontaneously or according to indications, is the main threat to the fetus, but due to tumor growth, intrauterine growth retardation, fetal hypoxia, premature or protracted labor can occur, which is also a serious risk for future offspring.

Photo

Finally, we will give you some photos of myomas so that you understand how it looks in real form.

Impressionable people do not look!

Uterine fibroids is a gynecological disease characterized by the appearance of benign neoplasms in the uterine muscle layer.

The sizes of fibroids can be different: from small, pea-sized and to huge, when the uterine fibroid reaches a weight of 3 kg and correspond to the volume of a full-term pregnancy. Moreover, it can be one neoplasm or several tumors, small in size, the so-called multiple myoma of the uterus.

In terms of frequency of occurrence, this disease continues to occupy a leading position among all gynecological pathology. According to statistics, such neoplasms are found in more than 28% of women during their lifetime. Among the patients, women over the age of 30 predominate.

In this article, we will look at what a uterine fibroid is, what signs precede this disease, and what symptoms you should pay attention to when the fibroid has already formed. We will not disregard the methods of treating uterine fibroids, including talking about the treatment without surgery. Reviews of women with this problem can be read in the comments.

Causes

Why does fibroid develop, and what is it? A uterine fibroid is a benign tumor that develops from the muscle tissue of the uterus. In medicine, this disease is also called fibroids, leiomyomas.

Like a benign myoma tumor has a number of characteristic features:

• is the most common tumor in women 35-55 years old;
• is capable of regression (decrease in size) and even complete disappearance during the postmenopausal period;
• can maintain its size for a long time and not grow, or grow very quickly;
• it may either not manifest itself in any way and be an accidental finding during an ultrasound examination, or be accompanied by certain symptoms.

The main reason for the development of fibroids is spontaneous division of uterine cells, this can occur as a result of some changes in a woman's body:

• frequent inflammation,
• abortion,
• operations on the uterus,
• use of an IUD,
• improper intake of hormonal drugs,
• other factors.

In other words, almost all abnormalities related to the reproductive organs can lead to the subsequent development of a tumor. Sometimes the reasons for the development of fibroids are not clear, but, nevertheless, the disease must be treated, otherwise the nodules can increase in size and cause a number of symptoms.

Classification

There are several types of this tumor, depending on the type of tissue from which it originates:

1. Intramural. It is the most common form of fibroids. Comes from the middle muscle layer. With this type of disease, an increase in fibroids in size also means an increase in the size of the uterus itself. It is expressed by the following signs: the onset of pain, the appearance of a feeling of heaviness and pressing sensations in the pelvic area, often there is a violation of the menstrual cycle.
2. Subserous. With this type of disease, the tumor develops in the outer muscle layer. It is actually located outside the uterus, outside, but at the same time it grows into the pelvic cavity. With this type of disease, the menstrual cycle is not disturbed, but with a sufficiently large tumor, a woman may experience some discomfort and discomfort.
3. Submucous or submucous... This is one of the least common uterine fibroids. Such a neoplasm develops under the thin mucous membrane of the inner layer of the uterine wall. That is why submucous myoma gives the most pronounced clinical symptoms. In this case, myomatous nodes can have a rather long leg, which allows them to descend into the cervix and even the vaginal cavity. In such situations, clinicians talk about a "nascent" tumor node.

Depending on the size of the myomatous nodes, which are compared with the timing of pregnancy, allocate:

• small fibroids (5-6 weeks),
• medium (7-11 weeks),
• large sizes (over 12 weeks).

Fibroid nodes can be located in groups, or occur as single formations. Their size varies depending on the severity of fibroids, ranging from a couple of millimeters to tens of centimeters. The nodes are located in 95% of cases directly in the body of the uterus, less often in the area where the ligamentous apparatus of the organ is located or in the cervix.

