It occurs in a woman of childbearing age of five. More often than not, fibroma are found in women over 30 years old. In rare cases, they occur in the ovary, which is capable of proliferation of virtually any type of tissue. Very rarely, fibroids become malignant. Symptoms and treatment of uterine fibroids are the topic of the article.
Diagnostics
Very often, fibroids are found during a routine examination of the pelvic organs, for example, screening for cervical cancer. The physician may also suspect fibroids if the patient experiences profuse or painful menstruation. In a clinical examination, it is sometimes difficult to differentiate large fibroids from ovarian tumors, undiagnosed pregnancy and malignant uterine tumors. The best method for determining the shape, size, position and structure of any neoplasms of the pelvis and the lower abdominal cavity is ultrasound. For examination of women in the post-menopausal period, radiography can be used. In order to confirm the diagnosis, magnetic resonance imaging is sometimes used. Small fibroids can be asymptomatic. However, with growth inside the uterine cavity, fibromyoma increases the area of the endometrium (the mucous membrane of the uterus) that flakes during menstruation. This leads to profuse menstrual bleeding, which can last longer than usual. A large loss of blood can cause anemia, sometimes severe. Infertility is probably the most common complication of fibroids, which most often develops in childless women. Sometimes the growth of fibroids outstrips the development of blood vessels in it. In these cases, it becomes painful due to degenerative processes. In some cases, fibroids with insufficient blood supply can be calcified. Such changes are favorable, as calcified formations stop growing and do not bleed. If the tumor puts pressure on the upper part of the bladder, the patient experiences frequent urge to urinate. In the event that the fibromioma squeezes the rectum, there are problems with the passage of stool, causing the development of constipation. Fibromiomas always begin to grow in the muscular layer of the uterus (intramuralia). With a deep location in the muscle layer, fibroids can grow into the uterine cavity (submucous fibroids), where it is covered with the endometrium, the uterine mucosa. Sometimes, instead of diffuse growth, the fibromioma is located on the stalk, while the main part of it extends into the uterine cavity.
The nature of tumor growth
Most often, the fibromioma grows in the peripheral direction, located on the outer surface of the uterus (subserous fibroids). However, often the growth of the tumor is limited to the muscle layer. As the development around the fibroids forms a connective tissue capsule. Submucosal and cervical fibroids can be single, but most patients have multiple formations. The tumor is usually characterized by slow growth, with a tendency to stop during menopause (after its onset, they may even decrease). The most severe complication in the period is heavy bleeding. The method of treatment depends on the presence of symptoms and the age of the patient. If symptoms are absent, and ultrasound examination reveals one or two small fibroids, there is no need for active therapy. However, the patient should undergo a second ultrasound examination in a few months. Diagnosis of anemia is carried out by means of a blood test. Treatment of anemia consists in reducing the area of the endometrium, as well as in replenishing the level of iron in the body with the help of tablets or injections.
Surgery
To eliminate fibroids of medium sizes that grow inside the uterine cavity, diathermy and laser therapy using a hysteroscope are used. The tissue of fibroids is necrotic, due to which the tumor volume after a few months is significantly reduced. For visualization of fibroids located on the outer surface of the uterus, laparoscopy is used. With the help of a laparoscope, it is also possible to remove the tumor, especially if it grows in the lining. The older method of myomectomy (removal of fibromioma) in the open abdominal cavity is still used by most gynecologists for tumors of large size. Hysterectomy - removal of the entire uterus - is used in women who no longer want to have children and are in menopause.
Hormonal therapy
The size of fibroids can be reduced by hormonal therapy. For this purpose, for example, preparations containing as active ingredient goserelin, which affects the pituitary gland and inhibits the production of stimulating hormone, are used. This drug, in addition, reduces the thickness of the mucous membrane of the uterus. It is given as an injection in the abdominal wall every 28 days for 3 months before the operation. Women in menopause, suffering from fibromyoma, are countered by hormone replacement therapy, because the estrogens involved in it contribute to the resumption of tumor growth.