What is a uterine myoma?
Myoma (fibroid) of the uterus is the most common benign tumor of the female genital organs. Myoma can be found in every third woman of reproductive age.
It is a nodular overgrowth of benign tumor-like tissue in the wall of the uterus. Myomas grow not only in the thickness of the wall, but also inside the cavity and on the surface of the uterus, attaching to it with a narrow leg or a wide base. Often myoma nodes are multiple.
Unlike malignant tumors, myoma is covered with a dense shell – a capsule. It does not grow into the surrounding tissues and does not spread through the blood to other organs. At the same time, having reached a large size, uterine myoma causes a woman a lot of problems.
Why does uterine myoma appear?
.
The cause of uterine myoma, like most tumors, is not definitively established. One of the main reasons for the development of myoma is considered to be hormonal imbalance in the woman’s body. Recent studies conducted in Western countries and in Russia have shown that myoma can occur as a reaction of the uterus to damage, as well as a result of inflammatory processes in the genitals. Traumatic childbirth, diagnostic scrapings, insertion of an intrauterine device, unprofessionally performed hysteroscopy (endoscopic examination of the uterine cavity) often become a trigger mechanism for tumor formation. A large number of medical abortions and caused by them hormonal disruption and damage to the endometrium are also a favorable ground for the development of myoma.
The hereditary nature of the disease is also important. Often uterine myoma is found in close relatives – sisters, mothers and daughters.
Increased risk of myoma development is also noted in women suffering from hypertension, especially in its early appearance – before the age of 35. A similar pattern is observed in patients with diabetes.
A significant risk factor for the development of myoma is excessive body weight – obesity. Subcutaneous fatty tissue has the ability to convert androgens into estrogens, which significantly increases the risk of uterine myoma, endometriosis and breast cancer.
It is precisely known that the growth of formed myomatous nodes occurs as a result of stimulation of myoma by female sex hormones, which are produced in a woman’s ovaries.
How does a uterine myoma manifest itself?
Unfortunately, uterine myoma can be asymptomatic until it reaches a large enough size. Or it happens that the symptoms are subdued and are often perceived as a variant of the norm. Many women do not even know that they have this disease and consult a doctor only when the myoma reaches a significant size.
Possible manifestations of uterine myoma that should alert you:
- Menstrual disorders – menstruation becomes prolonged, irregular, heavy. Often there are acyclic bleeding, not associated with menstruation. Blood loss leads to iron deficiency anemia – the level of hemoglobin gradually decreases. There is weakness, pallor of the skin, which is not always noticeable at once, and is perceived as a common ailment.
- Pain, a feeling of heaviness in the lower abdomen and lower back. If the blood circulation in the myomatous node is disturbed, the pain is acute. However, more often the tumor grows gradually, and the pain is more of a nagging nature, even if the myoma has a large size.
- The enlargement of the abdomen, the feeling of something extra inside.
- Disruption of the function of neighboring organs – urinary tract and gastrointestinal organs. In particular, this applies to the bladder and rectum – the tumor squeezes these organs. This can result in difficulties with urination and chronic constipation.
- Discomfort during intercourse.
- Infertility.
- Prematurity.
How can a uterine myoma be recognized?
During a routine gynecological examination, quite large nodes are easily detected. However, today the doctor can recognize a patient’s uterine myoma at the very beginning of its development with the help of special examination methods.
Already at the first meeting with the patient doctor of the Center for Obstetrics and Gynecology performs her ultrasound screening of the pelvic organs. It is completely painless and harmless to the woman. At the same time, allows the doctor to find in the wall of the uterus myoma nodes of small size and, with systematic expert ultrasound examination, to control the rate of their growth.
Myomas growing inside the uterine cavity, even very small ones, are detected with high accuracy during hysteroscopy. Hysteroscopy is an examination of the uterine cavity with a thin optical instrument inserted through the cervical canal of the cervix.
How does uterine myoma affect pregnancy?
Women with uterine myoma often suffer from infertility.
Myoma nodes growing into the uterine cavity, deform the uterus and disrupt the process of attachment of the fertilized egg to the uterine wall.
If pregnancy occurs, it often ends in spontaneous miscarriage or birth of a premature baby, as myoma nodes, occupying a significant place in the uterine cavity, interfere with the development of the fetus.
During pregnancy, myoma nodes usually increase in size due to swelling and changes in hormonal background, causing a woman pain and discomfort.
Childbirth in women with uterine myoma, as a rule, runs hard, with the development of anomalies of labor. In such situations, uterine myoma is an indication for cesarean section surgery. In addition, the postpartum period in some cases is complicated by bleeding.
