Myoma of the uterus 15 mm what to do. Large uterine fibroids - is it necessary to remove it? "Age" of fibroids and symptoms

Content

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

Dimensions for uterine fibroid surgery in millimeters

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

1. Small fibroids in size can be as large as 6 mm, or 14 mm or more, corresponding to a pregnancy period of 4-5 weeks. The limit of this stage of the disease is the tumor parameter 20 mm in diameter.
2. The average mime is 40-60 mm in size, which corresponds to a gestational age of 5-11 obstetric weeks.
3. Large fibroids - from 60 mm in diameter, which corresponds to the beginning of the second trimester.

Fibroid size in weeks and centimeters

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

• 5 obstetric weeks - up to 5 cm;
• 7-week obstetric term - from 6 cm;
• 10-13 week obstetric period - 10 cm;
• 18-19 week obstetric period - 16-21 cm;
• 24-25 - weekly obstetric period - 23-28 cm;
• 30-32 obstetric week - 29-33 cm;
• 40-41 - weekly obstetric term - 34-35 cm.

How fibroids are operated

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

• laparoscopy;
• laparotomy;
• hysteroscopy;
• hysterectomy;
• abdominal operation.

Indications for surgery for fibroids

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

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

Fibroid surgery 8-9 weeks

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

With such a surgical method, it is appropriate to safely remove 3-4 pathogenic nodules with a joint diameter of no more than 1.5 cm.With hard-to-reach nodes, in complicated clinical pictures and with large formations, it is better to choose another method of treatment, which already implies performing incisions, access to the focus of pathology through the vagina ... An alternative is hysteroscopy, which is more considered a diagnostic procedure.

Fibroid surgery 10 weeks

If an average fibroid develops, and it is possible that the functioning of the bladder is disrupted, doctors recommend a laparotomy. This is a serious operation, appropriate for large fibroids corresponding to the obstetric period of 12-15 weeks of pregnancy. Surgical manipulations are performed through an incision in the anterior peritoneal wall. The operation is appropriate if ultrasound shows deformation of the uterine body against the background of pathogenic growth of a benign neoplasm. Delaying the procedure is dangerous. Fibroid surgery for 10 weeks requires long-term rehabilitation.

Fibroid surgery 12 weeks

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

Last updated article 07.12.

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

The danger of fibroids is that the tumor may develop asymptomatically for a long time. And only when bleeding opens, pains begin, or discomfort is felt, a woman decides to seek medical help.

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

It is extremely important for women to understand at what size the uterine fibroids are operated on, and in which cases it is possible to limit themselves to hormone therapy and folk remedies.

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

In terms of size, the tumor can be divided into three categories or groups. There are uterine fibroids:

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

• Great. Fibroids 14-16 weeks old are characterized as large. It should be understood how dangerous a large tumor is. In this case, drug treatment is powerless, an operation is required. Myoma 20 weeks is a giant tumor that requires urgent removal.

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

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

Indications for surgery

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

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

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

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

Particular attention should be paid to uterine fibroids 9 weeks, as well as neoplasms of a different size, if a tumor develops in a woman during menopause.

During menopause, less estrogen is released, so doctors often decide that there is no need for surgery, preferring a wait-and-see approach.

What if the observation indicates tumor growth?

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

Abdominal surgery

Subserous uterine myoma of 9-10 weeks in most cases requires surgical removal, less often excision is required for smaller nodes. The traditional way of performing the operation is to remove the tumor through an incision in the abdominal wall.

It is necessary to carefully prepare for the procedure, and after its completion, the patient must be in the hospital for several days under the supervision of medical personnel.

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

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

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

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

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

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

Alternative ways to remove fibroids

Fibroids are not always operated on. Medicine has made great strides forward, which means that today women who have consulted a doctor in a timely manner have access to loyal methods. An effective solution would be excision of the node with a laser.

This is the least traumatic method with many benefits, such as:

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

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

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

The second loyal way to get rid of the tumor of the fifth week is UAE. Uterine artery embolization It is highly effective and does not relapse after the procedure. A catheter is inserted into the woman's femoral artery, through which a special solution will be injected into the arteries feeding the tumor. It has a clogging effect, the node ceases to receive nutrients and gradually dies off.

It is allowed to use UAE with a fibroid size of 9 weeks. The larger the tumor has reached, the more unexpected consequences may arise after having done the UAE. There have been cases when, after embolization of the arteries, a woman had an absence of menstruation - amenorrhea.

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

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

• Small tumor (about 2 cm), its term is 4-6 weeks no more. The reasons for the operation are only in case of twisting of the myoma stem. It can be removed due to excessive bleeding, which leads to anemia. Also if a woman has been diagnosed with infertility;
• Average (4 to 6 cm) period is 10-11 weeks. If the nodes do not grow actively and there are no pronounced symptoms, then the operation can be skipped. Lumps that are located on the outside of the uterus can disrupt the organs closest to them. With an average fibroid, infertility or miscarriage may occur;
• A fibroid exceeding 6 cm in diameter is considered large, its term is equal to 12-16 obstetric weeks of pregnancy. Such fibroids are removed only by an operable way and drug treatment to eliminate neoplasms.

