Uterine neoplasms of benign origin are considered quite common in women.
The leading number of cases of such a pathology falls on, which are more often found in patients aged 30-45 years. This pathology is characterized by uncontrolled proliferation of muscle tissues, as a result of which one, and more often, braided vascular network is formed.

Causes of the disease

Experts believe that the main hormone-dependent tumor, such as fibroids, is a violation of the hormonal background of a woman. This factor is considered fundamental in the development of myoma formations.

In a separate etiological group, experts classify factors that contribute to failures and disorders of the hormonal status.

Such factors include:

1. Lack of regularity in sexual life, especially after the age of 25. The absence of orgasms leads to congestion in the pelvic organs;
2. Absence of childbirth in a 30-year-old woman;
3. Genetic predisposition to myoma formations;
4. Chronic pathologies of the genital area of ​​inflammatory origin such as adnexitis, endometriosis, endometritis, adenomyosis, etc.;
5. Hypodynamic features of lifestyle;
6. Mechanical damage to the uterus resulting from curettage, gynecological surgical interventions, surgical termination of pregnancy, childbirth with complications, etc.;
7. Concomitant endocrine pathologies such as functional disorders of the thyroid gland, diabetes, metabolic disorders, obesity, and hypertension;
8. Stressful conditions that have a depressing effect on adrenal, ovarian and thyroid activity.

Since myoma formations are hormone-dependent in nature, such tumors do not occur in girls before puberty and in women after menopause. The main reason for the growth of a myoma tumor is not only an increased estrogen concentration, but an imbalance of this hormone and its derivatives and precursors in general.

Signs of uterine fibroids in the early stages

Usually the disease begins asymptomatically, however, with the growth of myoma formation of the uterus, a characteristic clinical picture appears, which is characterized by the following symptoms:

• Uterine bleeding between periods, menorrhagia, delayed menstruation and cycle failures. An increase in the volume of menstrual blood indicates a worsened contraction of the uterine muscle tissue. If the bleeding is intermenstrual in nature, then we are talking about bleeding of the uterine walls caused by tumor irritation;
• Pain syndrome. Usually, painful symptoms are localized in the lumbar region and the lower suprapubic part of the abdomen. Pain has a different characteristic, manifesting itself as aching or cramping sensations. A similar symptom never appears at the initial stage, therefore, painful sensations indicate the active development of the myoma process;
• Sometimes, against the background of the progression of fibroids, the patient has heart pain due to decreased cardiac muscle tone. Sometimes pain is accompanied by an increase in blood pressure. Such violations require mandatory cardiological examination;
• Infertility;
• Problems with bowel movements or urination caused by the pressure of the tumor on the tissues of the intestine or bladder;
• If a complication occurs in the form of torsion of the myoma formation, then necrotic processes begin in the tumor, accompanied by general intoxication. symptoms such as weakness, fever etc.;
• If the formation reaches a significant size, then in a patient with uterine fibroids, the stomach begins to grow, and body weight increases very slightly;
• Against the background of constant bleeding there is a decrease in hemoglobin levels and anemia of iron deficiency type develops.

Since fibroids do not appear immediately, it is recommended to undergo a gynecological examination annually to prevent the development of a tumor. Then the fibroids will be detected even in the initial stage, which is amenable to conservative methods of therapy.

Forms of formations and their symptoms

Some clinical features depend on the specific type of education.

There are 5 different types of fibroids:

1. - such a fibroid is localized on the extrauterine layer, often has a stalk and grows into the pelvic and retroperitoneal space. Such a tumor does not cause an increase in the abdomen, but it can be manifested by urinary disorders, constipation, discomfort in the lower abdomen or painful sensations in the suprapubic and lumbar region, hemorrhoids and cramping pains;
2. - is formed in the uterine muscle layer, but can germinate inside or outside the uterus. Accompanied by traditional soreness over the pubis, urinary disorders and constipation, heavy menstrual and intermenstrual bleeding;
3. , or submucosal. Such a tumor grows in the uterine cavity, is characterized by rapid development and is characterized by profuse prolonged bleeding between menstruation and during them, weakness, infertility, lumbar and abdominal pain;
4. a form of myoma tumor - such a formation is formed in the uterine neck and is relatively rare. Such a tumor does not cause menstrual failures and disorders, and the main signs of the tumor are traditional pain, problems with reproduction, squeezing of nearby structures;
5. Intraligamentary myoma tumor - is formed in the interligamentous space and develops asymptomatically. With progression to large parameters, the fibroid begins to put pressure on neighboring tissues, causing constipation and frequent urination.

Manifestations

Myoma symptoms may differ somewhat in accordance with certain stages of the patient's life.

With hormonal surges, the tumor begins to suddenly appear, causing pain or discomfort. Such changes are especially felt during the bearing of a child and in the menopause.

Myoma formation, although it is benign, can cause a lot of trouble to the patient, having a negative impact on her organic structures. In accordance with the nature and manifestations of fibroids, the specialist selects the necessary therapeutic technique, conservative or surgical.

Symptoms with menopause

If uterine fibroids before the postmenopausal period did not particularly bother, then during menopause it is quite capable of resolving. Such changes are caused by a sharp decrease in hormonal levels. But the regression of fibroids is possible only with the normal onset of menopause.

The tumor can grow to a relatively large size, then it will be accompanied by heavy bleeding and severe pain. In such a situation, surgical treatment is necessary.

Only the tumor or formation together with the uterus is subject to removal. Large knots are ways to cause heavy intermenstrual bleeding, which is very dangerous in menopausal age.

If fibroids develop in parallel with, then women often suffer from severe forms of anemia. In addition, with such a combination, the likelihood of myomatous formation is high.

During pregnancy

Quite often, fibroid formations begin to develop, which is also associated with changes in the hormonal background.

Not all tumors can negatively affect the course of pregnancy, however, if fibroids are detected, it is necessary to strictly follow medical recommendations.

Although fibroids are benign tumors, they can increase the risk of developing various complications such as:

• Inflammatory process and pain, which increase the tone of the uterus, and, therefore, the risk of miscarriage;
• Premature delivery or spontaneous miscarriage in the early stages;
• Placental abruption, which leads to abnormal development of the fetus;
• Hypoxic damage to the fetus.

