Uterine fibroid: treatment, symptoms, surgery, folk remedies. What is uterine fibroid and how to treat it? After surgery for uterine fibroids

One of the most common benign tumors in women is uterine fibroid. The tumor consists predominantly of dense connective tissue fibers and grows inside the wall of the organ or into its lumen.

There may be one or more fibrous nodes, which are often accompanied by painful heavy menstruation, frequent urination, and discomfort in the pelvic area.

What is the difference between fibroids and uterine fibroids?

These are two benign tumors, but they are formed from different types of cells. contains smooth muscle cells that form the muscular wall of the uterus. Fibroids include connective tissue (you can imagine it by looking, for example, at a skin scar).

Usually the tumor has a mixed composition and is a fibroid in its structure. Myoma and fibroma do not have any significant clinical features, diagnosis and treatment.

Main characteristics of pathological formation

Women often look for an answer to the question - uterine fibroids: what is it? This neoplasm occurs in every second woman and in the past was often the reason for removal of the uterus. Modern gynecology offers patients medications and minimally traumatic surgical interventions to help control the disease.

The tumor in the early stages is located inside the muscle layer. Subsequently, depending on the location of its main mass, the following types of fibroma are distinguished:

• submucosa, growing into the uterine cavity;
• intramural, or intermuscular;
• subserous, lying on the surface of the uterus and growing towards the abdominal cavity;
• cervical fibroma.

The most correct name for fibroma is uterine leiomyoma, which is a type of mesenchymal tumor. It can be very small, not causing any unpleasant symptoms, or it can grow to gigantic proportions. The tumor grows slowly.

Causes and provoking factors of development

The exact causes of uterine fibroids are still unknown. As a rule, the tendency to this disease is inherited. The disease occurs 2-3 times more often in women of African descent.

The tumor grows in response to stimulation of the uterus by female sex hormones - estrogens, secreted by any healthy woman. Therefore, fibroma can appear even at a young age (about 20 years). However, after the ovaries stop producing estrogen, fibroids often decrease in size.

Factors that increase the risk of developing a tumor:

• excess weight;
• childlessness;
• first menstruation before the age of 10 years;
• African-American descent.

Experts recognize a certain role of emotional factors. Psychosomatics is a branch of medicine that establishes a connection between the patient’s inner world and his diseases. It is possible that the appearance of uterine fibroids occurs when the patient is exposed to such emotions for a long time:

• constant stress;
• resentment;
• abortion decision;
• dissatisfaction with intimacy with a partner;
• anxiety and fears.

It must be remembered that a woman’s health is associated not only with external or hormonal influences, but also with her mental state. Peace of mind is one of the conditions for a healthy lifestyle.

Clinical picture

Even if the tumor has reached a large size, there are often no symptoms of uterine fibroids. The tumor is often discovered during a routine examination by a gynecologist.

Main signs of the disease:

1. Heavy menstrual bleeding (menorrhagia) with blood clots.
2. Frequent urination or the urge to urinate, caused by pressure of the tumor on the bladder.
3. Constipation due to compression of the rectum.
4. Feeling of heaviness, fullness in the abdomen.
5. Pain with uterine fibroids usually appears during menstruation; in the later stages it becomes constant, aching, in the lower abdomen or lower back.
6. An increase in abdominal circumference, which sometimes requires changing clothing sizes while maintaining the same weight.
7. Infertility or miscarriage.
8. A mass in the uterine area discovered by a doctor during a two-manual gynecological examination or ultrasound.

With a small tumor, a normal pregnancy is quite possible. However, it happens that the disease causes infertility or. When the node is located near the mouth of the tubes, a mechanical obstacle appears for the germ cells. A cervical node often causes miscarriage. A large formation can cause disruption of fetal development. Uterine fibroids usually do not change in size during pregnancy, but such patients need more careful monitoring.

The issue of delivery is decided in each case individually.

When do you need to see a doctor urgently?

Sometimes situations arise when you cannot do without urgent medical care. Is fibroid dangerous? Yes, in addition to problems with pregnancy, it can become a source of bleeding or death (necrosis) of the tumor node.

You should definitely contact a gynecologist if you have the following signs:

• irregular menstrual cycle, heavy periods, bleeding between periods;
• increasing pain in the pelvis or abdomen;
• fever or night sweats;
• increase in abdominal circumference;
• inability to get pregnant.

You need to call an ambulance in the following cases:

• menstrual bleeding requiring more than 3 sanitary pads per hour;
• severe or prolonged pain in the pelvis or abdomen;
• dizziness, chest pain and shortness of breath in combination with vaginal bleeding;
• bleeding from the vagina during actual or possible pregnancy.

To prevent serious complications from developing, timely diagnosis and treatment of uterine fibroids is necessary.

Diagnostics

An experienced gynecologist knows how to recognize uterine fibroids. He will ask the patient about her complaints and conduct a thorough bimanual examination on the gynecological chair.

Then one or more additional diagnostic options are prescribed. They are necessary not only to confirm the diagnosis, but also to exclude more serious gynecological diseases, as well as to prepare for surgery.

Diagnostic methods:

• organs of the abdominal cavity and pelvis, helps to determine the presence of a tumor formation. Transvaginal examination is preferable, allowing better visualization of fibromatous nodes.
• Hydrosonography is a method that allows diagnosing submucosal fibroma in 100% of cases, assessing its location relative to the angles of the uterus, its size, detecting concomitant diseases of the endometrium, and assessing the thickness of the uterine wall.
• , which is performed using a thin instrument passed into the uterine cavity through the cervical canal.
• – examination of the uterine cavity from the inside using a fiber-optic camera placed on a thin probe through the cervical canal.
• – introduction into the cavity of the uterus and tubes of a radiopaque substance, which helps to obtain an image of the internal contours of the organ being examined.
• Dopplerography of the uterine arteries is performed before embolization in order to assess the intensity of blood flow in the fibroid node. The method is also used to monitor the effectiveness of such an intervention.
• Before embolization, angiography is required - an examination of the vessels of the uterus after the introduction of an X-ray contrast agent into them. The method makes it possible to detect malignant degeneration of a tumor and thus change treatment tactics in a timely manner.
• with or without contrast, useful for giant lesions and for assessing the effectiveness of embolization.
• – a surgical procedure performed using miniature optical instruments inserted into the abdominal cavity through small holes.

Treatment

To answer the question of how to treat uterine fibroids, you need to know its size and location. In addition, treatment tactics depend on the symptoms of the disease, the patient’s age, desire to have a child in the future, and general health.

Many women do not require treatment for fibroids. This is possible if the tumor is small, there are no symptoms, or after menopause. If fibroids cause uterine bleeding, it may be necessary. In addition, such bleeding can be eliminated with the help of medications.