Uterine fibroid size in weeks and centimeters

The early stage of fibroids is 4 weeks. She has no symptoms and does not disturb the woman. The main thing is to determine this disease before 7 weeks. It will bring much less problems than late detection.

When it increases to 5 cm and a period of about 10 weeks of obstetric pregnancy, the first symptoms begin to appear.

• Menses with pain for which pain medication does not help.
• When you reach 12 weeks, the cervix increases, which causes bloating.
• If there is a diagnosis of fibroids on the leg, then the appearance of a sharp pain in the abdomen.
• With a large fibroid, its enlargement leads to squeezing of adjacent organs, which interferes with normal urination and defecation. Pain begins in the lower back and near the rectum.

Fibroids that are more than 12 weeks in size entail the formation of adhesions in the tissues of the body and nearby organs.

When a patient contacts with complaints, an ultrasound examination is performed, and appropriate tests are taken. Ultrasound is the most accurate detection of this disease, as well as the timing of its occurrence. Thanks to the examination, it is possible to accurately identify a benign tumor or not. The possibility of the transition of a tumor from a benign to a malignant one depends on the time of its detection. Every woman needs to make it a rule to undergo an ultrasound scan regularly.

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

• Uterine fibroids are 6 cm in size and last more than 12 weeks. This tumor size is life-threatening for the patient. Fibroid nodes that are more than 12 weeks old should be urgently removed.
• Stable intense pain. A trait inherent in medium and large fibroids. The myoma knot leads to squeezing of nearby organs, and also presses on the rectum. Defecation is impaired, which can lead to intestinal inflammation and intoxication of the body.
• Bleeding began. Basically, it leads to fibroids for a period of 15 weeks or more.
• Pregnancy planning. If a woman cannot get pregnant or bear a fetus, then medium-sized fibroids are often the cause. The hormonal background during pregnancy changes, which leads to tumor growth and poses a threat to the baby.

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

• There is a risk of a benign fibroid developing into a malignant one. This opportunity appears with the rapid growth of fibroids.

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

Tumor growth

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

• until 30 years old the woman did not give birth
• gynecological pathologies
• enough abortions
• taking hormonal drugs
• long-term effect of ultraviolet radiation on the body.

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

Effect of fibroid size on pregnancy

With small to medium-sized fibroids, pregnancy can be normal. If the tumor is large, then pregnancy, as well as carrying a child, is not possible. Even conception does not occur due to the fact that the nodes block the fallopian tubes.

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

Fibroids located in the vagina are considered the most serious. It becomes the cause of infertility, as well as spontaneous miscarriages. If the onset of pregnancy occurred with a benign tumor, then the patient is always under the supervision of doctors to prevent miscarriage. If the growth of the fibroid increases rapidly, then the pregnancy must be terminated.

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

Removal of fibroids

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

Removal of fibroids 8 weeks. If the tumor has begun to grow and has grown from a small stage to a medium stage and corresponds to a period of 8-9 weeks, it is recommended to undergo surgery. Here the type of operation is used - laparoscopy. This is the removal of fibroids through incisions made in the abdomen. After such an operation, no scars remain. The postoperative period lasts about two weeks.

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

Removal of fibroids 10 weeks. It is impossible to delay the removal. The operation is performed through an incision in the anterior abdominal wall. This, a rather serious operation to remove a benign tumor, is called laparotomy. After it, a long rehabilitation is required.

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

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

Complete removal of the uterus with fibroids

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

• late-onset knot formation,
• prolapse of the uterus,
• prolonged blood loss,
• suspicion of a malignant tumor,
• growing anemia.

Rehabilitation after removal

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

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

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

Take medicines to restore the life of the uterus. Also, for any unpleasant symptoms, consult a doctor.

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

Myoma of the uterus is a benign neoplasm resulting from the multiplication (proliferation) of muscle cells in the wall of this organ. It has the shape of knots. If the diameter of these nodes does not exceed 15 mm, they speak of small uterine myoma. Myoma can be single or multiple. The prevalence of this pathology reaches 30%, but in many cases the disease remains undiagnosed.

The appearance of this benign tumor occurs most often in women between the ages of 30 and 40, but there are also earlier cases of the disease.

Development mechanism

Small uterine myoma is a hormone-sensitive formation. It is believed to be caused by cell damage in the wall of the mature uterus.