Therefore, it is extremely important to clearly follow all the recommendations of an obstetrician-gynecologist if a fibroid was detected during pregnancy.

Usually, when the nodes are localized far from the placental location, pregnancy disorders are not observed, but if the tumor forms near the embryo, then there is a high probability of miscarriage or premature birth.

How to identify a disease

It is not difficult for an experienced and qualified specialist already at the first gynecological examination.

To confirm the diagnosis, additional diagnostics are prescribed, such as:

1. Ultrasound;
2. Laparoscopic diagnostics;
3. Hysteroscopy;
4. Magnetic resonance imaging;
5. Hysterosalpingography, etc.

Methods of treatment

Based on the diagnostic data obtained, the specialist: surgical or medical.

Drug treatment is used for relatively small parameters of myoma neoplasm. Such an approach to tumor therapy makes it possible to preserve the uterine body, which in the future gives the woman the opportunity for a happy motherhood.

The patient is prescribed hormonal drugs, as well as drugs to eliminate myoma symptoms, such as painkillers or drugs that relieve muscle tension. Usually, the basis of conservative therapy is drugs like Gestrinone, Zoradeks, Buserelin, etc.

If the formations reach a large size, then surgical treatment of fibroids is used, which can be carried out in several ways:

• Hysterectomy is the most radical way, involving the removal of the uterine body;
• - the most popular method in which the removal of nodes is carried out through small incisions on the abdominal wall. The operation is organ-preserving, so the patient will be able to become pregnant and give birth in the future;
• is a relatively new technique. It consists in ultrasonic evaporation of the formation;
• Arterial embolization - such an intervention involves blockage of the artery that feeds the fibroids, as a result of which the tumor dies.

Myoma formations are treatable, so do not postpone a visit to the gynecologist if there are signs of pathology. Only timely treatment will help preserve reproductive functions and avoid the neglect and even malignancy of fibroids. The main thing is not to miss the time and start therapy on time.

Video about the symptoms and treatment of uterine fibroids:

- this is a hormone-dependent, benign, tumor-like formation of the uterus, coming from its smooth muscle and connective (fibromyoma) tissue. Uterine fibroids are single, but more often - in the form of multiple myoma nodes with different localization. Uterine fibroids can range in size from a small nodule to a tumor weighing about a kilogram, when it is easily determined by palpation of the abdomen. The size of fibroids is usually compared with the size of the uterus at a particular stage of pregnancy. Small uterine fibroids can develop without clinical manifestations and are accidentally detected during a gynecological examination.

General information

Uterine fibroids is a hormone-dependent, benign, tumor-like formation of the uterus, coming from its smooth muscle and connective (fibromyoma) tissue. Uterine fibroids are single, but more often - in the form of multiple myoma nodes with different localization. Uterine fibroids can range in size from a small nodule to a tumor weighing about a kilogram, when it is easily determined by palpation of the abdomen. The size of fibroids is usually compared with the size of the uterus at a particular stage of pregnancy.

Uterine fibroids are most common in women during their reproductive years. In postmenopause, the growth of uterine fibroids usually stops and its reverse development occurs. In general, uterine fibroids are diagnosed in more than 20% of women when contacting a gynecologist with certain complaints or by accident.

Causes

Complications

Uterine fibroids are insidious and dangerous for their many complications. Most often, there is a violation of the blood supply to the myomatous node with the development of necrosis, torsion of the tumor stem, bleeding, anemia. Submucosal uterine fibroids can cause uterine contractions and the birth of a myomatous node through an open cervix, accompanied by pain and bleeding. Miscarriage and infertility can also accompany the development of uterine fibroids. Malignant degeneration (malignancy) of uterine fibroids into a cancerous tumor is up to 2% of cases.

Diagnostics

The diagnosis of "uterine fibroids" can be established already at the primary gynecological examination. With a two-handed vaginal examination, a dense, enlarged uterus with a bumpy, nodular surface is palpated. More reliably determine the size of uterine fibroids, its localization and classification allows ultrasound examination of the pelvic organs.

An informative method for diagnosing uterine fibroids is hysteroscopy - an examination of the cavity and walls of the uterus using an optical apparatus-hysteroscope. Hysteroscopy is performed for both diagnostic and therapeutic purposes: detection and removal of uterine fibroids of some localizations. Additionally, hysterosalpingoscopy (ultrasound examination of the uterus and fallopian tubes), probing of the uterine cavity, diagnosis of genital infections and oncopathology can be performed.

Treatment of uterine fibroids

Conservative therapy can only restrain the development of uterine fibroids for a certain time, but not eliminate it completely. Therefore, therapeutic methods are more justified in the treatment of women of older childbearing age, inhibiting the development of uterine fibroids before menopause, when it resolves on its own.

Surgery

The transition to surgical tactics for uterine myoma is indicated in the following cases:

• with large sizes of myomatous nodes (over 12 weeks of pregnancy)
• with a rapid increase in uterine fibroids in size (more than 4 weeks per year)
• with severe pain syndrome
• with a combination of uterine fibroids with an ovarian tumor or endometriosis
• with torsion of the legs of the myomatous node and its necrosis
• in violation of the function of adjacent organs - the bladder or rectum
• with infertility (if no other causes are identified)
• with submucosal growth of uterine fibroids
• with suspicion of malignant degeneration of uterine fibroids

When deciding on the nature of the surgical intervention and its volume, the age of the patient, the state of general and reproductive health, and the degree of perceived risk are taken into account. Depending on the obtained objective data, surgery 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, conservative surgical treatment is chosen to preserve reproductive function.