First signs

In the case of uterine fibroids, the signs of the disease are as follows:

• painful, heavy and prolonged menstruation;
• the release of large blood clots during menstruation;
• acyclic intermenstrual bleeding and bleeding;
• recurrent pain;
• pressing and pulling, as well as constant heaviness.

The larger the fibroid and the extent of its distribution, the more intense its manifestations will be.

Symptoms of uterine fibroids

Often, uterine fibroids are an accidental finding during a routine examination by a gynecologist. Many women with uterine fibroids do not complain or do not attach importance to the signs of the disease.

In cases where uterine fibroids do appear, its symptoms may be:

1. Unusually heavy periods (you have to change more than 3 pads in 1 hour);
2. Unusually long periods (more than 7 days);
3. A sharp change in the nature of menstruation. For example, if your already irregular periods have become even more unpredictable;
4. Irregular, scanty, smearing from the vagina between periods;
5. Long, pulling pains in the lower abdomen;
6. Pain during intercourse;
7. Increase in abdominal circumference, without significant increase in body weight;
8. Feeling of pressure in the lower abdomen.

With large sizes of uterine fibroids, the syndrome of compression of neighboring organs will join. In this case, frequent urination or chronic constipation is often observed. In the presence of submucosal fibroids, difficulties develop in conceiving and carrying a pregnancy.

Symptoms that appear are not always fibroids; a similar clinic is observed in other gynecological diseases, namely in genital cancer, endometriosis, etc. In order to accurately establish the disease, a timely examination by a specialist is necessary.

Myoma of the uterus: photo

What does uterine myoma look like, a photo of benign neoplasms is presented below.

Diagnostics

Diagnosing uterine fibroids is quite simple. Already at the first gynecological examination, the doctor can make a diagnosis with 90-100% confidence. On palpation, an enlarged uterus with one or more dense nodes is determined. Her mobility is not limited.

Additional survey methods include:

1. Ultrasound of the pelvic organs... It is performed using a vaginal probe. To improve visualization, the examination is performed with a full bladder. This method is highly informative, it allows you to identify the exact size and shape of the tumor;
2. Hysteroscopy. This method is informative for the recognition of fibroids, the growth of which deforms the cavity. During this procedure, the gynecologist takes a biopsy (piece of tissue) from the uterine cavity for further analysis;
3. Laparoscopy. This method is used only in cases where the specialist cannot distinguish between uterine fibroids and ovarian tumors.

Diagnostic curettage of the uterine cavity is indicated for all detected uterine fibroids in order to establish the pathology of the endometrium and exclude uterine cancer.

Uterine fibroids: treatment without surgery, reviews

In the case of detection of uterine fibroids, treatment depends on many factors: the presence or absence of symptoms, the age of the patient, concomitant diseases, the size of the formation. If the size of the tumor is not large, the symptoms are absent or are insignificant, then the doctor may prescribe medication for uterine fibroids, that is, without surgery, as well as periodic examination. This will help keep track of tumor growth and disease progression.

Conservative therapy consists in the appointment of special drugs. Medicines of different groups are used:

• gestagens (norkolut, dyufaston, premolut) with a course of 4-6 months;
• androgen derivatives (danazol, gestrinone) for 6-8 months;
• gonadotropin-releasing hormone agonists (buserilin, zoladex) for 3-6 months;
• oral hormonal contraceptives (Yarina, Janine, Regulon);
• the Mirena intrauterine device (contains a gestagen - levonorgestrel) for 5 years.

Main directions conservative treatment of uterine fibroids are as follows:

• rehabilitation of genital infections;
• stimulation, activation of immunity with the help of herbal medicine and other medicines;
• correction of nutrition, food intake;
• normalization of metabolism;
• normalization of the psycho-emotional state;
• , normalization of the menstrual cycle, elimination of bleeding.

Also, the treatment of fibroids without surgery includes a special diet, certain immunomodulatory drugs, herbal medicine, homepathic medicine, special physiotherapy procedures.