During the menstrual cycle, under the action of progesterone, hyperplasia (multiplication) of smooth muscle cells in the uterine wall occurs. If pregnancy does not occur, the "extra" myometrial cells die. Gradually "extra" cells that did not die during the next hormonal cycle accumulate. This process is accelerated under the influence of additional factors. The reasons contributing to the development of fibroids are inflammatory processes of the female genital organs, endometriosis, medical manipulations.

The formed "growth germ" begins to produce biologically active substances that support its development. At the same time, connective tissue begins to grow in the node. These processes are genetically determined. It is the dysfunction of genes that explains the tendency to develop myomatous foci.

Myoma of the uterus develops against the background of a woman's hormonal imbalance. An excess of estrogens, a deficiency of progesterone, and increased secretion of gonadotropic hormones are often noted.

With an increase in the nodes of more than 15 mm, the hormonal background of a woman ceases to affect their growth. Further development of the tumor occurs due to its own hormonal activity.

Clinical picture

It usually takes 6–8 years between the appearance of the tumor rudiment and the development of clinical signs. In the early stages, a woman is not worried about anything. Pain gradually appears, most often cramping, intensifying in the first days of menstruation. Pain can spread (radiate) to the lower back and inner thighs.

A fairly common symptom is heavy, prolonged menstruation. This is how multiple myoma manifests itself, which significantly increases the area of \u200b\u200bthe inner surface of the uterus. Significant blood loss may be accompanied by signs of anemia (weakness, dizziness, pallor, taste perversion, brittle hair, and others).

Signs of compression of the surrounding organs for small uterine fibroids are uncommon.

Small uterine fibroids can be accompanied by miscarriage, including spontaneous abortions (miscarriages).

The severity of symptoms depends not only on the size of the tumor, but also on its location, concomitant diseases of the genital organs, and the individual characteristics of the patient. After the onset of menopause, many women experience a reduction in myoma nodes in size and a decrease in the severity of symptoms.

Uterine fibroids never disappear without a trace, since the minimum volume of the node cells remains for the patient's entire life, regardless of treatment.

Diagnostics

1. A blood test to determine the number of erythrocytes, hemoglobin, hematocrit to exclude anemia.
2. Research of a woman's hormonal status to select the most effective treatment regimen.
3. Bimanual vaginal examination. A routine examination in a gynecological chair helps to assess the size of the uterus, its position in the pelvis, and soreness. On palpation, you can determine the unevenness of the contours of the organ, its mobility and consistency. These data help to suspect small uterine fibroids.
4. A polymerase chain reaction (PCR) smear test helps diagnose sexually transmitted infections. Identifying and treating these conditions helps in the treatment of fibroids.
5. Ultrasound examination of the pelvic organs using transabdominal and vaginal sensors is performed to determine the location, number and size of nodes.
6. Computed or magnetic resonance imaging is prescribed in cases of difficulty in the differential diagnosis of fibroids from adenomyosis.
7. Endometrial biopsy may be useful if endometriosis or other diseases are suspected.

Treatment

Small fibroids in most cases are treated conservatively, that is, with the help of drugs. Prescribed means of basic therapy, acting directly on the tissue of the node, and symptomatic treatment.

For basic therapy, such groups of drugs are used as:

• gonadotropin-releasing hormone agonists (goserelin, triptorelin);
• antigonadotropins (gestrinone).

Gonadotropin-releasing hormone agonists are prescribed primarily for premenopausal women. They reduce the size of myomatous nodes, stop pain and bleeding. These medications cause side effects that resemble menopause symptoms, so they are recommended to be prescribed simultaneously with hormone replacement therapy, which is in any case indicated for women at this age.

Antigonadotropins are used in younger women. They contribute to the reduction of nodes and even their disappearance.

Symptomatic therapy helps to improve the well-being of women with small uterine fibroids. The following groups of drugs are prescribed:

• non-steroidal anti-inflammatory drugs for pain relief (ibuprofen);
• etamsylate to reduce the amount of blood lost during menstruation;
• iron preparations to restore hemoglobin levels in case of anemia;
• antibiotics in the diagnosis of sexually transmitted infections.

After the end of the course of treatment, low-dose combined oral contraceptives are prescribed to prevent recurrence of fibroids and the growth of preserved nodes. These drugs can be the mainstay of therapy in young women with small tumors. For the same purpose, intrauterine devices with hormonal activity (spirals) are used.

Monitoring the effectiveness of treatment using ultrasound examination of the uterus is carried out after 6 months, and then annually.

If drug therapy is ineffective within 6 months, the patient may be offered surgery. The main methods of surgical treatment for small fibroids are uterine artery embolization and conservative myomectomy.

Embolization of the uterine arteries involves the cessation of blood flow in the vessels that feed the nodes. As a result, they shrink and become hardened. Conservative myomectomy involves the removal of nodes while preserving the function of the organ. After these operations, a normal pregnancy is possible.