• Myomectomy. Organ-preserving operations include myomectomy - husking of the nodes of uterine fibroids. In the future, a woman may become pregnant, but there is a risk of a relapse of the disease. In the postoperative period, the use of hormonal treatment and constant monitoring by a gynecologist are shown for the timely relief of the beginning recurrence of uterine fibroids. The least traumatic is myomectomy through hysteroscopy. At the same time, uterine fibroids are excised using a laser under the visual control of a doctor, the manipulation is usually performed under local anesthesia.
• Myometrectomy. Another option for organ-preserving surgery for uterine myoma is myometrectomy with reconstructive restoration of the uterus. The essence of the operation is to excise the overgrown myomatous nodes in the uterine wall while maintaining healthy submucosal-muscular-serous tissue of the organ. This ensures the future preservation of menstrual and reproductive function.
• radical operations. Assume the complete removal of the organ along with myomatous nodes and exclude the possibility of having children in the future. Such operations include: hysterectomy (complete removal of the uterus), supravaginal amputation (removal of the body of the uterus without a cervix), supravaginal amputation of the uterus with excision of the cervical mucosa. With a combination of fibroids with an ovarian tumor or with confirmation of malignancy of the fibroids, panhysterectomy is indicated - removal of the uterus with appendages.

Conducting conservative myomectomy or supravaginal amputation of the uterus is possible using a laparoscopic technique (usually with the size of uterine fibroids up to 10-15 weeks of pregnancy). This significantly reduces the surgical tissue trauma, the severity of the adhesive process in the future and the period of postoperative recovery.

High-tech treatments

An alternative to surgical treatment of uterine fibroids is the uterine artery embolization (UAE) procedure, which has been used relatively recently. The essence of the UAE technique is to stop the blood flow through the arteries that feed the myomatous node. The UAE procedure is performed in an X-ray operating room under local anesthesia and is completely painless. Through a puncture of the femoral artery, a catheter is inserted into the uterine arteries, through which an embolization preparation is delivered, blocking the vessels that feed the uterine myoma.

In the future, due to the cessation of blood supply, myomatous nodes significantly decrease in size or disappear completely. At the same time, all the symptoms of uterine fibroids that disturb the patient subside. The method of uterine artery embolization has already shown its effectiveness: the risk of disease recurrence after UAE is completely absent, and in the future, patients do not need additional treatment for uterine fibroids.

Forecast and prevention

With timely detection and proper treatment of uterine fibroids, the further prognosis is favorable. After organ-preserving operations in women in the reproductive period, pregnancy is likely. However, the rapid growth of uterine fibroids may require radical surgery to exclude childbearing function, even in young women. Sometimes even a small uterine fibroid can cause infertility.

To prevent recurrence of uterine fibroids in the postoperative period, adequate hormone therapy is necessary. In rare cases, malignancy of uterine fibroids is possible. The main method of preventing uterine fibroids is regular observation by a gynecologist and ultrasound diagnostics for the timely detection of the disease. Other measures to prevent the development of uterine fibroids are the correct selection of hormonal contraception, the prevention of abortion, the treatment of chronic infections and endocrine disorders. Women over 40 should limit themselves to prolonged exposure to the sun.

Uterine fibroids is a benign formation that occurs in the muscular tissue of the uterus due to hormonal pathologies.

Patients aged 35-50 suffer the most from it, although such a deviation can occur much earlier.

This can seriously complicate the lives of young women who dream of a child and those who are already carrying one. For doing, where its size and number of neoplasms are determined, after that it begins.

What it is?

It is important to note that myoma is a benign neoplasm that is quite treatable.. But it is very dangerous for the health and even the life of a woman, if there are a lot of them. On ultrasound, sizes are determined, which, due to the similarity of the growth process of the uterus with the same during pregnancy, are usually compared with.

On this basis, fibroids are divided into 3 categories:

• - it is no more than 20 mm in size and corresponds to 4 obstetric weeks.
• Neoplasm of medium size - 20-60 mm or 10-11 weeks.
• Large fibroids - over 60 mm or 12-16 weeks.

1. Abundant and prolonged periods with pain, which can not be removed by painkillers. Often, due to significant blood loss, they are accompanied by anemia.
2. Possible uterine bleeding in the middle of the menstrual cycle.
3. Due to the increase in the cervix is ​​noticeable.
4. If the neoplasm has a leg and it is twisted, then the pain in the abdomen becomes unbearable. Due to circulatory disorders in the tissues of the tumor and uterus, this is fraught with peritonitis.
5. Large nodes compress neighboring organs, this causes violations of defecation and urination. Pain in the lower back, heart, headaches, hot flashes, dizziness and weakness are also connected, and as a result of compression of the nerve roots in the rectum, the legs become numb.
6. With large sizes of subserous fibroids, ultrasound shows adhesions of uterine tissues with adjacent organs.
7. Pain during intercourse.
8. Watery-mucous leucorrhoea of ​​dark color with an unpleasant smell.

Causes

The main culprit for the appearance and development of uterine fibroids is a hormonal failure of estrogen metabolism. Splitting by liver enzymes, these female hormones can be transformed into high-quality, low-quality or even dangerous substances. Poor-quality estrogen metabolites contribute to the appearance of benign tumors. Dangerous, deforming cellular DNA, can cause them.

If the mass of such pathological changes becomes critical, then several myoma nodes appear. A significant role in their appearance is played by dysfunction of the immune system (especially if there are chronic infectious foci) and hereditary predisposition.

Other risk factors:

• Prolonged stress, hard physical labor.
• Lack of regular sexual intercourse.
• Abortions, childbirth, complicated by trauma.
• Obesity, hypertension, diabetes.
• Diseases of the endocrine system.
• Physical inactivity.
• Long-term use of hormonal contraceptives.
• Absence of childbirth by the age of 30.
• Prolonged sunbathing.

Is treatment possible without surgery?

How to treat and cure large uterine fibroids without surgery should be known to those who are faced with this problem. In many cases, fibroids are treated without surgery.

This applies, first of all, to short terms, single tumors or a small number of them. And the choice of the method of treatment of large benign neoplasms is associated with the patient's well-being, her age, the place of relief of nodes and the presence of complications from other organs that aggravate the course of the disease.

The widespread introduction of new treatment methods, which will be described below, will significantly reduce the proportion in favor of conservative methods. But so far, surgical gynecology of uterine fibroids is leading among other diseases.

Due to the diagnosis of myomatous nodes, almost 80% of gynecological operations are performed, in which in most cases. And this is the trouble of a third of women after 55 years.