Surgical intervention

When deciding on the nature of the surgical intervention and its volume, the patient's age, the state of general and reproductive health, and the degree of perceived risk are taken into account. Depending on the objective data obtained, surgical intervention can be conservative, with the preservation of the uterus, or radical, with complete removal of the uterus. For young, nulliparous women with uterine fibroids, if possible, the tactics of conservative surgical treatment are chosen to preserve reproductive function.

Exists indications for surgical treatment of the disease:

• sizes for tumor surgery more than 12 weeks of gestation;
• submucosal myoma, in which the nodes grow in the direction of the internal pharynx of the uterus;
• rapid tumor growth despite ongoing conservative treatment;
• the presence of other diseases of the female genital area;
• menorrhagias and metrorrhagias (acyclic uterine bleeding), leading to anemia;
• miscarriage and infertility.

How to treat? Based on the type, size and localization of the neoplasm, the doctor decides which operation to remove the myoma:

1. Laparoscopy - performed through small holes in the abdomen;
2. Hysteroscopy - work with the uterus through the vagina using a special instrument;
3. Abdominal surgery- an incision in the lower abdomen opens access to the myoma (an extremely rare operation);
4. Hysterectomy - complete removal of the uterus, is prescribed to patients without the hope of stopping the growth of fibroids with the help of sparing operations.

Laparoscopy and hysteroscopy are the most popular operations, as they have a number of advantages: almost complete absence of traces from the operation, preservation of the woman's ability to give birth to a child in the future, very quick recovery after surgery.

Embolization of the uterine arteries

A modern method of treating uterine fibroids, the principle of which is to stop the blood flow through the uterine arteries, and replace the fibroid nodes with connective tissue.

The method consists in passing a catheter through the femoral artery into the uterine artery and blocking blood flow in it using an embolization material. The procedure is performed in the X-ray operating room, refers to minimally invasive interventions and does not require anesthesia. Hospitalization for one day is usually required.

Some doctors argue that after such an operation a woman can become pregnant and bear a healthy child, others believe that this can be problematic, everything is very individual and depends on the type of fibroid, its size, and successful operation.

Folk remedies

Many women are looking for any effective folk remedies for the treatment of uterine fibroids. Almost all home treatment methods are reduced to the introduction of tampons and douching with herbal medicinal solutions.

However, there is not a single effective folk remedy that allows you to change the deep internal causes of fibroids. In any case, before trying any alternative methods of treating fibroids, you should definitely inform your doctor about this and discuss this method.

Prophylaxis

There are no special measures to prevent uterine fibroids. At the same time, in case of suspicion of uterine fibroids, the most important thing is timely diagnosis and timely treatment. Thus, the only prevention is periodic examinations by a gynecologist at least 1-2 times a year.

Forecast

With timely detection and correct treatment of uterine fibroids, the further prognosis is favorable. After breast-conserving operations in women in the reproductive period, pregnancy is likely.

However, the rapid growth of uterine fibroids may require radical surgery to exclude fertility, even in young women. Sometimes even a small uterine fibroid can cause infertility.

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Uterine fibroids - what is it and why is it dangerous? Symptoms and Treatment

Myoma is one of the most common non-inflammatory gynecological pathologies, which, according to many modern experts, does not belong to true tumors.

This is a benign, hormonally controlled hyperplasia of the muscular layer of the uterine wall of mesenchymal origin, which develops as a result of somatic cell mutation that occurs under the influence of various damaging factors.

It is presented in the form of a tumor, consisting of intertwined muscle and connective tissue fibers. In clinical practice, uterine fibroids and cervical fibroids are found.

What it is?

A uterine fibroid is a benign tumor that occurs in the muscle layer of the uterus - the myometrium. It is one of the most common diseases in women, reaching a frequency of 12 - 25% of all gynecological diseases.

