What sizes of uterine fibroids are dangerous in weeks and centimeters? Growth factors of benign tumors of the uterus and indications for surgical intervention Myoma 90 mm what to do.

The main danger of a neoplasm lies in its potential ability to grow and degenerate into a malignant cancerous tumor, which is why it is so important to monitor the increase in the size of myoma nodules.

With the diagnosis of uterine fibroids, the dimensions for the operation to remove it are determined by a set of studies:

visual-bimanual examination on a gynecological chair using a special mirror;
ultrasound examination, specifying the number and size of fibroids.

In order for the doctor to prescribe the correct treatment, it is necessary to repeat the ultrasound procedure several times. This will determine the rate of tumor growth. To obtain a detailed picture of the disease, it is recommended to do an MRI.

With the growth of fibroids, the cavity of the organ itself also gradually increases - this resembles the growth of an embryo. Due to this similarity, the size of uterine fibroids is usually compared with the weeks of pregnancy. For example, uterine fibroids 7 weeks is approximately 2.5 cm.

Myoma sizes

In gynecology, it is customary to conditionally divide uterine fibroids into three types, based on the size of the neoplasm:

small myoma. It is comparable to a pregnancy of 6-8 weeks and has a volume of up to 2 cm. Usually, such a tumor does not manifest itself in any way, a woman learns about the disease by accident. It is important to identify the formation during this period - a fibroid of 7 weeks in size will bring much less trouble than a neglected giant tumor.
Medium fibroids. In terms of pregnancy, the size will be 10-12 weeks or up to 7 cm. A patient with such a tumor may complain of heavy painful menstruation that cannot be anesthetized with medications. There are small discharges of blood in the middle of the cycle, the so-called "daub".
Large fibroids. The parameters of the neoplasm are comparable to the embryo at 12-15 weeks.

Symptoms

The presence of such uterine fibroids is manifested by severe symptoms:

pain in the belt, heart, and with adhesions to the tissues of neighboring organs - in other places;
frequent numbness of the legs due to circulatory problems;
violation of defecation or increased urge to urinate due to tumor pressure on the nearest organs - intestines, bladder;
an increase in the lower abdomen while maintaining weight at the same level.

Small and medium fibroids in the absence of complicating factors allow conservative treatment without surgical intervention. In such cases, conception and successful delivery are possible. But large-sized fibroids will become a serious obstacle to childbearing.

Even if the tumor is very small and is measured not in centimeters, but in millimeters, you should not relax: it can be located in a dangerous area. The growth of a tumor on a stalk can cause inconvenience even with a size of 9 mm: when the stalk is twisted, the pain is unbearable.

Another mandatory characteristic of fibroids is the rate of its growth: an increase in 12 months by more than 5 or weeks or 4 cm is considered a dangerous signal and one of the indications for surgery.

Heal can't be cut

A patient with a diagnosed tumor first of all asks the question: at what size of uterine fibroids do surgery and is it possible to do without it.

Doctors distinguish several indications for surgical intervention:

Fibroids are larger than 12 weeks or 6 cm. Such myoma nodes pose a threat to the life of a woman. If several medium-sized nodes are found, their urgent removal is considered strictly mandatory. At the same time, slightly smaller uterine fibroids, for example, 5 weeks, are subjected to drug treatment under the supervision of the attending physician.
woman planning pregnancy. Medium fibroids often cause infertility or miscarriages in the early stages. A change in the hormonal level during pregnancy stimulates the growth of the tumor: it can be either a small growth or a sharp increase at times, creating a threat to the baby.
Risk of degeneration into sarcoma- a malignant tumor. First of all, this probability is manifested by rapid tumor growth.
Constant severe pain. This symptom is also characteristic of medium and large fibroids. The location of the myomatous node can cause the tumor to compress the nearest organs, causing severe pain. So with pressure on the rectum, a rare stool is observed - 1 or 2 times in 6-8 days. This situation threatens with intoxication of the body and inflammation of the intestines.
heavy bleeding. Constant loss of a significant amount of blood leads to anemia. Uterine fibroids usually bleed heavily for 15 weeks or more.

Uterine fibroids of small sizes, i.e. less than 4 cm, rarely removed. Usually the doctor selects the right treatment and simply observes the condition of the tumor. It is better to treat myoma formations in a complex way: hormonal drugs, gymnastics, diet, folk remedies. An exception is a pedunculated fibroid, such a neoplasm is dangerous and painful, it is removed.