Observation by a gynecologist is necessary to determine the size and growth of fibroids, as well as to ensure that the process is benign. An annual follow-up is usually sufficient. If a woman has irregular bleeding or pain, she is prescribed follow-up examinations at least once every 6 months.

The effectiveness of traditional medicine

Non-drug treatment with folk remedies is ineffective and leads to delay in starting medication or undergoing surgery.

Often, to avoid hormonal treatment or surgery, women turn to homeopathic remedies. They must be selected by a specially trained specialist, and the effectiveness of such drugs has not been proven.

Enthusiasts of this method believe that homeopathy for fibroids:

• restores the balance of excitation and inhibition processes in the nervous system, which slows down tumor growth;
• reduces blood supply to the node;
• enhances the production of gestagens, relatively reducing the concentration of estrogens - fibroid growth factors;
• reduces the degree of blood loss and the severity of anemia.

Popular homeopathic remedies:

• Epigallate;
• Mammosan;
• Bupleroom;
• Milona-5;
• Indinol;
• Mylife;
• Wild Yams;
• Aurum;
• Calcium;
• Konium;

Remember that by taking medications that have not passed official tests, a woman is experimenting with her health with unpredictable consequences.

Drug therapy for fibroids

Drug treatment of uterine fibroids without surgery is prescribed when minor bleeding or abdominal pain occurs, if the size of the node does not exceed 3 cm in diameter. It may include one or more of the following drugs:

• Non-steroidal anti-inflammatory drugs (Ibuprofen), which have an analgesic effect.
• , reducing the amount of blood lost during menstruation and relieving pain.
• Gonadotropin-releasing hormone agonists are drugs that inhibit the production of estrogen in the pituitary gland. A decrease in estrogen levels leads to a decrease in the size of fibroids. This type of medication is often used in preparation for surgery to reduce the size of the node and blood loss. Within 3 months of taking these drugs, fibroids are reduced by 2 times. However, with a long course of treatment, a woman develops symptoms of estrogen deficiency that resemble menopause: hot flashes, brittle bones, vaginal dryness.
• The antihormonal drug Mifepristone is prescribed to reduce the size of fibroids before surgery. It reduces the intensity of pain in the pelvis and lower back, and normalizes urination. Side effects are also associated with suppression of estrogen production. The drug also causes miscarriage, so it should be used with extreme caution in patients planning a pregnancy.
• The drug Danazol causes complete cessation of uterine bleeding, that is, artificial menopause. It is a male sex hormone (androgen). It has serious side effects including weight gain, muscle cramps, decreased breast size, acne, unwanted hair growth, oily skin, mood swings and depression, decreased good cholesterol and signs of liver dysfunction.

When using the last three groups of drugs, menstruation stops. Treatment of uterine fibroids during menopause leads to the fact that menstruation no longer returns. In young women, combined estrogen-progestin agents are subsequently used to restore the cycle.

If the patient does not plan to become pregnant in the near future, to restore hormonal levels, she may be offered a device that provides a contraceptive effect and local release of gestagens. Women who smoke, especially over the age of 35 and who are at risk of thrombosis, are recommended to prescribe the contraceptive drug Charozetta.

Surgical operations

Surgical removal of uterine fibroids has both its risks and benefits. Therefore, the decision about surgery is made individually, depending on the characteristics of each patient.

Surgery to remove uterine fibroids is called a myomectomy. It can be performed using hysteroscopy, laparoscopy, or with open access to the abdominal cavity. The choice of intervention technique depends on the location and size of the formation.

Removal of the uterus (hysterectomy) is the most common operation for fibroids.

For submucosal variants, removal using a hysteroscope from the inside through the uterine cavity is indicated. For subserous tumors, laparoscopic removal is performed. In case of multiple intermuscular nodes, conservative treatment is performed: an incision is made in the lower abdomen, and the nodes are carefully removed from the muscular wall of the uterus.

To reduce blood loss and reduce the volume of surgery, a course of gonadotropin-releasing hormone agonists is prescribed before the intervention.

Myomectomy is much less likely to be accompanied by damage to the rectum or bladder. This operation preserves the organ, and pregnancy is possible after it.

The most common operation for fibroids is hysterectomy. Depending on the size of the tumor, it may be done through the vagina or through the abdomen. In some cases, laparoscopy is used.

Laparoscopy is not used in the following situations:

• uterus more than 18 weeks;
• low-lying nodes on the back wall;
• interligamentous nodes.

Gonadotropin-releasing hormone agonists are often prescribed before surgery. The consequences of hysterectomy surgery are irreversible infertility and absence of menstruation.

Hysterectomy is prescribed in the following cases:

• node growth more than 4 weeks per year;
• suspicion of a malignant tumor - sarcoma;
• fibroid size more than 16 weeks;
• its growth in postmenopause;
• cervical node;
• impossibility of organ-preserving surgery.

Hysterectomy is associated with less blood loss than myomectomy. If uterine cancer or ovarian damage is suspected, the appendages are additionally removed.

Even if the appendages are preserved, half of the patients experience symptoms reminiscent of menopause. Therefore, hormone replacement therapy is prescribed.

Alternative techniques

A new approach with promising results - . Manipulation involves stopping the arterial blood supply to the fibroid. The procedure is performed by inserting a thin tube (catheter) into the femoral artery. Under the control of special X-ray equipment, the characteristics of the blood supply to the uterus are determined. Tiny plastic or gelatin particles the size of a grain of sand are injected into the artery feeding the fibroid. This material blocks the blood supply to the fibrous node, as a result of which the latter decreases in size.

The method is more suitable for women who do not want to undergo surgery, when other methods are ineffective or there are contraindications to surgery. The organ is preserved, and pregnancy is possible in the future.

For a large node, embolization can be performed as a preparatory step before myomectomy to reduce the diameter of the fibroid and facilitate its removal.

Laparoscopic uterine artery occlusion is performed by inserting small instruments into the abdominal cavity and stopping blood flow through the vessels. However, the blood supply to the fibrous node does not completely stop. This intervention can reduce blood loss during subsequent myomectomy. In addition, after it the thickness of the myometrium decreases, and the nodes are clearly visible in the uterine cavity, which facilitates their removal.

FUS ablation

The newest treatment method is the action of focused ultrasound under magnetic resonance control. In this case, MRI is used to direct a beam of ultrasound rays that heat and destroy the fibroid lesion.

There are other modern technologies that make it possible to destroy submucosal nodes without surgery, for example, cryomyolysis (freezing) or electromyolysis (destruction of a node using electric current). They are used for small single formations.

The duration of disability depends on the volume and method of performing the operation:

After surgical treatment, it is recommended to wear compression stockings for 1 month and take Dipyridamole, Pentoxifylline or Aspirin to prevent thrombosis. Iron supplements are prescribed to restore hemoglobin levels in the blood. If necessary, hormone replacement therapy is added.