The highest incidence of uterine fibroids occurs in the late reproductive period and before menopause. There is an opinion that the true prevalence of fibroids is much higher and reaches more than 70% both in Russia and abroad.

Causes of uterine fibroids

Myoma is a polyetiological disease, the following risk factors can play a role in the development of which:

• hormonal imbalance;
• inflammatory pathology of the female genital area;
• the use of intrauterine contraceptives, for example, spirals;
• complicated course of childbirth;
• performing abortions;
• adenomyosis;
• obesity;
• disease of the thyroid gland, adrenal glands, organs of the hypothalamic-pituitary system.

Myoma is a hormone-dependent tumor, as evidenced by the following facts:

• receptors for sex hormones are found in the tumor tissue;
• as a rule, after the onset of menopause and a sharp decline in the level of sex hormones, tumors undergo a reverse development;
• most often, fibroids appear in women of reproductive age, in whose body there is a high content of estrogen;
• after menopause, fibroids can appear in women who take estrogen-containing drugs.

Classification

Depending on the localization of fibroids, there are several terms in clinical practice:

1. Uterine myoma on the pedicle is not a separate gradation, since the pedicle may have submucosal and subserous myoma. Within the definition, the size of the leg, fibroids on a wide or narrow base can be noted.
2. Interstitial, or intramuscular myoma - the neoplasm is located in the muscular wall of the uterus.
3. Submucous, or submucous myoma - the tumor grows right inside the uterus under the mucous membrane and goes into the lumen of the uterus.
4. Subserious myoma - the neoplasm is located on the outer side of the surface of the uterus and is separated by a membrane that separates the uterus and abdominal organs.

The first signs of uterine fibroids

In the initial stage, small uterine fibroids are not accompanied by noticeable symptoms. You can find it during the next gynecological examination.

As the uterine fibroid grows, the first signs may appear:

• long, heavy and irregular menstruation;
• constipation;
• infertility;
• bleeding;
• anemia;
• frequent urination;
• heaviness and constant pain in the lower abdomen;
• spotting during intercourse;
• back pain;
• an increase in the abdomen not associated with significant weight gain;
• frequent miscarriages.

Why is uterine myoma on the leg dangerous? When the "leg" is twisted, inflammation and rupture of the tumor occurs. This causes severe bleeding, severe pain in the lower abdomen, and fever. This condition can be fatal.

Symptoms

With large sizes of nodes, there is a violation of the function of neighboring organs: constipation, impaired emptying of the bladder, frequent urination. In some cases, tumor nodes can cause compression of the ureter with further impairment of the outflow of urine from the kidney, which leads to the death of the kidney. Symptoms of compression of adjacent organs more often appear with large nodes and low localization of nodes.

1. Interstitial myoma of the uterus (with intermuscular arrangement of nodes) leads to longer, heavy and painful periods. Especially often profuse, prolonged and painful menstruation is observed with a combination of uterine fibroids and adenomyosis. Also, with the intermuscular growth of the node, part of it can grow towards the uterine cavity. With this localization of fibroids, the same symptoms are noted as with the submucous growth of the node, and their severity depends on the size of the submucous fragment of the node.
2. For the submucosal location of the node (submucous myoma), abundant menstruation is most characteristic, and at large sizes, when the node begins to occupy a large area of ​​the uterine cavity, spotting from the genital tract loses its cyclicity, and sometimes does not stop at all. With this arrangement of the node, the patient almost always develops anemia due to profuse bleeding from the genital tract. Submucous myoma can give cramping pains, most often occurring on the days of menstruation. The submucous node is a kind of "foreign" body for the uterus, from which it is trying to free itself. Sometimes such nodes can even "be born" on their own. This process is accompanied by very severe cramping pains and bleeding.
3. Subserous (subperitoneal) fibroids are often clinically painful. Pain is localized in the lower abdomen and / or lower back. Their appearance is associated with the tension of the ligamentous apparatus of the uterus and the pressure of the growing fibroids on the nerve plexuses of the small pelvis. In case of impaired blood circulation in the node, the pains are acute and very intense.