Menopause stops the growth of fibroids due to a decrease in the production of estrogens - female sex hormones. Therefore, in menopause, tactics of passive observation are also acceptable. The alternative is a radical solution to the problem, removal of the uterus.

Of course, there is no need to rush to the operating table: a knowledgeable specialist uses all the possibilities to reduce myoma with medication. If the operation is the only possible way out, you should not delay it either, because delay can cost your health.

Traditional and alternative operations

Uterine fibroids that have reached the size for the operation must be removed - this is the golden rule of gynecology. In advanced cases, the tumor reaches the parameters of a full-term baby: it weighs up to 8 kg and has a diameter of up to 40 cm. The torment caused by the giant tumor body is terrible. And yet women endure pain for years and categorically refuse to remove the source of suffering.

Removal of uterine fibroids is an abdominal operation, but some fear of it is justified and natural. The intervention is performed under anesthesia, so you should not panic.

Modern medicine offers different options for getting rid of fibroids, let's start with gentle alternatives:
. It is applied to a node no larger than 6-7 weeks. Reviews of doctors characterize the laser as the least traumatic method, which has a lot of advantages:

does not leave ugly seams, only a small scar 1.5 - 2 cm in size, as seen in the photo;
maintains the maximum ability to bear children;
rehabilitation lasts only 14 days.

Given that the latest sensitive equipment is used and highly qualified doctors work, many patients prefer to clarify in advance how much the operation costs in different clinics. You can save on expensive treatment by getting a quota from the state. True, it will take some time.

Embolization of the uterine arteries. The effectiveness of UAE is 98%, while with conventional surgical removal, the risk of recurrence is 40%. Through a catheter on the femoral artery, a solution is injected that clogs the vessels that feed the myoma. As a result, the tumor gradually dries out and dies. It is best to do this intervention when the fibroid is about 9 weeks old or less. The long-term effects of the procedure are not fully understood. In some patients, after UAE, there was an absence of the menstrual cycle - amenorrhea.

How is the operation - video

Abdominal surgery

It happens that the state of fibroids does not allow using alternative methods of removal: the situation is complicated by necrotic processes in the tissues, the tumor stem is twisted, etc. Then the surgeons perform traditional abdominal operations, making incisions on the abdominal wall. After such a removal of uterine fibroids, the woman will have to spend the postoperative period in the hospital under the supervision of doctors.

There are four types of traditional abdominal operations:

Laparoscopy or myomectomy. The intervention occurs through the introduction of special equipment into the punctures on the abdominal wall - a laparoscope, therefore it does not leave large scars. The second plus is a short rehabilitation period, it will be only a week. During laparoscopy, several fibroids are usually removed, not exceeding 15 mm in diameter. The uterine cavity should be enlarged for a maximum of 15-16 weeks. For the uterus itself, the consequences of such an operation are the least severe, the risk of adhesions in the fallopian tubes is minimal.

Laparotomy or removal of fibroids through a small incision made in the abdominal wall. Indications for laparotomy:

distortion of the shape of the uterine body caused by rapid tumor growth;
growth of large tumors in the abdominal cavity or pelvic area;
the size of the nodes is more than 12-15 weeks.

Hysteroscopy or resectoscopy. A special device, a hysteroscope, is inserted into the uterine cavity through the vagina. The method is applied to single nodes on the uterus 6 or more weeks in size, located on the back or front wall of the uterus. The intervention is preferably carried out in the first 7 days of the cycle. The operation is so simple that it can be performed on an outpatient basis.

Hysterectomy- complete removal of the uterus. A radical measure used in extreme cases when other methods are no longer effective:

with a gigantic size of the tumor;
degeneration of a benign tumor into a sarcoma;
the presence of many different types of nodes;
climax.

Recovery will take 2 months. The doctor will prescribe pain medication for a few days, because. pain does not even allow you to just stand, and the implementation of the simplest movements is painful. Then you need to drink a course of antibiotics. Based on the patient's condition, general strengthening drugs are prescribed. In the postoperative period, the risk of bleeding is high. Any discharge of blood is a reason to immediately seek medical help.

