Causes and symptoms of uterine fibroids
The uterus is a hollow organ with a wall consisting of three layers of tissue: the internal epithelium, smooth muscle myometrium and the external perimeter. Myoma - abnormal proliferation, the formation of tumor nodes of the myometrium up to several centimeters in size. There are several types of fibroids at the location of the neoplasm and its shape.
The main causes of pathology are hormonal disorders in the production of sex hormones during the menstrual cycle. Risk factors:
The main signs of uterine fibroids, according to which pathology can be suspected, include:
There is also the absence of symptoms of uterine fibroids. In this case, pathology is detected with gynecological ultrasound.
Methods and means of treating uterine fibroids
The tactics for treating fibroids depend on the size and number of nodes, as well as on the manifestation of symptoms. Often in the absence of symptoms and the small size of the fibroids, the patient is invited to simply undergo an ultrasound scan periodically, that is, the doctor chooses a wait-and-see tactic. This position is very controversial, because myoma is a dangerous pathology. Therefore, a more reasonable approach would be to search for optimal therapy.
There are several treatments for fibroids. Let's consider them in more detail.
Is it possible to cure myoma with medications
Because of inefficiency, medications are practically not used for the treatment of fibroids abroad. Medicines at best stop the growth of fibroids or slightly reduce its size, and this effect is short-lived and everything can return to its previous state.
In addition, the treatment of fibroids with hormonal drugs, which post-Soviet doctors like to use, leads to a decrease in estrogen levels in women, interferes with fertility and promotes the development of osteoporosis.
Surgical treatment of fibroids
With a full-fledged surgical intervention, two approaches that are fundamentally different from each other are possible.
Laparoscopic myomectomy. This minimally invasive operation is performed both independently and after embolization of the uterine arteries in the presence of small external fibroids. The operation is performed through small punctures in the peritoneum, into which an endoscope with a backlight, a microscopic camera and microsurgical instruments is inserted. If possible, the SILS (Single Incision Laparoscopic Surgery) method is used - a single-port operation through a single puncture.
Hysteroscopic myomectomy. This is a minimally invasive operation to remove submucosal fibroids through the vagina into which the hysteroscope is inserted (NOTES method).
Open myomectomy. This operation is performed only in the presence of multiple large fibroids, when minimally invasive surgery is not possible. During the operation, an incision is made over the pubis with a length of about 10 cm.
Uterus removal. This is an extreme method of treatment, and it requires special indications. A hysterectomy is prescribed if the myoma is the cause of heavy ongoing bleeding, grows very quickly, precancerous or cancerous changes in the cervix or endometrium are revealed. During the operation, the ovaries and fallopian tubes can be removed (if indicated), followed by menopause. A hysterectomy is a complex operation, and recovery after it can last a very long time, both physical and psychological.