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Fibromyoma - Uterine, Diagnosis, Treatment
Fibromyoma - Uterine, Diagnosis, Treatment
Fibroids of the uterus - is the most common benign tumor in gynecology. It occurs in 25-30% of women over the age of 35 years and 30-35% in the age before menopause. The disease manifests the appearance of nodes in the thickness of the uterine body, which then grow in different directions: outside, inside the uterus and continue to grow inside the uterus. Most often there are multiple fibroids with different locations of the nodes of different sizes, rarely subserous (with growth nodes outside) and submucous (with an increase in inward). Occasionally (5%) myoma nodes are amazing and the cervix.
The reasons for the emergence and development of uterine fibroids to date remains an open question. One of the factors influencing the growth of fibroids is an increased level of estrogen hormones and progesterone deficiency. What matters is a violation of the synthesis and transformation of these hormones, changes in sensitivity to body tissue of the uterus (myometrium). Hereditary component also plays a role in causing the disease. It is more common in women, the nearest relatives are sick fibromyoma cancer and polycystic ovaries.
Complaints with fibromyoma depend on the size of units, location and characteristics of their growth, the duration of the disease, and other factors. The most frequent bleeding, anemia associated with prolonged bleeding, pain, signs of compression of adjacent organs. Monthly there are abundant and long, especially when submucous myoma, frequent bleeding, not associated with menstruation. Pain caused by tension ligament of the uterus, stretching her abdominal cover, and the pressure of the growing tumor to adjacent organs. Pain may be associated with the birth of submucous node torsion legs subserous fibroids, intraligamentous tumor growth, necrosis of the node dysfunction, and other adjacent organs occur more frequently when intraligamentous, cervical or uterine subserous located close to the cervix. The growth of the tumor anterior to the neck puts pressure on the bladder, causing urinary disorders. When the location of possible compression mezhsvyazochnom ureter with subsequent renal dysfunction. Pozadisheechnaya tumor compresses the rectum and causes a disturbance of bowel function.
Diagnosis of uterine fibroids
Diagnosis of uterine fibroids is not difficult with increasing size of the uterus. To clarify the number and location of sites used additional methods. The leading role is now played by ultrasound, which has very high with fibromyoma informative. To recognize the submucous nodes used and hysteroscopy (examination of the uterus using a special apparatus). At the same time revealed endometrial hyperplasia, endometrial polyps and other pathologies. According to the testimony used laparoscopy.
Treatment of uterine fibroids
Treatment of uterine fibroids questions are of great importance due to its wide distribution.
If the size of the uterus, more than 12 weeks gestation, submucous location node in combination with endometriosis and fibroid tumors, ovarian tumors with rapid growth and development of secondary anemia, necrosis and other components used radical surgical treatment of uterine fibroids: hysterectomy with or without neck it.
In younger patients, with a relatively small increase in the uterus, the presence of infertility may conduct conserving surgery: the conservative myomectomy, which is now often carried out by laparoscopic means. Before the surgery to reduce tumor size efficient use of GnRH agonist ('Zoladex', 'Dekapeptil Depot "). After application of these drugs is also observed increased levels of hemoglobin, the cessation of bleeding, which often allows for sparing surgery rather than radical.
In the absence of contraindications held non-operational treatment of uterine fibroids. For its success is very important early diagnosis and prompt initiation of treatment. Non-operational treatment is applied in the presence of diseases in which surgery is contraindicated.
The goal of treatment is to stop or deceleration of tumor growth. It should be integrated, not only gynecological but also diseases of internal organs of a woman (liver, kidney, heart, etc.).
Non-hormonal treatment is usually used to relieve symptoms. With increased blood loss and decrease in hemoglobin levels using iron supplements and reducing the uterus means. In the treatment group used vitamins B, C, E. Great importance is attached to vitamin A, needed a rational diet therapy, especially in the presence of obesity.
Plays a role herbal medicine, which combines the advantages of various non-hormonal treatments. The use of physical therapy is not contraindicated for uterine fibroids, as previously thought.
But the real effect of non-operational treatment of the disease can only be obtained when using hormones. Currently used progestins: "norkolut" or "primolyut-normal" in a cyclic or continuous mode, the 17-defense, "gestrinone" and "danazol". Highly 'Zoladex', which causes a significant reduction in the size of fibroids. Unfortunately, after the abolition of tumor growth, as a rule, renewed, and therefore, it is most rational for preoperative preparation, or if necessary to delay surgery.