Over the next years, it is better for the patient to avoid long exposure to the sun, visiting baths and saunas, massage of the lower back and buttocks.

Prevention and prognosis

Measures to prevent uterine fibroids:

• avoid excess weight after 18 years of age;
• to give up smoking;
• regular medical examinations.

The success of treatment largely depends on the severity of the disease and the method of therapy.

Is it possible to get pregnant with uterine fibroids?

Yes, it's quite possible. This increases the risk of miscarriage. However, many women with small tumors successfully bear children.

If fibroma is detected over the age of 35, at the same time processes of deterioration of ovulation are already underway, which increases the likelihood of problems with conception.

Fibroids rarely develop into cancer. This occurs more often in postmenopausal women. The main sign of malignancy in this case is a rapidly growing tumor that requires surgical intervention.

Uterine fibroid is a benign connective tissue tumor. Quite often it is combined with the growth of other components, including muscle fibers. It grows slowly and in rare cases becomes malignant. A malignant neoplasm of connective tissue is called fibrosarcoma.

Uterine fibroids are essentially the same as fibroids. Fundamental differences can only be revealed during histological examination of the microspecimen. The causes, clinical picture and diagnostic principles do not differ from those for uterine fibroids.

Fibroma and fibroids: what is the difference?

The national guideline for gynecologists defines fibroma as a benign, hormone-sensitive proliferation consisting of altered uterine cells. Myoma, leiomyoma, fibromyoma - all these terms are declared as synonyms. In the international classification of diseases, myoma and fibroma go together under the code D25. In clinical practice, the use of any of these terms is acceptable. For ease of perception, all such uterine formations can be designated as leiomyofibromas.

Benign neoplasms of the uterus: fibroids, leiomyoma, fibromyoma - are among the most common tumors.

You can see what uterine fibroids look like in the photo.

Large fibroid during surgery.

Clinical picture: leading symptoms to recognize the disease

The first signs of pathology appear when the tumor reaches a size of 2 cm. Until this point, fibroids are considered clinically insignificant. They do not cause concern, do not disrupt the menstrual cycle, and do not interfere with conception and birth of a child. Such nodes can be detected accidentally during a routine ultrasound.

As the disease progresses, the following symptoms occur:

• Menstrual irregularities: menometrorrhagia - heavy, prolonged and painful menstruation;
• on any day of the cycle and in postmenopause;
• Chronic pelvic pain: pulling and aching sensations in the lower abdomen, in the lower back, radiating to the sacrum, coccyx, perineum - depending on the location of the node;
• Disturbance in the functioning of adjacent organs: bladder and rectum - discomfort when urinating, chronic constipation.

In the early stages, fibroma makes itself felt moderately. Unpleasant sensations occur mainly during menstruation. As the node grows, the pain becomes more intense, and menstruation becomes longer and more abundant. The larger the size and number of nodes, the higher the likelihood of breakthrough uterine bleeding and other complications.

The growth of fibroids is often accompanied by pain in the lower back or lower abdomen, uterine bleeding, and disruption of the functioning of adjacent organs.

On a note

Uterine fibroids are often combined with other pathological changes in the genital organs: endometrial hyperplasia, polyps, endometriosis. In this situation, the symptoms are blurry and do not fit into the typical clinical picture of the disease.

Complications: what is the danger of a uterine tumor if it is not treated?

Uterine bleeding is not the only problem with fibroids. A benign tumor of the uterus can cause other equally serious conditions:

Birth of a node

Relevant for submucous tumors. An acute condition accompanied by cramping pain in the lower abdomen and bleeding. The intensity of discharge can vary, up to massive blood loss. You should not wait until the nascent node comes out on its own. Often this complication ends with uterine inversion, infection and sepsis, not to mention the risk of hemorrhagic shock due to bleeding.

Torsion of tumor pedicle

The most common complication of subserous nodes, especially peduncular ones. A tumor connected to the body of the uterus by a thin stalk can twist, which will lead to tissue ischemia with subsequent necrosis. This is indicated by the appearance of severe pain in the lower abdomen and lower back. A routine ultrasound will help confirm the diagnosis. Treatment is surgical only (removal of twisted fibroma).

Torsion of the tumor stalk can be determined using ultrasound.

Necrosis of the node

Characteristic of fibroids located deep in the muscle layer. It often occurs during pregnancy, when the nutrition of the tumor is disrupted. Cramping pain appears, and bleeding from the genital tract is possible. Surgical care should be provided to the woman immediately.

Degeneration into sarcoma

In modern clinics, ultrasound examination is necessarily supplemented by Doppler ultrasound - assessment of blood flow in the vessels feeding the tumor. These parameters are important when developing treatment tactics, in particular when determining indications and contraindications for UAE.

Laparoscopy is one of the most accurate methods for diagnosing all types of benign neoplasms.

Other examinations are also prescribed according to indications:

• Blood test for hormones (relevant for infertility);
• Test for tumor markers.

Principles of therapy for uterine fibroids

The goal of treatment is to eliminate unpleasant symptoms, avoid the development of complications and restore reproductive function. In young women, doctors try their best to preserve the uterus, but this is not always possible. The sooner the patient sees a doctor and begins treatment, the greater the chance of a favorable outcome of the disease.

Emergency care for bleeding due to fibroids is provided in a gynecological hospital. Curettage of the uterine cavity is performed with mandatory histological examination of the material. Further tactics are developed taking into account the data obtained.

Non-drug therapy

Non-drug treatment is not effective. No methods - yoga, therapeutic exercises, acupuncture or auto-training - will bring the desired result and will not allow you to get rid of a uterine tumor. . Various pseudo-scientific methods are not considered either. All a doctor can do is give recommendations on how to increase the overall tone of the body and maintain immunity:

1. Diet: balanced diet with limited spicy, spicy, fried foods. Increasing the proportion of plant products in the diet: fresh vegetables and fruits, whole grain cereals;
2. Taking vitamins taking into account age and time of year;
3. Physical activity;
4. Weight control, weight loss if necessary.

Of course, these methods will not help cure fibroids, but they will give the body strength and allow it to recover faster after hormonal therapy or surgery.

On a note

There is an opinion that if you have fibroids, you should not sunbathe, visit a solarium, sauna or swimming pool. In fact, no scientific evidence has been obtained about the dangers of these activities, so there is no strict ban.

Drug therapy

Is it possible to get rid of fibroids without surgery? Yes, but only if certain conditions are met:

• Tumor up to 3 cm in size;
• The node does not grow or increases in size by no more than 4 weeks per year;
• The woman does not suffer from frequent anemic bleeding, chronic pain and other complications;
• There is no evidence of malignant transformation of the tumor.