Popular Treatments

Is there a cure for uterine fibroids? The answer is yes, they are treated conservatively and surgically. Conservative treatment is carried out for fibroids up to 10-11 weeks. This, and physiotherapy. A set of measures stops tumor growth, such treatment is especially effective in reproductive age, in periods of menopause and postmenopause.

Conservative treatment lasts up to six months in combination with the prevention of endometrial hyperplasia. With menopause, hormonal drugs are prescribed for years.

With the ineffectiveness of conservative methods, uterine fibroids are removed, and in severe cases, together with the organ.

Surgery is indicated in such cases.:

1. The size of the neoplasm is at least 12 weeks.
2. She is developing rapidly.
3. Planning for pregnancy.
4. At the risk of developing a benign form into a malignant one.
5. Severe pain, in which painkillers are powerless.
6. Compression of the rectum, bladder and nerve roots.
7. Severe bleeding with the development of anemia.
8. Risk of peritonitis due to torsion of the tumor stem.
9. Violation of urination with stagnation of urine.
10. General intoxication and bloating.
11. Infertility or not carrying a pregnancy.

Conservative treatment of fibroids includes a number of methods, more on that.

Embolization of the uterine arteries

- blockage of the blood vessels that feed the organ, preventing its blood supply. To understand the principle of uterine artery embolization (UAE), it is necessary to understand the uterine blood supply. It is fed by 4 arteries: the left and right uterine, and the same ovarian. The main load lies on the uterine arteries.

If you block them, then the power of the body will be disturbed. First of all, this will affect myomas, the protective properties of which, due to their pathological nature, are not perfect. But well-adapted healthy tissues will survive even in such extreme conditions. The ovarian arteries and other small blood vessels will help them in this.

A special bonus of UAE is the extremely rare recurrence of the disease, and all myomatous nodes are exposed to it. There is no need for medication here. The mini-surgery is performed under local anesthesia. First, a puncture is taken from the right femoral artery, and then, under the control of an X-ray machine, micro-balloons are alternately inserted into the veins, blocking the uterine arteries. The procedure lasts a maximum of 40 minutes, the patient does not feel pain.

Usually, after 3 months, fibroids are halved, and in a year - by 2/3. The cessation of pain and bleeding during menstruation with the normalization of their duration in most patients is observed already a couple of months after UAE.

FUS ablation

is a method of treatment without surgery, which is reduced to the removal of fibroids by focused ultrasound under MRI control. And tomography helps to reveal the degree of its decay.

Advantages of this technique:

• Bloodlessness, no side effects, pain, intoxication.
• There is no need for anesthesia.
• Guaranteed preservation of the organ and its functionality.
• Efficiency with large nodes, their rapid reduction by a factor of three.
• Elimination of the symptoms of the disease, the absence of relapses.
• Possibility of outpatient treatment, fast rehabilitation after the procedure.

Disadvantages of the method:

• Significant cost of equipment and high cost of the procedure.
• One-time exposure is possible for a maximum of 2 knots.
• Limited use in obesity and cicatricial tissue changes.
• The duration of the treatment session and the patient's uncomfortable posture during it.

hormone therapy

Hormonal treatment helps to restore reproduction, while the following drug groups are used:

1. Androgens(Gestrinon, Danazol) - their purpose is to reduce the effects of estrogens that promote the growth of neoplasms. Treatment lasts 7-8 months.
2. Gestagens(Utrozhestan, Norkolut) - used for small fibroids to normalize the endometrium.
3. Installation of hormonal which normalizes hormonal balance. This is achieved through a daily portion of the hormone, which is able to delay the growth of the tumor. It works for 5 years and still has a contraceptive effect.
4. Combined drugs(, Regulon, Yarina) - they are effective for small tumors and are prescribed for a period of more than 3 months.

Folk remedies

List all effective not possible, this is only a small part of them:

1. Broccoli seed sprouts. The indole-3-carbinol contained in them destroys tumor cells without affecting healthy ones. Sprouts grown from seeds to a height of 4 cm in a box of sand are ground with the addition of vodka. For a week, you need a glass of the drug, which is drunk in a spoon three times a day before meals. The course of treatment is up to 12 weeks.
2. Tincture of the fruits of Vitex-Sacred. Soak half a glass of ground raw materials in 0.5 liters of alcohol diluted by half in the dark for 3 weeks, shaking daily. Add 10 parts of vodka to the filtered product, shake well. It is dissolved in the mouth for a couple of minutes, 25 drops per spoon of water twice a day - after waking up and before going to bed. The treatment course is at least 2 months.
3. Golden mustache tincture. Keep about 30 joints in half a liter of vodka for 2 weeks in the dark. In the morning, on an empty stomach, dissolve with 2 tablespoons of water, starting with a dozen drops, also in the evening 40 minutes before dinner. Every day, increase the dose by a drop at a time, bringing it to 35. Then, drop by drop, to the original amount. After the third course, introduce an additional one more dose. There are 5 of them in total, but after the first two, take a week break, and then a ten-day break.

For medicinal purposes, an alcohol tincture of walnut partitions is also used - three times 20 drops for 2 months, an aqueous tincture of burdock root - half a glass 4 times a day for several months with 10-day breaks, a decoction of flaxseed - half a glass three times a day for at least a month. Infusions on other medicinal herbs are also used.

Hirudotherapy

Treatment with medical leeches can normalize blood circulation in the pelvis, eliminate congestion. The salivary enzymes of the worms have an antitumor effect and can even out hormonal imbalances.

The duration of the procedure is half an hour, 10 sessions are practiced with a 2-3-month break. Small bite wounds heal in a couple of weeks.

Physiotherapy

This method of treatment helps to normalize the hormonal background, the menstrual cycle and the functions of the nervous system, and prevents the nutrition of the tumor.

Such types are effective:

• Radon and iodine-bromine baths. They act through the skin and nerve receptors, increasing immunity, reducing estrogen production, improving metabolism, helping to relieve inflammation and normalize ovarian function.
• electrophoresis practice with fibroids less than 12 weeks and their slow growth from 5-7 days of the menstrual cycle. At 15-20 procedures (except for the days of menstruation), potassium or sodium iodide is used.
• Magnetotherapy- with the help of a special apparatus placed on the abdomen where the tumors are localized. The procedure lasts 10 or more minutes, and the course consists of a dozen sessions.

