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Uterine fibroids Causes, Diagnosis, Treatment
Uterine fibroids Causes, Diagnosis, Treatment
Fibroids of the uterus is one of the most common benign tumor of women. Frequency of amazingly high - one in four women older than 30 years and every third woman predklimakterichesogo age has this pathology. Approximately every second patient department of operative gynecology is elective surgery for uterine fibroids.
Uterine fibroids or, more precisely, leiomyofibroma - a tumor of the smooth muscle of the uterus with a strong component of connective tissue. Fibroids (leiomyoma) of the uterus in its pure form is rare. Thus, the fibroids with nodes located in the middle of the myometrium is the ratio of muscle and connective parts 2-1 and more like a true myoma. In podbryuschinnyh fibroids sites this ratio is 1:3.
The causes of fibroids include, above all, a stimulating effect on the hormonal myometrium. Found that estrogen increased the background is not observed in all patients, but it develops the metabolism of estrogens and corpus luteum function, changing the sensitivity of the uterus to the action of hormones.
A role in the emergence and development of uterine fibroids are disturbances in the hypothalamic - pituitary - ovaries - uterus. Although specific data in this regard is small, most authors agree on the idea that since the beginning of puberty before menopause estrogen levels in the blood increases about 3 times, and this factor should be considered, if not causal, then one of the most important starting points. Heredity is also important, ie in families where there were fibroids and polycystic ovaries at risk of developing fibroids immediate relatives is much higher.
The development of uterine fibroids most often characterized by the formation of multiple units of various sizes. Single units are rare. The most frequent localization sites - along the median line, near the spools and lateral parts of the cervix, where there is a close intertwining of the muscle fibers. Quite often, the node starts to grow within the muscular layer. Outside the uterine fibroids often grow on the leg muscle. Sometimes the stem is so thin that it can twist and cause complications of the disease. Simple fibroids, uterine proliferative and predsarkoma are usually developmental stages of malignant disease - sarcoma, and therefore prompt treatment fibroids are the most effective way to prevent the development of LMS.
Clinic for fibroids
The clinic depends on the type of tumor, its location and other factors. With slow growth years of the disease nodes can occur without any symptoms, despite the relatively large size of fibroids by the time of its detection. The rapid growth of the tumor gives a more pronounced symptoms, and are likely to fall into the surgical ward after 1-2 years of onset.
Patients go to the doctor when they detect bleeding associated with it anemia, abdominal pain, symptoms of the bladder and other adjacent organs. Bleeding is usually manifested in the form of monthly heavy (with clots, more than 5 days), but then can be transformed into cases of bleeding outside the menstrual period.
With long-term course of disease observed dysfunction of the ovaries until the lack of ovulation or luteal dysfunction, which leads to even more pronounced hormonal shifts. These shifts are stimulating factor in the development of cystic changes in ovaries and endometrial hyperplasia. With the onset of menopause, a decrease in tumor size. If the size of the tumor for the year increased by 5 weeks of pregnancy, you will need a thorough examination to exclude malignant transformation of uterine sarcoma.
Diagnosis of fibroids
The diagnosis is easily have a normal gynecological examination. If you suspect that submucosal fibroids is sometimes necessary to hysteroscopic examination (examination of the uterus). Of great importance in the diagnosis are the means of medical imaging, among which played a leading role ultrasound. They are also used magnetic resonance imaging, X-ray and other methods.
Treatment for fibroids
Primarily surgical. Now try to use organ-saving operations. However, the rapid growth of the tumor, suspected malignancy, large size of the tumor performed radical surgery: amputation of the uterus, uterine ektirpatsiya.
But modern surgery can remove even large fibroids laparoscopically, which creates additional opportunities for the treatment of a doctor and patient. Sometimes you can do without surgery. In these cases, medication is carried out inhibition of tumor growth through a comprehensive treatment of hormonal and nonhormonal drugs.