A tumor with a large number of connective tissue fibers does not respond well to conservative treatment, so the case often ends with surgery. The following groups of drugs can be used in therapy:

• Gonadotropin-releasing hormone (GnRH) agonists;
• Antiprogestogens;
• Combined oral contraceptives;
• Progestin agents (including the Mirena intrauterine system).

It is believed that the use of combined oral contraceptives inhibits the growth of fibroids.

All these drugs act on the same principle: they reduce estrogen levels, which leads to a decrease in tumor size or its regression. GnRH agonists are prescribed intramuscularly once a month, COCs and gestagens are prescribed in tablets. The choice of a specific remedy will depend on the woman’s age and the presence of concomitant pathology.

Herbal medicines, dietary supplements and other non-hormonal agents can also be used in complex treatment. are not used. Local preparations can be used for concomitant inflammatory diseases to sanitize the vagina and cervix.

Conservative therapy can be carried out according to different schemes:

• The main method of treatment;
• The first stage of therapy before surgery is to reduce the size of the node and reduce blood loss;
• The final stage of treatment after tumor removal.

On a note

Numerous reviews from doctors indicate that the optimal effect is achieved in the first month of taking hormonal drugs. Within 30-90 days, the fibroma decreases in size, and the woman’s condition improves. In the future, the node practically does not change, so treatment with hormones for more than 6 months does not make sense. For the same reason, gynecologists do not advise postponing pregnancy and recommend planning to conceive a child immediately after restoring the natural cycle while discontinuing hormonal medications.

Surgery

Indications:

• The size of the node is more than 3 cm;
• Multiple nodes;
• Fibroids grow more than 4 weeks per year during reproductive age;
• Tumor activation during menopause;
• Compression of neighboring organs;
• Fibroma as a cause of infertility;
• Frequent and heavy uterine bleeding;
• Tumor malignancy.

The choice of treatment method will depend on the location of the fibroma, the number of nodes and their diameter. The following options apply:

The prognosis for fibroma directly depends on the stage of the pathological process at which treatment was started. Small and single nodes are easy to treat, and subsequently nothing prevents the woman from leading her usual lifestyle. Radical operations are more difficult to tolerate and require long-term rehabilitation and specialist supervision.

Prices for the treatment of uterine fibroids depend on the volume of therapy, the chosen method and the presence of concomitant pathology. The cost is also determined by the woman’s region of residence, the place where treatment and rehabilitation will take place (public or private clinic). Definitive information on this issue can only be obtained after a targeted examination of the patient in consultation with the attending physician.

Useful video about uterine fibroids: about the danger, causes of occurrence and modern methods of treatment

Interesting facts about fibromyomatous nodes

Fibroma is the most common benign tumor of the female genitourinary system. Fibroma formation occurs from connective cells. The tumor grows from the walls of the uterine body.

Now let's look at this in more detail.

What is “uterine fibroid”?

Uterine fibroid is a mature benign tumor. Clinical manifestations of pathology are directly related to the growth of the tumor. Fibroma can appear in any organ. Most often the tumor is localized in:

• ovaries;
• mammary glands;
• uterus;
• on the skin.

The pathology can be a single compaction or a whole nodular accumulation. The size of the tumor can vary significantly. It usually varies from a few millimeters to several centimeters. In extremely rare cases, uterine fibroids can develop into a malignant tumor. There are several types of uterine fibroids. The list includes:

Fibroids come in two varieties - soft and hard. They are dominated by cellular elements. At the same time, the amount of fibers is insignificant. This leads to the fact that the tumor has a soft consistency to the touch and is easily squeezed with your fingers. If you press on the skin around the tumor, it will not disappear. Externally, a soft fibroma is a small polyp, the size of which varies from 1 to 10 mm in diameter. He hangs on his leg. The surface of the neoplasm can be folded or lobed. Typically, soft fibroids are localized in the folds of the skin. Such neoplasms usually do not appear in the uterine cavity. Soft fibromas are almost always multiple.

In dense fibroids, elastic and collagen fibers predominate. There are very few cellular elements in them. For this reason, the tumor has a dense elastic consistency. These fibroids usually have the shape of a mushroom. Its size ranges from 0.5 to 10 cm in diameter. It is this type of pathology that most often appears in the uterus and tissues. A type of fibroma is a dense and protruding neoplasm. It is covered with skin or mucous membrane of a constant color. Dense fibroma has moderate mobility. This means that it is not fused to the underlying tissues. Usually the neoplasm is single. If you squeeze a fibroma that appears on the surface of the skin with your fingers, it will go deep inside, leaving a small hole on the surface. This behavior is a characteristic sign of dense fibroma.

Such a tumor can exist for years. It increases in size very slowly. Pathology cannot disappear on its own. Fibroids are usually removed by excision of the lesions with a scalpel, a special laser, or using electrocoagulation. Once a dense fibroid is removed, it does not recur. To better understand what this type of neoplasm in the uterus looks like, it is recommended that you familiarize yourself with the photo.

There is a separate type of pathology called desmoid. It is a neoplasm, similar in structure to a dense fibroma. It is usually localized in the anterior abdominal wall. In the uterus, this type of pathology is rare. Unlike ordinary fibromas, desmoid is capable of rapid and aggressive growth, as well as metastasis. The tumor must be removed surgically as quickly as possible. However, after the process is completed, the tumor can recur.

The first signs of uterine fibroids

Very often the pathology does not manifest itself in any way for a long time. Signs of fibroma may be completely absent, even if the tumor has reached an impressive size. It is often discovered during a routine preventive examination by a gynecologist.

However, much depends on the location of the tumor and its size. In some cases, a woman may experience a feeling of heaviness or fullness in her abdomen. Sometimes constipation may occur. This occurs because the rectum is compressed. A woman may experience a frequent urge to urinate. This sign can indicate the pressure of the tumor on the bladder. The patient's belly may increase to such an extent that a change in clothing size is required. At the same time, the woman maintains her previous weight. Menstruation is very profuse. Blood clots may be present in the discharge.

Symptoms of uterine fibroids

According to statistics, only every 4 fibrous tumors manifest clinical symptoms. In other situations, the disease does not make itself felt. Features of the course of the disease depend on the direction of fibroid growth, its location and volume. The main symptoms are pain and bleeding. Pain from uterine fibroids usually occurs due to the fact that the tumor compresses the nerve endings, and the uterus itself and nearby structures can be affected. The latter situation is possible with submucosal localization. In this case, the tumor grows outward towards the walls of the pelvis. In this case, the pain is localized in the lower abdomen. She may be:

• intense;
• pulling;
• aching;
• cramping.

If sharp pain occurs, this may indicate torsion of the neoplasm and necrosis. Typically, women who have fibroids complain of pain during menstrual bleeding.