Read also about uterine fibroids.

douching

This is the introduction of drugs into the vagina using a rubber pear or Esmarch's mug.

Multiple Recipes:

1. Soda: 2 tablespoons per 2 liters of warm water - daily for up to six months.
2. : infused decoction of 2 tablespoons of crushed leaves in a liter of boiling water (cook for a quarter of an hour).
3. Pharmacy chamomile or calendula: 3-hour infusion of a spoonful of dry raw materials in a glass of boiling water.
4. Celandine: simmer a chopped spoonful of leaves for a quarter of an hour in a glass of boiling water, use daily for up to six months. Soak the dried celandine root in a glass of boiling water with the addition of a spoonful of honey for a quarter of an hour. The procedure is carried out twice a day.
5. Golden mustache tincture: before going to bed every day, ten drops per liter of warm water for 3 weeks with a week break.

Method contraindications:

• pregnancy;
• menstruation;
• after an abortion or any gynecological surgery.

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, fibroids of the body of the uterus and myoma of the cervix are found.

What it is?

Myoma of the uterus is a benign tumor that occurs in the muscular layer of the uterus - 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, in the development of which the following risk factors can play a certain role:

• 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 reverse development;
• most often, fibroids appear in women of reproductive age, in the body of which there is a high content of estrogens;
• after menopause, fibroids may appear in women who take estrogen-containing drugs.

Classification

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

1. Stem uterine myoma is not a separate gradation, since there can be submucosal and subserous myoma on the stalk. Within the definition, the size of the pedicle, fibroids on a wide or narrow base can be noted.
2. Interstitial, or intramuscular fibroids - the neoplasm is located in the muscular wall of the uterus.
3. Submucous, or submucosal fibroids - the tumor grows right inside the uterus under the mucous membrane and goes into the lumen of the uterus.
4. Subserous fibroids - 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, uterine fibroids of small size are not accompanied by noticeable symptoms. You can find it at the next gynecological examination.

As the uterine fibroids grow, the first signs may occur:

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

What is dangerous uterine fibroids on the leg? When the “legs” are twisted, inflammation and rupture of the tumor occurs. This causes severe bleeding, sharp pain in the lower abdomen and fever. This condition can be fatal.

Symptoms

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

1. Interstitial uterine fibroids (with intermuscular arrangement of nodes) leads to longer, more abundant and painful periods. Especially often abundant, prolonged and painful menstruation is observed with a combination of uterine fibroids and adenomyosis. Also, with intermuscular growth of the node, part of it can grow towards the uterine cavity. With such localization of fibroids, the same symptoms are noted as with submucosal growth of the node, and their severity depends on the size of the submucosal 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, bloody discharge from the genital tract loses its cycle, and sometimes does not stop at all. With this arrangement of the node, the patient almost always develops anemia due to abundant bloody discharge from the genital tract. Submucosal fibroids can give cramping pains, most often occurring on the days of menstruation. The submucosal node is a kind of "foreign" body for the uterus, from which it tries to free itself. Sometimes such nodes can even “be born” on their own. This process is accompanied by very strong cramping pains and bleeding.
3. Subserous (subperitoneal) fibroids often manifest clinically as a painful symptom. 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 violation of blood circulation in the node, the pain is acute and very intense.

Pain accompanies 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 a pronounced growth of nodes. With node necrosis, the pain syndrome is pronounced, there may be an increase in body temperature, intoxication phenomena. Also, an emergency situation may arise if the patient has subserous nodes “on the leg”. With a thin “leg”, the knot is twisted; power supply is interrupted 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 myoma formation involves the following activities:

1. Collection of anamnesis. Particular importance is given to the age criteria of the patient, since such a myomatous pathology is found mainly in women of reproductive age. As a rule, women have complaints about menstruation, which can become longer, more profuse, painful, irregular.
2. Ultrasound diagnosis of pelvic organs helps to accurately identify myoma formation, determine its parameters, location.
3. Gynecological examination. It is carried out on a gynecological chair with the help of the necessary tools. The size of the uterine body, the location of the ovaries, the shape and mobility of the cervix, 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 study. Hysterography refers to radiopaque techniques that allow 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 refers to surgical methods. The 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 removal of small tumors, etc.
7. Hysteroscopic examination. Helps to visualize the uterine cavity. It is carried out through the use of 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 is obtained for histological examination.

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

How to treat uterine fibroids?

There are two main treatments for uterine fibroids:

1. Conservative treatment - with the help of medications and non-invasive procedures.
2. Surgical treatment - through surgical intervention.

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

The conservative method is based on the use of hormonal drugs orally and by 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, a non-surgical method of treatment is used mainly in women in older childbearing age.

At the same time, the growth of the tumor is restrained until the onset of the menopausal period. At this time, the probability of self-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 the use of 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 preparations;
• Adjustment of diet and diet;
• Normalization of the endocrine system;
• Formation of an even psycho-emotional background;
• Elimination of bleeding;
• Anemia treatment;
• Bringing the menstrual cycle back to normal.

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

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 - (Decapeptyl, Diferelin, 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 long-term use of these drugs is not acceptable, as it can lead to the development of osteoporosis and other consequences for the female body due to lack of estrogen. Within six months of using these drugs, the size of fibroids can be reduced by 50%, and the intensity of fibroid symptoms may also decrease. Often, these drugs are used to shrink uterine fibroids before surgery to reduce blood loss during surgery.
3. Combined oral contraceptives. These include such combinations: desogestrel with ethinylestradiol (Mersilon, Marvelon, Novinet), ethinylestradiol with norgestrel (Ovidon, Rigevidon). These remedies effectively help reduce the symptoms of uterine fibroids, such as pain in the lower abdomen, 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 nodes. Under the influence of such therapy, only nodes, the initial size of which did not exceed 1.5 cm, can be reduced 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 in particular dydrogesterone (Dufaston), for uterine myoma is unacceptable. Others believe that the use of this drug is fully justified, since it is the lack of progesterone that causes the growth of fibroids. The effectiveness of therapy with such agents as linestrenol (Orgametril, Eskluton), medoxyprogesterone acetate (Provera, Depo-Provera), nor-ethisterone (Norkolut, Primolut-Nor) for uterine myoma has not been proven , so many gynecologists do not recommend these drugs. However, the use of these agents with a combination of endometrial hyperplasia and uterine fibroids is justified. The growth of fibroids does not just come from a deficiency or excess of any hormone, but rather from an imbalance between hormones, so 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). In uterine fibroids, treatment with these drugs is rarely used, since they cannot reduce the size of the nodes, but only help to reduce the intensity of the symptoms of fibroids, moreover, they have a number of undesirable side effects, such as acne, voice changes, body and facial hair growth. These drugs for fibroids can only be used with little effectiveness of other treatments.