Prevention

A thorough ultrasound of the uterus is recommended for all women over the age of 25. It is used to search for the rudiments of myomatous nodes. Early diagnosis significantly increases the effectiveness of conservative therapy. It leads to a decrease in the number of operations, including those accompanied by the removal of the uterus.

Prevention and timely therapy of endometriosis and inflammatory diseases of the genital organs is important. Prevention and treatment of sexually transmitted infections is important.

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

Timely stopping of a small fibroid will avoid complications and fully restore the functionality of the female reproductive system.

Myoma of the uterus is called a benign formation, consisting from endometrial cells and vascular tissue, which is localized in the walls of the uterus. The vascular tissue provides nutrition for the fibroid and the active growth of its cells.

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

Options

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

According to these parameters, small fibroids include tumor no more than 2 cmin which the uterus enlarges in accordance with 5-12 weeks of pregnancy. The main symptom of a small tumor is small dense myomatous node, which forms the center of future large sprawl.

On palpation, the node reveals tight stable core... It persists even in the absence of blood supply to fibroids or an unfavorable hormonal background.

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

A small tumor is myoma, which has not yet acquired an independent growth mechanism.

Small fibroids are accompanied by some symptoms:

• an increase in the volume of menstruation;
• shortening the cycle;
• increased intensity of pain during menstruation;
• appearance smearing brown discharge;
• discomfort or pulling pain in the lower abdomen.

Therapy and prognosis

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

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

A course of antigonadotropins and synthetic agonists of gonadotropic releasing hormones

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

1. Regulation of hormonal levels, by reducing the hormonal activity of the ovaries, to a level that stops the development of fibroid cells.
2. Stopping the spread of benign lesions to abnormal areas, by reducing their sensitivity to estrogen.

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

In fact, the drugs used have anti-hormonal action, at which the menstrual cycle stops, and all the signs of menopause appear. Due to this action, complete regression of fibroids.

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

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

Usually, after 4 months of therapy, tumor volume decreases by 70%... In addition to the therapeutic effect against benign tumors, the drug helps to restore the cycle and eliminates soreness during menstruation.

But besides the positive properties, this method has one significant disadvantage with irregular use or incorrectly selected dosage, after treatment is observed renewal fibroid growth, only in a more active form.

Embolization

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

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

During the procedure, the doctor uses several needles makes punctures in the area of \u200b\u200bbenign educationpenetrating into the uterine artery and blood vessels up to 0.9 mmframing the tumor. These vessels are located on the border between healthy and pathological tissues.

Through needles no more than 1.5 mm in size into these vessels a special preparation is deliveredblocking the arterial cavity, and thus preventing blood from flowing to myoma. The drug is a mass of organic matter in the form of irregularly shaped microparticles or small balls.

To benefit from the treatment of a small tumor, usually one procedure is enough... Within 7 or 10 days after surgery, neoplastic cells perish, and myoma resolves. During this period, the patient does not need to be in the hospital.

At the site of the destroyed fibroid, a scar is formed, which completely disappears after 3-5 months.

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

In two weeks after treatment is noted reduction of tumor by 74%... In 5% of patients several months after therapy completely disbanded central hub.

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

Progestin

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

They aim to fix the problem by normalization of ovarian function, which begin to actively produce progesterone, which suppresses the growth of fibroid cells. To obtain a positive result, the treatment must be carried out strictly according to the scheme prescribed by the drug developer or drawn up by the doctor.

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

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

Levonorgestrel-containing hormonal coil Mirena

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

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

The spiral is a thin t-frame, which contains the hormone levonorgestrel. Throughout the treatment, spiral produces this hormone, throwing it into the blood in small quantities. This type of treatment is used only at reproductive age. Also, the tool cannot be installed with chronic inflammation endometrium.

Antiplatelet and anticoagulants

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

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

Symptomatic therapy

In addition to the main treatment, during the period of stopping a small fibroid, additional therapy is prescribed to eliminate the symptoms associated with the disease. For this, the following means are used:

• hemostatics. Designed to reduce the severity of bleeding with hormonal treatment. For this, the reception of Etamsilat, an extract of water pepper and a decoction based on shepherd's purse is shown;
• antispasmodics. Indicated for the elimination of pain caused by spasm of the muscles of the uterus. The most effective in this case is Spazmalgon;
• pain relievers. During the treatment of fibroids, nonsteroidal pain relievers are prescribed, which are aimed at stopping pain and reducing the symptoms of inflammation. These drugs include Naproxen and Ibuprofen;
• antidepressants. They allow to improve the psychoemotional state of the patient, which can be noted during the first time of treatment with hormonal agents.

Indications for surgery

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

• submucosal location of the tumor;
• high probability rebirth into a cancer formation;
• submucous type of myoma with interstitial and centripetal development;
• the presence of constant profuse bleeding;
• overly active the growth of education;
• infertility;
• necrosis central hub.