Removal of fibroids - video with Elena Malysheva

Features of rehabilitation

The operation to remove uterine fibroids is not the most difficult and dangerous, but it is still important to follow a number of rules in the postoperative period. This will help you quickly return to a normal rhythm of life and restore hormonal levels.

The advice of gynecologists is mandatory, especially since it is not difficult to follow them:

avoid constipation, especially in the first postoperative days;
try to move more, while eliminating any load on the stomach (slow walking will do);
in the first six months after surgery to remove uterine fibroids, you can lift no more than 3 kg;
eliminate stressful situations, tk. they lead to hormonal disruptions and relapse of the disease.

You can plan a pregnancy only after consulting with your doctor. The operation performed is always stressful for the reproductive organs, the recovery of which may take quite a long time.

During the rehabilitation period, it is mandatory to take medications that normalize the structure of the uterine body and the menstrual cycle. Any unpleasant symptoms should not be ignored - it is better to once again make sure that everything is fine than to allow the development of complications.

Uterine fibroids is one of the most common gynecological pathologies, and you will not surprise anyone with such a diagnosis. According to statistics, the disease is detected in 35% of women over the age of 35 years. In modern gynecology, practitioners often have to deal with formations of small and medium sizes.

Large fibroids are somewhat less common due to the developed system of diagnostics and the timely passage of regular medical examinations by women. It is noted that huge nodes are detected mainly after 40 years in patients who have refused treatment for a long time.

The largest fibroid in the world, according to medical literature, weighed 63 kilograms, and so far this sad record has not been broken. This fact makes it clear: a uterine tumor can grow almost indefinitely, reaching gigantic proportions. There is no need to wait until the weight of the fibroids is equal to the weight of an adult. Timely therapy avoids such a development of events and prevents the rapid growth of the myomatous node.

What fibroid is considered large

On numerous forums on the Internet, you can find entries in the style of “I have been living with a large fibroid for many years, I don’t know what to do.” At the sight of such messages, women involuntarily ask themselves the question: which fibroids should be considered large and are there clear criteria for this condition (for example,)? Gynecologists adhere to the generally accepted classification, according to which a large fibroid is considered a node with a size of 6 cm (60 mm).

A large tumor is considered to be more than 6 centimeters in size (the photo shows a fibroid removed along with the uterus more than 15 cm in diameter).

The size of the uterus in this case corresponds to a 12-week pregnancy. But here are some important points to note:

In the medical literature, one can find a mention that a large fibroid is a node with a diameter of 5-6 cm. In this situation, it is not entirely clear which category a tumor with a size of 5 or 5.5 cm belongs to - medium or large nodes? If we analyze the case histories of patients, we can see that fibroids of such borderline sizes are classified as both large and medium tumors. Practitioners in this situation are advised to look not only at the size of the formation, but also at the size of the uterus, and if it exceeds 12 weeks, classify the tumor as large;

A photo of a large fibromyoma can be seen below:

With the leading value is the size of the dominant node - they are guided by it when drawing up a treatment protocol;
Giant fibroids deserve special attention among large formations. Which tumor to consider as such is a debatable question. It is customary to refer to giant nodes from 10-12 cm in diameter. Such formations are poorly amenable to conservative therapy, and their removal within healthy tissues requires special skill of the surgeon. Often, with giant tumors of the uterus, the only method to solve the problem becomes.

A photo of a giant fibroid is presented below:

On a note

Uterine leiomyoma according to ICD-10 has code D25, regardless of the size of the node.

It is important to understand that theoretically a benign tumor can reach any size if its growth is not limited by anything.

Distinctive features of large myomatous nodes

It is important to know

If a woman is planning a pregnancy, treatment of a large fibroid should not be delayed.

Successful conception of a child does not mean that the pregnancy will pass without complications. With large fibroids, placental insufficiency and concomitant fetal growth retardation are often recorded. Pregnancy against the background of a large tumor can end prematurely, and rarely any of the women manage to bring the baby to at least 36-37 weeks.

Childbirth with myomatous nodes from 6 cm in size is quite often complicated by anomalies of labor activity and bleeding. According to the reviews of women who gave birth with a large fibroid, it becomes clear: the percentage of cesarean section in this case is very high.

With large fibroids, a woman can hardly give birth on her own. In this case, as a rule, a caesarean section is used.