FUS ablation of fibroids

A method of treating fibroids based on heating the tissues of the nodes with 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 node tissue 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 on a table) and an MRI machine. Conducting ultrasound is carried out through the anterior abdominal wall. The MR tomograph controls the localization and, most importantly, the heating temperature in real time.

The method allows the destruction of a clearly defined area without damaging healthy tissues. The zone between the "treated" and healthy tissue is only a few rows of cells. Thus, focused ultrasound has come closer than ever to the concept of “ideal surgical instrument” The procedure does not require the introduction of instruments into the body cavity, anesthesia and hospitalization, however, it is not possible in all cases and requires proper selection of patients. The substrate for exposure to focused ultrasound is the connective tissue located in the myoma.

The connective tissue accumulates energy well and allows you to reach the temperature necessary for thermal necrosis. Thus, the so-called fibromyomas, which account for 70% of all fibroids, respond very well to FUS treatment. Leiomyomas, or cellular myomas, are absolutely not suitable for FUS treatment due to the lack of a substrate for exposure and high-intensity blood supply, which does not allow for sufficient heating of the tissue.

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

Indications for the use of FUS ablation for uterine fibroids are the standard indications for organ-sparing treatment for uterine myoma. Depending on the clinical tasks set by the gynecologist, the technology can be used in four tactical options. 1. Organ-saving treatment of uterine fibroids. 2. Prevention of clinical manifestations of uterine fibroids (which allows you to abandon expectant outpatient practice in relation to the growth of myomatous nodes). 3. Preparation of the fibroid 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-sparing method, without hospitalization, without pain, saves a woman the highest chances of a successful pregnancy compared to other methods, has the lowest percentage of complications among all methods used to treat uterine fibroids (currently less than 0.05%). The method has been recognized 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 sections 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 myomas 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 Society of Obstetricians and Gynecologists, is prohibited. There are a huge number of publications in the literature illustrating the consequences of unsuccessful uterine artery embolization. As a rule, these are young nulliparous women aged 25–35 years who 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 an operation to remove the uterus for fibroids indicated?

Indications for radical surgical treatment of uterine fibroids:

1. Tumor sizes from 12 weeks (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 leg and necrotization of the myomatous node;
6. The birth of a submucosal myomatous node;
7. The combination of endometriosis and fibroids;
8. Suspicion of malignant fibroids.

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

• laparoscopy - through a small opening in the abdomen;
• through the vagina using a special tool - hysteroscopy;
• band surgery - open method, through an incision in the lower abdomen (very rare);
• if sparing operations are not possible, 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, maintaining the ability to become pregnant and bear a child in the future, and the almost complete absence of traces from the operation.

Prevention

Prevention of uterine fibroids consists in observing the diet, sleep and rest, reducing 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.

If a woman, on the basis of ultrasound, the doctor says that she has uterine fibroids, of course, she is seized by anxiety, panic. Why did uterine fibroids appear and what is it? You should not fall into despair and get upset, you should definitely repeat the examination with the same doctor on a device with a vaginal sensor after the next menstruation, and for fidelity with another specialist in order to accurately confirm or exclude this diagnosis. What is uterine fibroids, symptoms and treatment, causes and how to treat uterine fibroids - we will consider these issues in this article.

What is uterine fibroids?

Uterine fibroids, as well as leiomyoma, fibromyoma is a benign tumor (not oncology), the growth of which occurs in the walls of the cervix or in the walls of the uterus itself. In size, such growth can be either a few millimeters or several centimeters, most often in women there is a multiple fibroid, when several neoplasms are formed at once. For the convenience of assessing the size of fibroids, gynecologists use the analogy of the size of the uterus in women during pregnancy, 4 weeks, 12 weeks, etc. Given the location of uterine fibroids, there are several terms in medicine:

• Subserous myoma- when the neoplasm is located on the outside on the surface of the uterus, under the membrane that separates the abdominal organs from the uterus.
• Intramuscular or interstitial fibroids- in this case, the fibroid is located inside the muscular wall of the uterus.
• Submucosal or submucosal fibroids- when the tumor grows inside the uterus, right under the mucous membrane and goes into its lumen.
• Uterine fibroids on a leg- this is not a separate gradation, since there may be subserous fibroids on the leg and submucosal on the leg. Only the leg can be narrow or wide, that is, fibroids on a wide base.

Causes of uterine fibroids in women

The development of fibroids is a consequence of a hormonal imbalance in a woman, this is considered the main cause of uterine fibroids. Therefore, most often, fibroids form in young women, and can resolve on their own during menopause, at a time when it is noticeably reduced. So, the main causes of uterine fibroids:

Consider some of the causes of uterine fibroids in more detail:

Excess estrogen, lack of progesterone

Uterine fibroids are considered a hormone-dependent tumor, therefore, it practically does not occur in girls before the onset of puberty, that is, before the first menstruation and in women in the postmenopausal period. If the local regulation of hormones that feed this organ is disturbed, when their level rises, fibroids grow. Moreover, many researchers argue that not just a high level of estrogen is “guilty” of her growth, but an estrogen imbalance that cannot be established by a single analysis; for this, the full hormonal status of a woman should be determined. Also, chemicals such as xenoestrogens, which are present in the body, have an estrogen-like effect, and their increase can affect the development of endometriosis, uterine fibroids.