In the case of compression of the bladder, the unpleasant sensation is localized in the suprapubic region. A woman may experience a frequent urge to urinate. If the patient has developed a tendency to constipation, and the pain is localized in the lumbar region, this indicates that the tumor is growing towards the rectum and sacrococcygeal region.

Uterine bleeding can indicate the presence of a neoplasm. In this situation, the presence of a neoplasm leads to excessive growth of the endometrium up to the development of hyperplasia. If the bleeding is cyclical, it is called. When the symptom actually appears, it is called metrorrhagia. If the bleeding is intense, it can lead to anemia.

Fibroma can also be diagnosed during menopause. This period of pathology is usually asymptomatic. Subsequently, spontaneous regression is possible. The fact is that during this period there is a natural decrease in the concentration of sex hormones.

In general, most neoplasms included in this category do not cause significant disruption. The danger entails the development of a large tumor. It can exert a compressive effect on nerves, pelvic structures and blood vessels. Excessive blood loss can lead to severe anemia. It requires replacement therapy. At the same time, the risk of malignancy in fibroids is minimal. It is believed that malignant connective tissue neoplasms are initially malignant. They do not have a benign stage.

It is noteworthy that small fibroids do not affect the course of pregnancy in any way. A woman is able to bear a healthy child. However, there are exceptions to the rule. An obstacle to conception and normal bearing of a child can be large fibromatous nodes and neoplasms that are located in the area where the fallopian tubes originate. In this case, the entrance to them may be blocked by a tumor. This leads to an obstacle during fertilization and movement of the egg into the endometrium.

A large fibroma can pose a danger to normal. The fact is that they can disrupt its normal position in the uterus, which in turn often leads to miscarriage or premature birth. The most dangerous location of the tumor is considered to be the cervical one. This can lead to complications during childbirth and massive bleeding. If a woman is diagnosed with fibroma, she should be under the supervision of specialists. If dangerous types of pathology are observed, it is better to get rid of the tumors before pregnancy or childbirth, if such a possibility exists.

Causes and prevention of uterine fibroids

The exact causes of fibroids have not been identified today. However, experts have identified a number of reasons that increase the risk of pathology. The list includes:

The lack of an exact cause does not allow specific disease prevention. Therefore, experts limit themselves to general recommendations, advising patients to try to avoid stress, promptly treat pathological processes occurring in the uterus or other organs of the genitourinary system, and maintain immunity. It is better to give up bad habits, and choose environmentally friendly areas for your place of residence.

Treatment of uterine fibroids

Uterine fibroids will not resolve on their own. Therefore, treatment is necessary. It is carried out by gynecologists and endocrinologists. Features of therapy directly depend on the size of the fibrous formation. If it is no more than 12 weeks of pregnancy, conservative treatment is carried out. Indications for its implementation are also:

• there is no intermenstrual or excessive bleeding;
• the patient does not experience intense pain;
• there are contraindications to surgical treatment;
• the formation is interstitial or subserous in nature.

Basically, iron-containing drugs, hormonal drugs, vitamins, and non-steroidal anti-inflammatory drugs are used to combat pathology. The emphasis in the fight against pathology is on hormonal therapy.

If the tumor is submucosal in nature, or there is a pronounced clinical picture, a surgical approach to the treatment of uterine fibroids is carried out. Surgery is prescribed for large tumors and concomitant pathological processes. Surgery is usually performed intravaginally, laparotomically or laparoscopically. During the action, all nodes are deleted. The uterus can usually be saved.

Treatment can be done with hysterectomy. However, this method is considered radical. This method of dealing with the problem is usually used for women who do not plan to have children in the future.

A fibroid type tumor is diagnosed in 20% of women during their childbearing years and 40% of patients over 35 years of age. The neoplasm does not appear in girls before menstruation and postmenopausal women.

Types of uterine fibroids

Taking into account the growth of the fibroid node, the following types of pathology are distinguished:

Depending on the nature of the tumor process, three stages of uterine leiomyoma are distinguished:

• first stage (simple fibroma) - accompanied by the formation of a tumor rudiment and a slow increase in the node up to 3 cm;
• second stage (proliferating leiomyoma) - characterized by fibroid maturation, active cell division without atypical changes and rapid tumor growth;
• third stage (presarcoma) - accompanied by stopping the growth of the tumor and its aging, which leads to the appearance of atypical (deformed) cells.

Sometimes fibroids regress on their own and disappear. If the causes of the tumor are not eliminated, the fibroid tumor may reoccur.

Causes of uterine fibroids

The exact causes of leiomyoma formation have not been established. Some experts associate the appearance of tumors with hormonal dysfunctions and genetic predisposition. Changes in the level of hormones (estrogen, progesterone) play a role in the mechanism of fibroid tumor formation. Even in the presence of a hormone imbalance, uterine fibroids do not always form.

Factors contributing to the occurrence of tumor formation include:

• spontaneous terminations of pregnancy, abortions;
• first birth after 30 years;
• intrauterine interventions (installation of an intrauterine contraceptive device, hysteroscopy, diagnostic curettage, etc.);
• later menarche (first menstruation);
• long-term use of hormonal contraceptives;
• chronic pathologies of the reproductive organs;
• difficult childbirth;
• thyroid diseases;
• hormonal diseases of the ovaries;
• lack or irregular sex life;
• diabetes;
• overweight, obesity;
• sedentary lifestyle;
• frequent stress, emotional overstrain;
• fibrocystic mastopathy.

Also, the formation of fibroid type tumors can be caused by varicose veins, pathologies of the heart and blood vessels.

Signs and symptoms of uterine fibroids

In the early stages of leiomyoma formation, there are no clinical manifestations. They begin to appear when the tumor reaches 5 cm.

Menstrual dysfunction

One of the first signs of the disease is the appearance of menstrual abnormalities. Menstruation becomes painful and profuse, which is caused by pathological growth of the endometrium against the background of an enlarged tumor. The growth of fibroids leads to a decrease in the tone and contractility of the uterus. As a result, intermenstrual bleeding is observed and the menstrual cycle becomes irregular.

Pain in the lower back, stomach

The cause of severe pain with fibroma can be separation, twisting of the tumor stalk, poor circulation, or compression of nerve endings. The occurrence of pain is not associated with the onset of menstruation. The localization of the pain syndrome depends on the location of the fibroid nodes. Interstitial and subserous leiomyomas are manifested by nagging pain in the lower back and pubic area, which is caused by stretching of the walls of the peritoneum and uterus. The submucosal form of the pathology is characterized by the occurrence of spasmodic pain in the lower abdomen, which radiates to the rectum and bladder. Pain during menstruation tends to intensify.