Painful sensations accompany the development of fibroids in every third woman and may have a different origin. With interstitial nodes of small size, painful menstruation is noted. Constant aching pains are observed with pronounced growth of nodes. With necrosis of the node, the pain syndrome is pronounced, there may be an increase in body temperature, and intoxication. Also, an emergency situation may arise if the patient has subserous nodes "on the leg". With a thin "leg", the knot is twisted; power is disturbed in the node. This situation is often manifested by an acute condition: severe pain syndrome, with the possible development of peritonitis. In such a situation, urgent surgical intervention is required.

Diagnostics

The diagnostic process for suspected myomatous formation involves the following activities:

1. Collecting anamnesis. Particular attention is paid to the age criteria of the patient, since such myomatous pathology is found mainly in women of reproductive age. As a rule, women have complaints about menstruation, which can become longer, profuse, painful, irregular.
2. Ultrasound diagnostics of low-volume organs helps to accurately identify myomatous formation, determine its parameters, location.
3. Gynecological examination. It is performed on a gynecological chair with the necessary instruments. The size of the uterine body, the location of the ovaries, the shape and mobility of the neck, etc. are taken into account.
4. Diagnostic curettage. It is usually performed to determine endometrial changes, as well as to exclude cervical or uterine cancer.
5. Hysterographic examination. Hysterography refers to a radiopaque technique that allows you to visually see the uterine cavity. For this, a contrast agent is injected into the body of the uterus, and then a picture is taken.
6. Laparoscopy. A similar technique belongs to surgical methods. A laparoscope is inserted through punctures in the peritoneum and displays an image of the organ under study on the monitor. During the procedure, it is possible to obtain biomaterial for histology or to remove small tumors, etc.
7. Hysteroscopic examination. Helps to visualize the uterine cavity. It is carried out using special equipment that is inserted into the uterus. This method is not only diagnostic, but also therapeutic. In this way, various polyps are removed, a biomaterial for histological examination is obtained.

The approach to the treatment of uterine fibroids is determined in accordance with the stage of formation.

How to treat uterine fibroids?

There are two main treatments for uterine fibroids:

1. Conservative treatment - with medications and non-invasive procedures.
2. Surgical treatment - through surgery.

The choice of treatment method depends on the severity of the clinical symptoms of uterine fibroids, the size of the myomatous node, the woman's age, and the intention to have children in the future.

The conservative method is based on the use of hormonal drugs by mouth and injection, as well as symptomatic therapy (pain relief, treatment of anemia, reduction of blood loss, etc.). Conservative therapy is effective only for curbing tumor growth. It is impossible to eliminate uterine fibroids conservatively. Therefore, the non-surgical method of treatment is used mainly in women of older childbearing age.

At the same time, the growth of the tumor is suppressed until the onset of the menopausal period. At this time, the likelihood of spontaneous resorption of the tumor is high.

Treatment of fibroids without surgery

Non-surgical treatment of uterine fibroids is a set of measures, including adherence to an appropriate diet, the use of immunomodulators, herbal medicine, permitted physiotherapy procedures, and hormonal drugs.

The course of treatment consists of the following stages:

• Anti-inflammatory therapy of infectious processes in the gynecological sphere;
• Activation of the immune system with special drugs;
• Correction of diet and diet;
• Normalization of the endocrine system;
• Formation of an even psycho-emotional background;
• Elimination of bleeding;
• Treatment of anemia;
• Bringing the menstrual cycle back to normal.