Therefore, surgical removal of the node followed by reliable suturing of the uterine wall is considered the best option when planning a pregnancy. Only then a favorable outcome of pregnancy is possible.
What happens to uterine myoma without treatment?
Once appeared, the tumor tends to increase in size, more and more nodes appear. The growth of myoma in each woman goes at a different rate. Growing myoma can destroy the uterus and fill the entire pelvic cavity and even the abdomen. Myoma uterus sooner or later leads to uterine bleeding with the development of anemia, pain, disorders of neighboring organs, infertility and termination of pregnancy when it occurs.
Sometimes there can be serious complications associated with a torsion of the leg of the node and the development of inflammation in the abdominal cavity. In these situations, emergency surgery is required. In rare cases (1 out of 100) in the myoma node can appear malignant tumor – sarcoma.
With the onset of menopause, as a rule, there is a decrease in the size of the tumor. The ovaries stop their work. Due to the lack of female sex hormones, myoma begins to “shrink”. But, in the presence of sufficiently large tumors, and here the woman is under danger – as a result of nutritional disorders of myoma can occur its dying off and severe inflammation. And this leads to the need for emergency surgical intervention.
Can uterine myoma be cured conservatively (non-surgically)?
Myoma of the uterus can not be completely cured by conservative methods. In some cases, taking hormonal drugs can reduce its size or stop its growth. This is enough for a safe coexistence with the disease. In this case, it is important to systematically visit the gynecologist and conduct ultrasound examinations to maintain control over the process.
However, the complete removal of uterine myoma, like any tumor, is carried out only surgically. There are clear criteria in which case surgical intervention is necessary: if there is pain, bleeding and anemia, uterine myoma of large size – more than 12-14 weeks, there is a rapid growth of myoma, violation of the function of neighboring organs, etc. Specialists of the Hospital Center of the Medical Company BFE can accurately determine a particular way of solving the problem, based on their innovative approach to the classification of myomas, which allows you to calculate the coefficient of volumetric deformation of the uterine wall.
Can the uterus be preserved during surgical treatment of myoma?
The question of the possibility of preserving the uterus is decided by the operating gynecologist. With myoma, it is almost always possible to save it. Our gynecologists-surgeons have a number of techniques that allow before the operation myoma to reduce, for the duration of the operation to de-blood the uterus, and, accordingly, to minimize the risk of losing the organ.
What types of surgical treatment for uterine myoma are used in the inpatient department of BFE Medical Company?
The vast majority of operations at BFE Medical Company are performed using gentle organ-preserving technologies: laparoscopy (endoscopic surgery through abdominal wall punctures 5-10 mm), minilaparoscopy (through punctures 3-4 mm), hysteroscopy (through the cervical canal of the cervix). Removal of myomas growing into the uterine cavity is possible with hysteroresectoscopy without incisions and punctures. Our clinic has developed unique modified technologies of operations and suturing the bed of myoma node, which allow not just leave the uterus, and preserve its ability to carry a baby and safe delivery.
What are the advantages of laparoscopic (endoscopic) surgery?
- Organ-preserving surgical techniques.
- Instead of a wide abdominal wall incision (7 to 30 cm in length), several punctures of 3-10 mm are made. Therefore, there is virtually no postoperative pain, cosmetic defects, there is no need to follow a strict bed rest, strict diet.
- The average length of hospitalization is 1-3 days. In open surgeries, the usual period of hospitalization is 2-3 weeks. Normal well-being and the ability to normal household and labor activities are quickly restored.
- Due to the absence of a large incision, postoperative hernias are very rare. Ventral hernia is a frequent complication after open surgery, especially in elderly patients.
- Due to the absence of a large incision, postoperative hernias are very rare. Ventral hernia is a frequent complication after open surgery, especially in elderly patients.
- With a laparoscope, the surgeon has a much better view of the abdominal organs than with a large incision. As a result, blood loss is several times lower, there is less trauma to tissues, there is an opportunity to clarify the existing diagnosis, instant change of treatment tactics if necessary, the possibility of diagnosing concomitant pathology.
- During endosurgical intervention there is no contact of tissues with the surgeon’s gloves, there is no talcum powder on the organs and peritoneum, less manipulation of the intestines, no gauze napkins are used – all this excludes the development of infectious complications and reduces the possibility of postoperative adhesions leading to infertility, intestinal obstruction and other severe pathologies.
Thus, uterine myoma is a benign tumor that often occurs during the reproductive years.