Uterine bleeding

Bleeding can occur when the tumor is injured or due to menstrual dysfunction. Excessive blood loss provokes the development of anemia, which is manifested by dizziness, cardiac dysfunction, fainting, and general weakness.

Impact on the pelvic organs

As the leiomyoma grows, it puts pressure on the bladder, which causes problems with urination. As a result, inflammation occurs, which can spread to the kidneys. In this case, an increase in temperature and the appearance of pathological impurities in the urine are observed. Localization of fibroid formation on the posterior uterine wall causes constipation and flatulence.

A large submucosal fibroma emerges through the uterine cervix into the vagina, which causes rupture of the neoplasm and severe bleeding. Against this background, inflammatory processes and painful sensations develop.

Diagnosis of uterine fibroids

Detection of a fibroid tumor begins with the collection of anamnestic information and complaints from the patient. Then a gynecological examination is performed, during which an enlarged uterus is palpated, with a dense, tuberous surface.

It is impossible to differentiate fibroma from sarcoma or fibroids with a routine examination, so additional examinations are carried out:

• Ultrasound of the pelvic organs. This is a highly informative and reliable technique, which in 95% allows you to detect fibroids, determine the size and number of nodes, their growth pattern and location, as well as the deformation of the uterine cavity.
• Hysterosalpingography. A diagnostic method that, by introducing a contrast agent into the uterine cavity and tubes, allows one to study the condition of endometrioid tissues, diagnose submucosal neoplasms, their number and size, as well as assess the patency of the fallopian tubes and the presence of obstruction in the orifices.
• Hysteroscopy. This diagnostic method is used to visualize the uterine mucosa and identify submucosal leiomyomas. If suspicious areas of the mucous membrane are identified, a biopsy is prescribed - taking a piece of tissue for histological examination.
• MRI, CT. These techniques are used to make a final diagnosis, as well as to exclude ovarian cystoma or uterine sarcoma.
• Diagnostic laparoscopy. This procedure is performed in cases where it is not possible to differentiate an ovarian tumor from a fibroid tumor using other diagnostic tests.

Based on the results of clinical studies, the doctor develops appropriate therapeutic tactics.

Treatment of uterine fibroids

The tactics and regimen of therapy are determined taking into account the location and size of the tumor, the duration of the disease, the nature of clinical manifestations, the presence of concomitant disorders and the need to preserve reproductive functions.

Small fibroids (no more than 5-6 weeks of pregnancy) do not require treatment. In such a case, a wait-and-see approach is used. Every 4-5 months a woman should be examined by a doctor and undergo an ultrasound examination once a year. Large fibroid tumors require appropriate treatment, which can be carried out using conservative or surgical therapeutic methods.

Treatment of uterine fibroids without surgery

Treatment of leiomyoma with conservative methods is carried out in the following cases:

• low-symptomatic course of the pathology (minor pain syndrome, absence of heavy, painful menstruation);
• the size of the leiomyoma does not exceed 12 obstetric weeks;
• desire to get pregnant;
• the presence of restrictions on surgical intervention;
• interstitial fibroma, subserous node on a broad base.

The main medications used as part of conservative treatment are hormones:

• Androgen derivatives - suppress the synthesis of gonadotropins by the pituitary gland and reduce the production of estrogen in the ovaries.
• Gestagens - normalize endometrial growth. These medications are prescribed for the treatment of small nodes.
• Combined oral contraceptives - restore the level of gestagens, estrogens and reduce the amount of menstrual flow.
• GnRH analogues reduce the production of estrogen, which leads to disruption of the blood supply to the nodes and their reduction. Since these drugs achieve a temporary effect, they are prescribed 3-4 months before surgery.

As part of the treatment of fibroids, an intrauterine hormonal system can be used. After being introduced into the uterine cavity, it secretes a hormone that slows down the growth of leiomyoma.

In addition to taking hormonal medications, it is recommended to adhere to a diet that includes foods rich in protein and iron in the daily menu. The use of sedatives and iron-containing drugs is also indicated. To relieve pain, painkillers and non-steroidal anti-inflammatory drugs are prescribed.

Surgery for uterine fibroids

Surgical therapy for fibroid tumor is prescribed in the presence of the following indications:

• large neoplasm (more than 12 weeks);
• submucosal location of the node;
• rapid growth of the tumor;
• ineffectiveness of conservative therapy;
• severe symptoms of the disease (uterine bleeding, anemia, disruption of adjacent organs, severe pain);
• fibroma necrosis, subserous tumor on the pedicle (if the pedicle is torsed, emergency surgery is performed);
• cervical location of the fibroid node;
• the presence of concomitant pathologies (adenomyosis, endometrial hyperplasia and other tumor formations of the genitourinary organs).

How is uterine fibroid removed? The tactics of surgical intervention are determined by the doctor depending on the properties of the tumor, the location of the node, the presence of concomitant gynecological disorders and the need to preserve reproductive function.

The presence of a fibroid tumor of the uterus does not always mean removal of the organ. More often, uterine fibroids are removed using gentle, minimally invasive operations:

• Laparoscopic myomectomy. Intramural and subserosal nodes are removed using laparoscopic access. If the fibroma is localized in the thickness of the myometrium, enucleation (enucleation) of the tumor is performed. The subserous formation is removed along with the pedicle. During such an intervention, the uterus is preserved, which is especially important if it is necessary to preserve reproductive functions.
• Transhysteroscopic myomectomy. This intervention is performed when the node is located submucosally. The operation consists of mechanical (unscrewing), laser or electrosurgical removal of leiomyoma.
• Embolization of the uterine arteries. The operation involves the introduction of special substances into the uterine arteries that disrupt their blood supply. This leads to occlusion and stopping the growth of fibroids.
• FUS (ultrasound ablation). The intervention consists of evaporating the tumor tumor with high-frequency ultrasound. The manipulation is performed under MRI control.

In addition to gentle surgical interventions, radical methods can be used in the treatment of uterine fibroids. Radical treatment for leiomyoma (hysterectomy) involves removing the organ. Indicated for patients with large and multiple nodes, as well as women who do not plan to have children.

Hysterectomy has several options:

• supravaginal amputation - removal of an organ while preserving the stump and uterine cervix;
• extirpation - resection of an organ together with the neck;
• defundation is a semi-radical surgical intervention that involves removing the uterine fundus (part of the organ continues to function normally after the operation).

After removal of uterine fibroids, antibacterial, anti-inflammatory and immunostimulating drugs are prescribed. This will avoid postoperative consequences and speed up the recovery of affected tissues.

Is uterine fibroid dangerous during pregnancy?

Can uterine fibroids affect conception and pregnancy? The presence of a fibroid tumor, in most cases, causes difficulties with fertilization. This is due not only to hormonal disorders, but also to a mechanical obstacle that forms a node located close to the uterine cervix or in it itself. As a result, fibroma impedes the movement of sperm and blocks the entrance to the fallopian tubes.