Number of pregnancies, births, abortions

When determining the hormonal status of a woman, it is taken into account - when the first menstruation began, the number of interrupted and full-term pregnancies, the duration of lactation and other factors. In women who have given birth to at least one child, the likelihood of developing fibroids decreases.

woman nutrition

An increase in the level of estrogen contributes to metabolic disorders, obesity, and even just the constant use of refined foods, lack of fiber, excess saturated fatty acids in a woman's daily diet. It has been proven that overweight, or rather excess fat mass in relation to muscle mass of the body, is also a factor contributing to the excessive formation of female sex hormones, since fatty tissue promotes the transition of androgens to estrogens, which increases the risk of breast cancer, endometriosis, uterine fibroids.

Vegetarians have a much lower risk of developing hormone-dependent diseases of the female genital organs. A diet containing mainly vegetables, cereals, fruits, dairy products with a small amount of fat reduces the risk of developing fibroids. Every extra 10 kg. weight increases by 20% the risk of its development. An interesting observation is that most women with elevated estrogen levels are well-fed, very energetic, healthy, look younger than their years, very feminine.

Lack of orgasm during sexual intercourse

Lack of harmony in intimate life, lack of orgasm during intercourse, when the rush of blood after sexual arousal does not go away, but stagnates in the small pelvis, this causes vascular tension and venous stasis (one of the). If a woman does not experience satisfaction from sex for a long time, this can provoke a hormonal imbalance and the development of fibroids.

Diabetes and hypertension

Women with metabolic disorders, and those suffering from hypertension in their early development, that is, before the age of 35, also have a high risk of developing fibroids. The figure of a woman can speak of this tendency, if she resembles an apple and fat deposits are concentrated in the waist area, this is a greater risk of fibroid growth than with a figure resembling a pear, when accumulations of excess adipose tissue are mainly in the hips.

• Urban women have a higher risk of developing fibroids than women living in rural areas
• The use of oral contraceptives
• Genital injuries, inflammatory diseases

Studies show that traumatic childbirth, frequent medical abortions, diagnostic curettage, inflammatory diseases of the genital organs contribute to hormonal disruptions and are a trigger for the occurrence of uterine fibroids.

Symptoms of uterine fibroids

In almost all cases, with a small size of uterine fibroids, there are no symptoms, and the disease is recorded in most cases by chance during a routine examination or when the patient visits a gynecologist for other diseases. When interstitial or subserous uterine fibroids develop, symptoms in many cases are absent, and if the tumor is large, then complaints will be.

Very rarely, fibroids can show symptoms, but if they occur, these are not 100% signs of fibroids, since such manifestations can also be with other diseases - endometriosis, ovarian cancer, uterine cancer. Therefore, when they appear, you should definitely consult a doctor for a complete examination.

Signs and symptoms of uterine fibroids may include:

• , irregular periods,
• Prolonged constipation, frequent urination This is due to compression of adjacent organs by the tumor: intestines and bladder
• Submucosal fibroids are characterized by bleeding, sometimes very profuse, lengthening of menstruation and an increase in the volume of menstrual blood. All this leads to the development of chronic anemia (see.
  
• Feeling of pressure in the lower abdomen, frequent long-term pulling pains not associated with menstruation
• Growth in abdominal circumference, without weight gain.

Is it possible to treat uterine fibroids without surgery?

In the case when a woman approaches premenopause (see), the size of the fibroids is less than 12 weeks, it grows slowly and the woman is not bothered by severe symptoms of uterine fibroids, then her conservative treatment is possible, because with the onset of menopause, the growth of fibroids stops in a woman. Treatment of uterine fibroids without surgery consists in the use of the following drugs:

Combined oral contraceptives

These include such combinations: desogestrel with ethinylestradiol (Mersilon, Marvelon, Novinet), ethinylestradiol with norgestrel (Ovidon, Rigevidon). These remedies effectively help reduce the symptoms of uterine fibroids, such as pain in the lower abdomen, 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 nodes. Under the influence of such therapy, only nodes, the initial size of which did not exceed 1.5 cm, can be reduced in size.

Gonadotropin-releasing hormone agonists

The drugs in this group include: triptorelin - (Decapeptyl, Diferelin, 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 long-term use of these drugs is not acceptable, as it can lead to the development of osteoporosis and other consequences for the female body due to lack of estrogen. Within six months of using these drugs, the size of fibroids can be reduced by 50%, and the intensity of fibroid symptoms may also decrease. Often, these drugs are used to shrink uterine fibroids before surgery to reduce blood loss during surgery.

Antiprogestogens

Mifepristone (RU-486) ​​is often used to treat uterine fibroids or as pre-operative therapy. This remedy both eliminates the symptoms of fibroids and helps to reduce the size of the nodes.

Antigonadotropins

Danazol (Vero-Danazol, Danazol, Danoval, Danol, Danogen), gestrinone (Nemestran). In uterine fibroids, treatment with these drugs is rarely used, since they cannot reduce the size of the nodes, but only help to reduce the intensity of the symptoms of fibroids, moreover, they have a number of undesirable side effects, such as acne, voice changes, body and facial hair growth. These drugs for fibroids can only be used with little effectiveness of other treatments.

Gestagens

The use of these funds today is a controversial, open issue, some doctors consider their use in uterine myoma unacceptable, especially such a drug as dydrogesterone (Dufaston). Others, consider its use justified, as it leads to the growth of fibroids. The effectiveness of the use of drugs such as nor-ethisterone (Primolut-Nor, Norkolut), medroxyprogesterone acetate (Depo-Provera, Provera), linestrenol (Eskluton, Orgametril) with myoma has not been proven, and the use of many gynecologists is not recommended. However, it is believed that their use is justified in the combination of fibroids and endometrial hyperplasia. The growth of fibroids is caused not simply by a lack or excess of a particular hormone, but rather by a general hormonal imbalance, so the use of these drugs should not be in all cases, but according to indications.