At home, the treatment of uterine fibroids without surgery consists in the use of the following drugs:

1. Antiprogestogens. Mifepristone (RU-486) ​​is often used as a preparatory therapy before surgery or for the treatment of fibroids. This drug not only eliminates the symptoms of pathology, but also helps to reduce the size of the formation.
2. Gonadotropin-releasing hormone agonists. The drugs in this group include: triptorelin - (Decapeptil, Dipherelin, Decapeptil depot), buserelin, goserelin (Zoladex), leuprorelin (Lukrin depot). The disadvantage of using these drugs for the treatment of uterine fibroids is that after the end of therapy, the nodes can recover in size, and prolonged use of these drugs is not permissible, since it can lead to the development of osteoporosis and other consequences for the female body due to a lack of estrogen. Within six months of using these funds, the size of the fibroids can be reduced by 50%, and the intensity of the symptoms of fibroids can also decrease. These drugs are often used to shrink uterine fibroids before surgery to reduce blood loss during surgery.
3. Combined oral contraceptives. These include the following combinations: desogestrel with ethinyl estradiol (Mersilon, Marvelon, Novinet), ethinyl estradiol with norgestrel (Ovidon, Rigevidon). These remedies effectively help reduce the symptoms of uterine fibroids, such as lower abdominal pain, bleeding. However, for the treatment of uterine fibroids in order to reduce its size, tablets of this group are not a priority, since they do not always lead to a decrease in the nodes. Under the influence of such therapy, only the nodes, the initial size of which did not exceed 1.5 cm, can shrink in size.
4. Gestagens. The use of such funds today is a controversial issue, since some doctors believe that the use of such drugs, and especially dydrogesterone ("Duphaston") with uterine fibroids, is unacceptable. Others believe that the use of this drug is fully justified, since it is the lack of progesterone that is the reason for the growth of fibroids. The effectiveness of therapy with such agents as linestrenol ("Orgametril", "Escluton"), medoxyprogesterone acetate ("Provera", "Depo-Provera"), nor-ethisterone ("Norkolut", "Primolut-Nor") with uterine myoma has not been proven therefore, many gynecologists do not recommend these drugs. However, the use of these funds in combination with endometrial hyperplasia and uterine fibroids is justified. The growth of fibroids occurs not simply from a deficiency or an overabundance of any hormone, but rather from an imbalance between hormones, therefore, the use of such drugs should not be carried out everywhere, but if indicated.
5. Antigonadotropins. Danazol (Vero-Danazol, Danazol, Danoval, Danol, Danogen), gestrinone (Nemestran). With uterine fibroids, treatment with these drugs is rarely used, since they cannot reduce the size of the nodes, but only help reduce the intensity of the symptoms of fibroids, moreover, they have a number of undesirable side effects, such as acne, voice changes, hair growth on the body and face. These drugs for fibroids can be used only with low efficacy of other treatments.

FUS ablation of fibroids

A method of treating fibroids, based on heating the tissues of the nodes with a high-intensity focused ultrasound, due to the transfer of a large amount of energy to a clearly localized area after which the destruction of the tissue of the node occurs - thermal necrosis. The principle of operation is very similar to the concentration of sunlight with a magnifying glass. The pinnacle of the development of the method today is the combination of a focused ultrasound source (emitter mounted in a table) and an MRI machine. Ultrasound is performed through the anterior abdominal wall. The MRI scanner monitors the localization and, most importantly, the heating temperature in real time.

The method allows for the destruction of a well-defined area without damaging healthy tissue. The area between the "treated" and healthy tissue is only a few rows of cells. Thus, focused ultrasound has now more than ever approached the concept of “ideal surgical instrument”. The procedure does not require the introduction of instruments into the body cavity, anesthesia and hospitalization, but it is not possible in all cases and requires the correct selection of patients. The substrate for the action of focused ultrasound is the connective tissue located in the fibroid.

Connective tissue stores energy well and allows reaching the temperature required for thermal necrosis. Thus, the so-called fibroids, which account for 70% of all myomas, respond very well to the FUS method. Leiomyomas, or cell fibroids, are absolutely not suitable for FUS treatment due to the lack of a substrate for exposure and a high-intensity blood supply, which does not allow sufficient heating of the tissue.