If pregnancy does occur, neoplasms of a submucosal nature are especially dangerous for its preservation. Sharp hormonal fluctuations characteristic of the gestation period can provoke an increase in leiomyoma. As a result, there is less space in the uterine cavity, which prevents the full formation and development of the embryo. This also affects the presentation of the fetus. Incorrect intrauterine position of the baby interferes with its passage through the birth canal, which, as a rule, leads to artificial delivery.

Uterine fibroids increase the likelihood of developing an ectopic pregnancy and can also cause premature labor or miscarriage. To avoid side effects, it is better to plan your pregnancy and undergo a preliminary comprehensive examination. Small and non-growing tumors do not require treatment during pregnancy. The operation is performed when the nodes grow rapidly and there is an increased risk of complications.

Prevention of uterine fibroids

Prevention of fibroid type tumors involves careful health care. It is important to regularly undergo preventive examinations with a gynecologist and promptly treat any gynecological or infectious diseases. Such preventive measures are especially important for patients at risk.

In addition, it is necessary to adhere to sexual hygiene, carefully choose partners and use barrier contraceptives. Also, prevention of fibroids includes maintaining a healthy lifestyle: giving up bad habits, proper, balanced nutrition, taking vitamin complexes, walking outside, and moderate physical activity.

If it was not possible to avoid the formation of leiomyomas, when the first signs of a tumor process are detected, you should consult a doctor. After conducting a series of diagnostic studies, the doctor will determine the form and stage of the pathology and prescribe individual treatment.

Attention! This article is posted for informational purposes only and under no circumstances constitutes scientific material or medical advice and should not serve as a substitute for an in-person consultation with a professional physician. For diagnostics, diagnosis and treatment, contact qualified doctors!

Uterine fibroids are a disease known as uterine leiomyoma, a common, noncancerous growth of the endometrial lining of the uterus. Myomas are muscle cells and tissues, ranging in size from a pea to 12.7-15.24 cm in width.

25-30% of women are diagnosed with fibroids. Although the pathogenesis is not completely understood, fibroids depend on individual fibroid cells and not on a metastatic process. Fibroids are considered the most common benign solid tumors of the female genital tract. Although often asymptomatic, signs can cause infertility, pain, and bleeding. Gynecology is the field of study of uterine fibroids. The ICD-10 code (this is a classification of diseases approved by WHO) for uterine fibroids is D25.

Fibroids can outgrow their blood supply and degenerate. The degeneration is described as hyaline, myxomatous, calcific, cystic, fatty, red (pregnancy only), or necrotic. The patient often appears concerned about fibroid cancer; sarcomatous changes occur in less than 1% of patients. A connective tissue tumor is benign.

Myoma happens:

• intramural (uterine wall);
• submucosa (under the lining of the uterus);
• subserous (under the outer surface of the uterus).

Causes

The cause of uterine fibroids is unknown. Hormones produced in the ovaries (estrogen, progesterone) are thought to play a role in development according to OWH. Researchers believe that ovarian hormones influence growth. Fibroids rarely occur before a woman goes through pregnancy and menopause.

Fibroids are more common in obese women and menopause. Cigarette smoking is recognized as a provoking factor.

Onset of symptoms

Often women do not feel symptoms. Submucosal fibroids alter the uterus' ability to control menstrual bleeding, leading to heavy periods associated with blood clots that cause cramps. The difference is that they typically do not cause pain or emergency bleeding between periods.

Nodular and subserous fibroids, unlike others, as a rule, do not lead to difficult periods.

Symptoms of uterine fibroids:

• chronic blood pressure;
• symptom of difficult bowel function;
• lower back pain and pelvic pain;
• pain during sex;
• clothes seem tight.

Based on the listed signs, it is possible to recognize fibroids.

Fibroids can cause anemia, fatigue, and blockage of blood vessels and nerves, causing sharp and severe pain.

Myoma is dangerous by increasing the risk of infertility. During pregnancy, this threatens recurrent spontaneous abortion.

Diagnosis

A critical analysis of the surgical treatment of fibroids compares available myomectomy techniques. Statistical analyzes highlight the advantages of laparoscopic and hysteroscopic approaches.

While open myomectomy results in limited morbidity similar to hysterectomy, the differences of laparoscopic myomectomy result in significant benefits for the patient medically, socially, and economically, with less postoperative pain and shorter recovery time.

Sem and Mettler published the first paper on laparoscopic myomectomy in 1980. Today, the uterine growth is enucleated using the indicated method. Standard laparoscopic surgery is complemented by robotic support and abdominal entry, often modified to NOS (natural orifice surgery) and natural transluminal endoscopic orifice surgery called single-port entry.

Individual nodes may not be palpable during a gynecologist's examination. Thus, the specialist will not be able to make an accurate diagnosis.

Ultrasound is recognized as the standard method for detecting benign uterine tumors. This helps to see the location and size of the nodes, plus distinguish cancer from fibroids.

Additionally, hysteroscopy and laparoscopy are used.

The examination should show a neoplasm in the ovary and uterine appendages. Data on the period and results of ultrasound examination are required to make an accurate diagnosis.

Complications

Women with subserous uterine fibroids are predicted to have a favorable pregnancy, but this does not reduce the risk of complications. Complications: premature birth in a pregnant woman, the baby is in position, during childbirth there is a possible risk of needing a cesarean section. Select women during pregnancy experience pain during the 1st and 2nd trimester.

Consequences and complications may arise due to the location of fibroids in the uterus. They range from intermittent bleeding to continuous bleeding over a number of weeks, from single episodes of pain to severe pain, from dysuria and constipation to chronic spasms of the bladder and bowels. Peritonitis is extremely rare.

The difficulty of laparoscopic and hysteroscopic myomectomy differs in achieving satisfactory hemostasis using appropriate sutures. Hysteroscopic myomectomy requires an operative hysteroscope and an experienced gynecological surgeon to operate on the connective tissue in the uterus.

Sometimes fibroids can distort and block the fallopian tubes, making it difficult for sperm to pass from the cervix into them.

Treatment

Gonadotropin-containing hormone (GnRH) is used to relieve the symptom of pain.

Asymptomatic fibroid tumors do not require treatment. A woman should be examined periodically (every 6–12 months) by a gynecologist.

For symptomatic fibroids, treatment options include ovarian hormone suppression to control bleeding. Opportunities are suboptimal and limited. Physicians should consider medical clinical treatment and discuss other options before performing surgery. Agonists (GnRH) are sometimes given before surgery to shrink fibrous tissue. These drugs often stop menstruation and allow blood counts to increase. During the perimenopausal period, it is permissible to wait, because the mature growth decreases in size after menopause or may disappear.