FUS-ablation

FUS ablation is a relapse-free, non-invasive technique for the elimination of fibroids. A modern method of treating uterine fibroids without surgery, which is expressed in the evaporation of fibroids using an ultrasonic beam. This procedure is performed with an ultrasonic beam, which is precisely, focusedly directed to the tumor localization sites, for a more accurate beam guidance to the node, the surgeon uses MRI. The use of tomography also helps to monitor the degree of destruction and the degree of impact of the ultrasound beam on the tumor in real time.

Advantages of FUS ablation:

• Absence of blood loss, anesthesia, trauma
• Preservation of childbearing function, organ-preserving method
• High effect even with large nodes and multiple fibroids
• Significant reduction in the size of nodes, 2-3 times
• No side effects, no pain, no fever, no intoxication
• No recurrence, treatment of symptoms of uterine fibroids
• The shortest terms of rehabilitation, the possibility of carrying out the procedure on an outpatient basis

With this method of treatment of uterine fibroids, intensive infusion procedures are not required, there is no intervention in the body, since the procedure takes place remotely, the uterus is not injured, there is no risk of developing infertility or miscarriage in the future. In the process of FUS-ablation, there should be no burning of the skin, in the lower abdomen, pain radiating to the leg.

Basic principles of non-surgical treatment of uterine fibroids

In the treatment of uterine fibroids without surgery, conservative therapy includes dietary nutrition, the use of homeopathic medicines, immunomodulatory drugs, herbal medicine, physiotherapy, and hormonal drugs. The main directions of conservative treatment of uterine fibroids are as follows:

• Sanitation of genital infections
• Stimulation, activation of immunity with the help of herbal medicine and other medicines
• Correction of nutrition, eating habits
• Normalization of metabolism
• Normalization of the psycho-emotional state
• Treatment of anemia, normalization of the menstrual cycle, elimination of bleeding

How to treat uterine fibroids - one of the latest studies

Belgian researchers want to create an effective drug for the treatment of uterine fibroids, if its progressive growth requires a radical hysterectomy. They created new EsmyaTM tablets, which include ulipristal acetate, a selective progesterone receptor modulator, and this active substance is part of an emergency contraceptive.

As soon as it was established that not only estrogen, but also progesterone influences the occurrence and rapid growth of fibroids, research scientists began to study the effect of drugs that block the effect of progestogens. Then a team of researchers in Brussels at the University Hospital of St. Luke, became interested in the effect of emergency contraceptive pills with ulipristal acetate.

To study the effect of EsmyaTM on uterine myoma, 550 women participated in the experiment, who were preparing for surgery to remove fibroids. Within 3 months, one group was given a placebo (see), the other EsmyaTM tablets. At the same time, another study was conducted that tested the effect of these drugs in comparison with injections of hormone blockers. According to the results of both studies, it was possible to establish that the use of EsmyaTM reduces the size of fibroids, as well as the intensity of clinical symptoms and signs of uterine fibroids.

The result of the study is the following conclusion: in 90% of patients who took EsmyaTM, a positive effect was registered, in 50% there was no need for surgery, the effect is comparable to the effect of injections of hormone blockers. After taking EsmyaTM, there are no such side effects - degeneration of bone tissue and hot flashes that occur with injections of blockers. It is also important that a month after the injections, the fibroids in women began to grow again, and in patients who received EsmyaTM, the growth of fibroids was not observed even after 6 months. Perhaps in the near future, the question of how to treat uterine fibroids will be easier to solve than it is now.

When is hysterectomy indicated?

Cases when you should not hesitate with the operation:

• The size of the nodes, the size of the tumor is more than 12 weeks, it presses on neighboring organs
• Myoma contributes to severe uterine bleeding
• Rapid Growth (4 weeks in 6-12 months)
• Myoma node necrosis
• R pending submucosal nodule (emergency laparotomy) or node necrosis
  
• Combination of fibroids with adenomyosis, submucosal fibroids

Depending on the type of fibroid, its location, size, the doctor chooses the type of surgery to remove the fibroid. Myomectomy is currently performed in 3 ways:

• Laparoscopy - through small openings in the abdomen
• During hysteroscopy, a special instrument is inserted into the uterus through the vagina.
• Strip surgery through an incision in the lower abdomen is very rare.
• When it is impossible to stop the growth of fibroids in any other way, and sparing operations are not possible, with such uterine myoma, the treatment is complete - hysterectomy.

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

Embolization of the uterine arteries - a modern unique method for the treatment of fibroids

A very effective way to treat uterine fibroids. The uniqueness of this operation is that when a small probe is inserted, doctors determine which vessels supply the fibroids with blood, inject special substances into them that clog these vessels. After such an operation, the nutrition of the fibroids stops, it decreases and resolves. Some doctors claim 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 a successful operation.

Is it possible to treat uterine fibroids at home, folk methods?

So many women are looking for any effective folk remedies for the treatment of uterine fibroids. Almost all home treatments involve inserting tampons and douching with herbal medicinal solutions. There is not a single effective folk remedy that allows you to change the deep internal causes of fibroids. Especially it is not necessary to douche with uterine myoma, why? See about. In any case, before trying any alternative methods of treating fibroids, you should definitely inform your doctor and discuss this method.

Complications and consequences of fibroids

• The most serious, dangerous complication of uterine fibroids is the development of a malignant process against the background of fibroids. It is believed that the risk of such a degeneration into cancer is not high, however, it exists and a woman with such a pathology should be regularly examined by a gynecologist, monitor the dynamics of the size of the fibroid, since it is the rapid growth of the fibroid that is the main sign of its malignancy.
• Other less formidable consequences of uterine fibroids, which are not life-threatening, are the development of anemia, against the background of heavy bleeding during menstruation, as well as infertility. In recent years, there has been an increase in the number of women who have to completely remove the uterus due to fibroids, which is a serious stress and can worsen a woman's quality of life.
• Necrosis of the node and the birth of the submucosal node, torsion of the subserous node on the leg - this requires an emergency laparotomy.
  

If such an operation is unavoidable, the woman should calm down and make the right decision. The uterus is the organ that a woman needs only to bear a child, and if she already has a child, and the price of the issue is the possible degeneration of fibroids into a malignant tumor or removal of the uterus, which has already fulfilled its function. The best option speaks for itself.