Fitness and sports. Intense exercise that increases blood flow to the pelvic organs is not recommended. It is forbidden to train the press and pelvic muscles;

Yoga. You can do it, but asanas that affect the abdominal muscles are excluded;

Visiting the sauna and bath. Although the effect of heat on the growth of the myomatous node has not been proven, gynecologists do not recommend getting involved in such procedures;

Taking medication. Do not take drugs that can affect the growth of fibroids.

There are no special prohibitions regarding intimate hygiene. A woman can use panty liners, absorbent pads, and tampons (such as Tampax). The latter option is not very convenient, since it does not always allow you to fully assess the amount of bleeding during bleeding. There is no prohibition on sexual life, provided that the woman feels well.

The prognosis for large myomatous nodes depends on the timeliness of diagnosis. The sooner a tumor is detected and treatment is started, the easier it will be to stop its growth and prevent the development of complications.

Treatment methods for large fibroids

Case study: removal of a giant uterine fibroids

Uterine fibroids is a benign neoplasm in the body of the uterus or cervix, which occurs quite often in women of different ages. Such tumors are usually not dangerous to life and health, but sometimes they grow to large sizes, put pressure on the surrounding organs, and there is a possibility of their degeneration into a malignant tumor. Myoma is preferred to be operated on in most cases, it is worth learning more about the size of uterine fibroids in millimeters for surgery, what types of surgical intervention are.

Myoma is one of the most common gynecological pathologies along with various types of cysts. The neoplasm is benign, it is usually dense, consists of fibrous tissues and muscle fibers, the symptoms of this disease are usually rather mild. Often, the disease is detected only during a preventive examination by a gynecologist. According to the latest data, fibroids are detected in 80% of women. However, clinically the tumor appears only in 35% of women.

Previously, it was believed that this disease occurs exclusively in older women, but recently doctors often diagnose pathology in young women. Most likely, this is due to the fact that the diagnostic capabilities of medicine are improving over time, now the disease is detected much earlier, it is possible to track the slightest changes and differences from the normal state in the organs of the reproductive system.

Myoma can increase or decrease in size under the influence of various factors, this process can proceed quite slowly. In medical practice, cases have been recorded when the tumor reached 18-20 centimeters in diameter and squeezed the organs of the small pelvis and abdominal cavity.

At the very beginning of the development of pathology, a neoplasm can usually be eliminated with the help of medications, they are required if the tumor is small in size, it is just starting to develop. Larger fibroids have to be removed surgically, using different methods depending on the size and location of the tumor.

Also, multiple fibroids are quite common, the tissues that form the tumor are distributed unevenly and form several separate neoplasms. Before starting treatment and operations, it is important to find out the exact number of tumors, their location. If you leave any fibroid, it can continue to grow, you will not be able to get rid of the disease completely.

Also, in the early stages, removal and any intervention may not always be required. The approach to the treatment of this tumor is usually individual, it is impossible to derive any general treatment plan that would suit each patient with this disease. Depending on the indication, it may only be necessary to observe the nature of the development of the tumor without intervention up to certain stages.

In general, fibroids are not a dangerous diagnosis. However, without observation and the necessary surgical intervention, proper treatment, it develops uncontrollably, you can miss the moment when complications begin to develop.

Important! To detect fibroids at an early stage, all women of reproductive age are advised to visit a gynecologist once a year with an ultrasound examination in order to notice changes in time.

In general, fibroids are considered a fairly “safe” tumor, it rarely leads to the oncological disease, provokes other disorders in the organs of the reproductive system. However, it is worth noting that the dynamics of changes in this disease is still worth monitoring, applying suitable treatment, if necessary.

First of all, fibroids, especially large ones, cause many unpleasant symptoms: pain in the lower abdomen, complicated menstruation, bleeding can be more abundant and prolonged. There is also always the possibility of squeezing adjacent organs, such as the kidneys, urinary tract with formations of hydronephrosis (dilated kidney) and hydroureter (dilated ureter). The larger the neoplasm, the higher the likelihood of such complications.

Uterine fibroids are especially dangerous during pregnancy. During the bearing of a child, small tumors tend to decrease, but a large tumor can begin to grow faster under the influence of changes in the hormonal background of a woman, large neoplasms greatly increase the likelihood of a miscarriage and other complications during pregnancy. Therefore, before carrying a child, it is always advised to undergo an examination by a gynecologist and make sure that there are no pathologies that may affect the health of the future mother and child.