Drugs for fibrous tumors

A number of drugs are used to relieve symptoms, reduce fibrous growth, or both:

• agonists (GnRH);
• exogenous progestins;
• antiprogestins;
• selective estrogen receptor modulators (SERMs);
• danazol.

Agonists (GnRH) are often the drugs of choice. For large fibroids, they can reduce fibrous size and bleeding.

These drugs can reduce estrogen production. Agonists (GnRH) are most useful if given preoperatively to reduce fibrous and uterine volume, making surgery technically more feasible and reducing blood loss. In general, the drugs mentioned should not be used long term. Increased recovery to pretreatment size within 6 months is common, and bone demineralization is possible. To prevent long-term use of the drugs, doctors must give patients extra estrogen.

Exogenous progestins may partially inhibit estrogen stimulation of uterine fibrous growth. Progestins may reduce uterine bleeding but may not reduce fibroids as well as agonists (GnRH). These medications may be taken every day (continuous therapy). Such therapy often reduces bleeding and provides contraception.

Progestin therapy causes the muscle layer to grow in some women's uteruses. A levonorgestrel-releasing intrauterine device (IUD) may be used to reduce uterine bleeding.

Danazol is an androgen agonist that can suppress fibrotic growth in the early stages, but has a high rate of adverse effects (weight gain, acne, swelling, hair loss, flushing, vaginal dryness), so it is less commonly taken.

Surgery for fibroid tumors

Surgery is usually used for women in the following cases:

• Rapidly growing tumor-like formation of the small pelvis.
• Recurrent uterine bleeding, unresponsive to drug treatment.
• Severe or constant pain or pressure under the skin (requires opioids for control or is intolerable to the patient).
• A large uterus that has a mass effect in the abdominal cavity, causing urinary bowel symptoms or compressing other organs, causing dysfunction (eg, hydronephrosis).
• Infertility (if pregnancy is desired).
• Recurrent spontaneous abortions (if pregnancy is desired).
• Dimensions for mimoma removal surgery.
• Other factors favoring surgery are the completion of the birth of the child and the expressed desire of the patient to choose the exact treatment.

Myomectomy is done laparoscopically or without automated methods.

A hysterectomy can also be done laparoscopically, vaginally, or by laparotomy (an incision in the abdomen).

Most indications for myomectomy and hysterectomy are similar. Patient choice is important, but people should be well informed about the expected difficulties and complications of myomectomy versus hysterectomy.

Removal in sections is done during a myomectomy or hysterectomy. Remove in parts, including cutting fibrous tumors or intrauterine tissue into small parts so that they can be removed through a smaller incision (for example, laparoscopically). It is extremely rare for women undergoing surgery for uterine fibroid tumors to have an unsuspected, undiagnosed sarcoma or other uterine cancer. If removal is done piecemeal, malignant cells may be disseminated into the peritoneum. Patients should be advised that if piecemeal removal is used, there is a small risk of dissemination of cancer cells.

If women desire pregnancy or want to keep the uterus, myomectomy is used. In approximately 60% of women with infertility due to fibroid tumors, myomectomy restores fertility and it is possible to become pregnant after approximately 14 months. However, hysterectomy is often necessary or preferred by the patient.

This is a more precise treatment. After a myomectomy, new fibroids sometimes begin to grow again, and approximately 25% of women with myomectomies have a hysterectomy approximately 4-8 years later.

Patients have other pathologies that make surgery more complicated (extensive adhesions, endometriosis).

Hysterectomy reduces the risk of other problems. This includes cervical intraepithelial neoplasia and others.

New procedures may relieve symptoms, but the duration of symptom relief and the effectiveness of the procedures in restoring fertility have not been evaluated.

• High intensity focused echography.
• Cryotherapy.
• Radiofrequency amputation.
• Magnetic resonance guided focused ultrasound surgery.
• Detection on x-ray.
• Uterine artery embolization.

Uterine artery embolization tends to cause infarct formation of fibroid tumors throughout the uterus while sparing normal uterine tissue. Women recover more quickly after the procedure than after a hysterectomy or myomectomy, but complication rates and return visits tend to be higher. The treatment failure rate is 20-23%; in such cases, treatment with hysterectomy is required.

Choice of treatment

To treat fibroma, factors are taken into account:

• Asymptomatic fibrous tumors: no treatment required.
• Women after menopause: trial of expectant management, after menopause the fibroids become smaller.
• Symptomatic fibroids provided that pregnancy is desired: uterine artery embolization, another new method (high intensity focused echography) or myomectomy.
• Severe symptoms when other treatment has failed, especially if the pregnancy is unwanted: hysterectomy, possibly preceded by drug treatment (with GnRH agonists).

Treatment of uterine fibroids with folk remedies

Treatment of uterine fibroids with folk remedies is a fairly popular treatment method aimed at eliminating unpleasant symptoms, as well as reducing bleeding.

For treatment, exclusively natural plant components are used, for example, calendula, which is brewed and taken orally.

Other remedies include blue iodine with milk, walnuts, and flaxseeds. But before self-medicating, you need to consult a doctor.

Calendula (2 tablespoons) is poured into an empty bottle, left in the dark for two weeks, shaken daily. Juice gradually appears. After the expiration date, filter the resulting mixture. Drink 1 tbsp. spoon 3 times a day.

Homeopathy helps to get rid of symptoms and tumors so as not to undergo hormonal treatment. This restores balance in the central nervous system. The concentration of estrogen decreases. The preparations are selected by a qualified homeopath. But this does not always achieve a certain effect.

Prevention

1. Regular visits to the gynecologist.
2. Diet (inclusion of vitamins in the diet).
3. Diet involves eating healthy. Fried foods, alcohol, and overeating should be excluded.
4. Elimination of bad habits - smoking.
5. Check hormone levels.
6. Use contraception.

Psychosomatics of fibroids

Psychosomatics greatly influences the course of the disease. If you often experience stress or overeat, this will aggravate the situation, and the cure of the disease will proceed more slowly.

Modern research shows that there is a connection between psychological state and the development of uterine fibroids. This must be taken into account during treatment and explained to women, because with psychological help one can achieve good results, to the point that fibroids can shrink without the use of surgical methods.

Factors influencing the development of a psychosomatic condition:

• unwillingness to become pregnant and making decisions about abortion;
• lack of pleasure from sexual contact;
• stress associated with resentment;
• low self-esteem;
• lack of self-love.

These psychosomatic factors launch a destructive program. As a result, the internal condition worsens and various diseases appear, which include uterine fibroids. Miscarriage also often affects the psychosomatics of the disease. Long-term depression appears, from which fibroids develop.

Uterine fibroids are a serious disease. The course of the disease depends on monitoring your own health. You need to be calmer about everything and not worry about the little things. Then the disease may disappear altogether.