Benign tumors of the uterus
If you believe in medical statistics, then myomaThe uterus is diagnosed in every fifth woman, aged between thirty and forty-five. As a rule, these are nulliparous women. In ninety-five cases out of a hundred, the tumor develops in the uterus body and only in five cases in the cervix.
The main reason for the development of benignThe tumor of the uterus is an imbalance in the level of sex hormones (decreased levels of estrogen). Usually it happens in the menopause. It should be noted that the benign tumor in cancer practically does not degenerate.
The clinical picture of uterine myoma is differentSignificant polymorphism and largely depends on the woman's age, localization, duration of the disease, the size of education and its morphogenetic type. In addition, the tumor can be affected by genital and extragenital comorbidities. In forty two percent of cases, the tumor for a long time does not cause any symptoms.
The probability of degeneration into a malignantThe tumor is very low - 0,25-0,75%, during the menopause the risk is slightly higher. However, uterine fibroids are often accompanied by pancreatic cancer, mammary glands, endometrium.
Symptoms of fibroids:
- Increase in tumor size;
- Violation of the work of neighboring organs.
The appointment of a specialist with myomas depends on the locationThe size and number of myomatous nodes, symptoms, the presence of concomitant pathology, the age of the woman and her desire to have offspring in the future, the features of the morpho- and pathogenesis of education.
Pathogenetically justified treatment of fibroidsIs medicamentous and surgical, i.e. Combined effect. Therefore, although many modern methods of treatment have appeared-laser, electro- and cryosurgery, the use of endoscopic techniques-treatment with hormonal drugs is still relevant. The goal of conservative treatment is to reduce the severity of symptoms and (or) the size of the tumor.
The use of surgical intervention is indicated when:
- Rapid increase in tumor size;
- Violation of the work of neighboring bodies;
- A large amount of education (over the fourteenth week of pregnancy);
- Presence of other diseases of the genitals, which require surgical intervention;
- Submucosal location of myoma, which is accompanied by abundant and prolonged menstruation, anemia;
- Necrosis of the myomatous node;
- Subperitoneal myoma, which has a thin base (on the "leg"); Such formations are associated with a high probability of the appearance of a torsion of the base of the node and with the development of its necrosis in the future;
- Infertility (in those cases when it is proved that the cause of infertility is precisely this disease);
- Myoma of the cervix with localization in the vagina.
Surgical intervention can be: Conservative, semi-radical and radical. By the nature of access to organs located in the small pelvis, the operations can be vaginal and abdominal. The amount of intervention depends on the existing gynecological diseases (condition of the fallopian tubes, endometrium, ovaries and cervix), the age of the woman, reproductive function.
Conservative operations include:
- Removal of submucosal nodes;
- Enucleation of nodes (otherwise, conservative myomectomy).
By semi-radical operations include:
- High amputation of the uterus;
- Defundation of the uterus.
With these operations, the woman retains her menstruation, but the reproductive function is absent.
Radical operations are:
- Supravaginal amputation of the uterus;
- Extirpation of the uterus;
If a woman is interested in preservingReproductive function, then it is enucleated myomatous nodes. If the location of the tumor is sub-serous, then conservative myomectomy is performed by abdominal and laparoscopic methods. If the tumor is submucosal, then the myomectomy is performed using a hysteroresectoscopy.