During the testing of the method and its introduction into clinical practice, incorrect selection of patients caused frequent relapses and was mistakenly interpreted as ineffectiveness of the method. To assess the feasibility of FUS ablation, the patient must undergo an MRI scan, which determines the type of myoma. Recently, numerous works of various authors, based on retrospective studies of treated patients, have shown a high efficiency of the method, which is not inferior in terms of indicators to other methods of treating uterine fibroids, provided it is used correctly.

Indications for the use of FUS-ablation in relation to uterine fibroids are standard indications for organ-saving treatment for uterine fibroids. Depending on the clinical tasks set by the gynecologist, the use of the technology is possible in four tactical options. 1. Organ-saving treatment of uterine fibroids. 2. Prevention of clinical manifestations of uterine fibroids (which allows you to abandon the expectant outpatient practice in relation to the growth of myoma nodes). 3. Preparation of the myoma node for transcervical myomectomy (as a result of FUS destruction, the size of the node and the intensity of blood flow decrease, which significantly reduces the risk of possible complications and facilitates the operation); 4. In order to delay surgical treatment.

Unlike other methods, FUS-MRI ablation of uterine fibroids is a non-invasive, organ-saving method, without hospitalization, without pain, keeps a woman the highest chances in comparison with other methods of a successful pregnancy, has a minimum percentage of complications among all the methods of treatment of uterine fibroids (currently less than 0.05%). The method has received recognition in many countries CE (Europe), FDA (USA), MHLW (Japan), CFDA (China), ANVISA (Brazil), Canada FDA, KFDA (Korea), RF, Taiwan.

Uterine artery embolization (UAE)

This is the introduction of special plastic balls into the uterine arteries in order to stop the blood supply to certain parts of the uterus and fibroids. The UAE procedure has very limited indications for use and is used mainly in women over 40 years of age with submucous myomatous nodes and severe uterine bleeding.

The use of uterine artery embolization methods in women of reproductive age, according to the recommendations of the European and American Societies of Obstetricians and Gynecologists, is prohibited. In the literature there are a huge number of publications illustrating the consequences of unsuccessful uterine artery embolization. As a rule, these are young nulliparous women aged 25–35 years who have lost the opportunity to have children as a result of the UAE procedure for small fibroids that did not require treatment at all.

When is the operation to remove the uterus for fibroids indicated?

Indications for radical surgical treatment of uterine fibroids:

1. Tumor sizes from 12 weeks (a bulky tumor compresses adjacent organs, blood vessels, interfering with their normal functioning);
2. Rapid growth of the myomatous node (from 4 weeks per year);
3. Myoma is the cause of massive bleeding;
4. Severe pain syndrome;
5. Torsion of the legs and necrotization of the myomatous node;
6. The birth of the submucosal myomatous node;
7. Combination of endometriosis and fibroids;
8. Suspected malignancy of fibroids.

Depending on the size, location and type of fibroids, the doctor selects the most convenient type of surgery to eliminate it. Myomectomy today is performed in three ways:

• laparoscopy - through a small hole in the abdomen;
• through the vagina using a special instrument - hysteroscopy;
• lane operation - in an open way, through an incision in the lower abdomen (very rarely);
• if sparing operations are impossible, and it is impossible to stop the growth of fibroids in other ways, treatment involves a complete resection of the uterus - hysterectomy.

Hysterectomy and laparotomy are the most popular methods of surgery, since they have a number of advantages: quick recovery after surgery, preservation of the ability to become pregnant and bear a child in the future, and almost complete absence of traces from the operation.

Prophylaxis

Prevention of uterine fibroids is to adhere to the diet, sleep and rest, reduce stressful situations. An important method of preventing uterine fibroids is timely pregnancy and childbirth (up to 25 years), as well as preventive examinations by a gynecologist.