Important! Also, the very fact of the occurrence of a tumor can indicate various disorders in the body, for example, problems with the hormonal background in a woman.

Can fibroids dissolve

Do not confuse this neoplasm with a functional cyst, which can easily disappear on its own. Fibroids do not resolve on their own, however, small tumors can pass under the influence of drug treatment, usually drug therapy is suitable for small uterine fibroids no more than eight millimeters in diameter.

For treatment without surgery, various drugs are used, depending on the disorders that accompany the development of the neoplasm, hormonal drugs, hemostatic drugs may be required. You may also need to take various vitamins and switch to a healthy diet.

First of all, it is worth noting that there are many types of surgical intervention, its choice depends on the size of the fibroids, usually experts determine it in weeks, comparing it with the size of the uterus during pregnancy. In general, all neoplasms can be divided into several groups, the classification by size is as follows:

Small. Size - up to 2 centimeters (20 millimeters), usually talking about four weeks.
Average. Size - from 2 to 6 centimeters (up to 60 millimeters), term - 10 - 11 weeks.
Big. Size from 6 centimeters (from 60 millimeters), term - from 11 weeks and above.

Dangerous sizes are considered large, in which the tumor can be six centimeters or more, especially from 15 weeks. At this stage, in most cases, removal is indicated, especially if the likelihood of complications is high.

Operation types

Depending on the size of the fibroids in weeks or millimeters, it is best to choose the type of intervention. There are several types of operations, it is also worth paying attention to other characteristics of fibroids: are there multiple nodes, its location, the presence of complications, for example, torsion of the tumor stem. Depending on all factors and size, the following types of interventions are usually resorted to:

organ-preserving operations. With such interventions, only myomatous nodes are removed. The operation can be performed laparoscopically - the most sparing method. With such an operation, only a few punctures are made, the recovery period does not take much time, several nodes can be removed in one operation with multiple myoma. The second method is transcervical (access through the cervix).
A radical method of removing fibroids is hysterectomy, the complete removal of the uterus along with the tumor. This technique is indicated in the later stages of the disease, with large tumors, if there are concomitant pathologies, for example, endometriosis. Before resorting to this method, it is first worth considering other types of interventions. Most of all, this method is suitable for the treatment of women with menopause, the uterus is removed if there are several nodes for more than fifteen weeks.

There are practically no contraindications to various types of surgical intervention, modern techniques allow the operation to be carried out as safely and without complications as possible. After removal of fibroids, you need to be observed by a gynecologist for some time, since there is a possibility of new nodes.

Sizes for surgery during pregnancy

It happens that fibroids have to be removed during pregnancy. This is done in extreme cases, the removal of such a tumor depends rather not on the size, but on the danger to the fetus. If the tumor greatly interferes with normal gestation, the likelihood of a miscarriage in the expectant mother increases, the fibroids must be removed.

In addition, pregnant women with such tumors are delivered, as a rule, by caesarean section, since fibroids also affect the course of childbirth - untimely discharge of water, anomalies of contractile activity, etc. During a caesarean section, after removing the child, it is sometimes necessary to remove myomatous nodes, and even the entire uterus.

In general, during pregnancy, large tumors begin to grow faster due to the influence of hormones, pregnancy in this case should proceed under the constant supervision of the attending physician. The presence of a large fibroid, malnutrition of the child is an indication for myomectomy.

Myoma is a benign tumor that is localized in the uterine myometrium (muscle layer). In medicine, a pathological formation is also called leiomyoma and fibromyoma. The age of patients who are faced with such a diagnosis varies between 20-70 years. Most often, tumors are found in reproductive age. To prescribe treatment, the doctor needs to determine the size of the growths, their number, location, type, etc. We will figure out at what sizes of uterine fibroids surgery is performed and when conservative treatment is prescribed.

Briefly about the disease

A benign neoplasm has the shape of a ball of various sizes.

The severity of the disease lies in the asymptomatic course. The first discomfort appears at the moment when the tumor has reached a medium or large size and progresses further. The pathological process is caused by hormonal disorders. According to statistics, multiple fibromyomas are most often diagnosed.

To determine the formations, an examination and ultrasound examination are performed. Knots are measured in mm, cm and weeks. The process itself is very similar to the development of a baby in the womb. With the growth of the neoplasm, the uterus increases, bleeding, pain and other discomfort may occur. If there is an excess of estrogen in the woman's body, the pathology will progress.

