Uterine fibroids are benign tumors originating from the smooth muscle tissue of the uterus. Tumor development is associated with disorders in the hypothalamic-pituitary region and increased estrogen production. There are interstitial, subserous and submucosal uterine fibroids. The nodes can be located in the body (95%) and cervix (5%) of the uterus.
Symptoms
It usually occurs in women over 30 years of age. The disease is manifested by cyclic bleeding (menorrhagia), against which acyclic uterine bleeding (metrorrhagia) is not often observed due to the development of a submucosal node or a combination of a tumor with dysfunctional uterine bleeding. If the tumor grows towards the bladder and rectum, then symptoms of compression of these organs are found. Tumor growth is relatively slow. Palpation is painless, the tumor is dense, bumpy.
Complications: torsion of the legs of the subserous node, necrosis of the node (traditionally interstitial and submucosal), hemorrhage. When the pedicle of the tumor is twisted, a picture of an acute abdomen appears. Necrosis is characterized by abdominal pain, fever, chills, soreness, and softening of the node.
Diagnostics
If a submucous node is suspected, probing of the uterus, hysteroscopy and hysterosalpingography are used. Differential diagnosis is carried out with uterine sarcoma, cystoma and ovarian fibroma. To differentiate a tumor of the uterus from a tumor of the ovary, it is necessary to displace the cervix with the help of bullet forceps applied to it: if the tumor comes from the uterus, then it belongs to the movement of the cervix.
Treatment
Treatment depends on the age of the patient, the rate of tumor growth, the severity of symptoms, the location of the nodes and the presence of complications. Women with small tumors (up to 12 weeks of gestation) without bleeding need a systematic examination by a gynecologist.
Conservative therapy is indicated for small tumors and moderate menorrhagia. Uterine-contracting products are used (cotarnine chloride, methylergometrine, calcium chloride, pituitrin). Hormone therapy is carried out: at a young age, progesterone or combined estrogen progestogens. In the second phase of the menstrual cycle after 45 years, androgens are prescribed: methyltestosterone 5 mg under the tongue 3-4 times a day for 12-14 days, on the 24-26th day of the cycle, cotarnine chloride 0.05 g 3 times every day.
Treatment courses are repeated 5-6 times. Indications for surgical treatment: rapid tumor growth; profuse uterine bleeding leading to anemia; symptoms of compression of adjacent organs; submucous myoma; cervical fibroids; tumor node necrosis; twisting of the leg of the node. The operation can be palliative (husking the nodes) or radical (amputation or extirpation of the uterus).