According to medical data, large nodes (12-16 weeks), which reach 6 centimeters or 60 millimeters, require surgical treatment. Medium tumors (10-11 weeks) are not always removed. Small lesions (4 weeks) 2 cm or 20 mm are treated with drugs, physiotherapy, etc. The main danger of the process lies in the possibility of degeneration into cancer.

The size of fibroids and their symptoms

Every woman should understand at what size of nodes an operation is needed, and when drug treatment is needed. Doctors compare the development of a tumor with an embryo, so the size of the uterus is determined in weeks, as during pregnancy, as well as in millimeters and centimeters. By size, the nodes are divided into 3 categories, according to the size, various symptoms appear:

small- such tumors are no more than two cm in size. Formations are found by chance, normally they do not cause pain and other signs of the pathological process. Fibromyoma 7 weeks is not subject to removal, hormone therapy and observation are prescribed.
Medium- from 20-40 mm to 60 mm, but not more than 7 cm. The patient has profuse menstruation with pain, which cannot be drowned out with painkillers. If the fibroids are more than 11 weeks old, the woman has a swelling of the lower abdomen due to an increase in the cervix.
Large- over 60-70 mm. This is a serious condition that requires surgical intervention, drugs are ineffective here. The nodes squeeze the organs that are nearby, which disrupts the process of defecation and urination. The patient complains of pain in the heart muscle and lumbar region. Numbness of the legs is observed, as the formation presses down on the nerve endings near the rectum.

A pedunculated leiomyoma with torsion causes severe abdominal pain. Such symptoms indicate a violation of the blood flow of the tumor, which is fraught with peritonitis.

Dimensions are determined using ultrasound, only after that the doctor prescribes treatment.

Below is a table of tumor sizes, in which you can see the correspondence of sizes in centimeters to weeks of pregnancy.

Size in weeks	In centimeters
8-9	8-9
10-11	10-11
12-13	10-11
14-15	12-13
16-17	14-19
18-19	16-21
20-21	18-24
22-23	21-25
24-25	23-27
26-27	25-28
28-29	26-31
30-31	29-32
32-33	31-33
34-35	32-33
36-37	32-37
38-39	35-38
40-41	34-35

With any unpleasant symptoms, a woman should definitely see a doctor, some tumors cause serious bleeding.

Indications for removal

To find out whether an operation is needed or not, a thorough examination of the patient is carried out. Doctors distinguish several main indications for surgical interventions:

Severe bleeding - most often excessive bleeding is caused by nodes of 15 weeks or more, if left unchecked, anemia appears;
The size of the fibroid is 12 weeks (in centimeters it is more than 6). If multiple nodes of medium size are found, the woman must be operated on. These tumors threaten the life of the patient. If the fibroid is less than 5 cm, but there are still medium and large nearby, concomitant drug therapy is indicated;
Pregnancy planning – medium fibromyomas can cause infertility or miscarriage. After fertilization, the level of hormones changes, which is fraught with stimulation of the growth of nodes. They can grow slowly or too quickly, because of which the baby will suffer;
The risk of oncology - if the tumor grows rapidly, malignancy occurs;
Regular pain syndrome - pain occurs with medium and large nodular growths. They squeeze neighboring organs, stool and urination are disturbed, which can cause inflammation of the intestines or intoxication of the body.

Neoplasms smaller than 4 cm are usually not removed.

Surgery is indicated in the diagnosis of fibromyoma from 9 weeks during menopause. Menopause stops the development of nodes, as estrogen production is inhibited, but the patient must be monitored. As an alternative, a radical method of therapy is used - removal of the uterus.

Abdominal operations

The golden rule for the successful treatment of pathology is that a formation that has reached the size for an operation must be removed.

If you start the process, the node grows to the parameters of the child and can weigh up to 7-8 kg. Today there are many methods, both traumatic and sparing. In cases where the condition is complicated by tissue necrosis or pedicle torsion, it is decided to operate in the traditional way, abdominal surgery is chosen. To do this, incisions are made on the peritoneum, through which the tumor will be removed. There are 4 types of such interventions, we will consider them.

Laparotomy

It is used in cases where the fibromyoma has reached the size of 14 weeks and presses on neighboring organs. The operation is performed through small incisions in the abdominal wall, which are then sutured. This method of removal provides for a long rehabilitation, more than one month. During the recovery period, one should not overwork much, lift weights, etc. You can leave the hospital after a week, when the stitches are removed.

Hysterectomy

This technique is used if the node has reached a gigantic size, is growing rapidly and is prone to degeneration into cancer. Also, the intervention is prescribed during menopause and in the presence of multiple tumors. A hysterectomy is the complete removal of the uterus, so it is only used as a last resort. The recovery period is 2 months, the first few days they take painkillers. Then an antibiotic is prescribed. During the rehabilitation period, the risk of bleeding increases.

If a woman notices spotting, you need to call an ambulance.

Hysteroresectoscopy

The operation is carried out using a special device. A hysteroscope is inserted into the vagina, which penetrates the uterus. The method is used for single formations of 15 mm or more, if they are localized on the anterior or posterior wall. The intervention is scheduled in the first week of the cycle.

This method has received many good reviews, it can be carried out even on an outpatient basis.

Myomectomy

Removal occurs through punctures in the peritoneum with a laparoscope, so there are no noticeable scars. Of the advantages of laparoscopy, one can note a short recovery time, approximately 7 days. The method is used to remove several formations of 9-11 mm, but not more than 15. In this case, the uterine cavity should not exceed 8 weeks. The organ practically does not suffer, the risk of adhesions is minimal.

After the operation, the patient remains fertile.

Other treatments

If the fibroid is not more than 12-13 weeks, hormonal therapy is used. Such drugs inhibit the production of estrogen and the rate of progression of nodes, as well as reduce their size.

UAE and laser removal are also prescribed. Gentle methods have a number of advantages:

There are no large scars, usually they do not exceed a diameter of 2 centimeters.
The ability to bear children is preserved.
Short rehabilitation - up to 14 days.
Minimal risk of bleeding and complications.

Expensive operations are not affordable for everyone, so you can apply for a state quota. This will take time, you will have to prove that other methods will not work.

Conservative treatment

The therapy is relevant for young women who are planning a pregnancy in the future. Hormones are often used, sometimes after surgery, to prevent recurrence. Oral contraceptives are effective for infertility caused by fibroids. Doctors use Femoden, Novinet, etc. The drugs contain gestagens that stop the growth of tumors.

Antagonists of gonadotropin-releasing hormone help well with sizes from 10 mm to 30 mm. Zoladex, Lucrin-depot and others are prescribed. The course of therapy does not exceed 6 months, since long-term use of such drugs causes menopause.

aGnRH reduces tumor formation by 2 times, pregnancy can be planned immediately after the end of treatment. Some patients during therapy note increased sweating, mood swings and hot flashes.

If the fibroid does not reach 7 mm, it is observed. Removal or other treatment is not appropriate until there is no progression of the disease. However, during menopause, nodes of small sizes are sometimes removed, for example, about 9 mm.

Embolization

If conservative therapy does not give the desired results, UAE is prescribed. The size of the knots should not exceed 3 centimeters. The technique copes with pathology at any stage. In the process, there is a blockage of the arteries with a special substance, which causes the tumor to die, being without proper nutrition.

The woman retains reproductive functions, since the uterus does not suffer. The procedure takes up to 50 minutes, anesthesia is not required. After the operation, the patient remains under observation until the morning, then goes home. After a while, weak pain sensations are possible, which are eliminated by painkillers.

Recovery occurs after seven days, improvements are noticeable already in the next menstrual cycle. Eliminates discomfort and heavy discharge. In the first week after UAE, weakness, fever, and chills are possible. Soon, the unpleasant symptoms will disappear.

laser removal

Laser beams are used for neoplasms up to 4 centimeters. The beam dosed hits the affected area, maintaining the optimal depth. At the same time, neighboring tissues and cells do not suffer. The therapy has a number of benefits, including:

Speed of implementation;
No pain, scars, scars and anesthesia;
The reproductive function is preserved;
During the intervention, the bleeding stops;
Possibility of outpatient treatment.

The postoperative period does not exceed 2 days. As a result of such treatment, menstruation is normalized, well-being improves, and the ability to bear children returns. The disadvantages include a high risk of recurrence and the impossibility of intervention with large-scale growths of tumors.

Uterine fibroids is a benign formation that occurs in the muscular tissue of the uterus due to hormonal pathologies.

Patients aged 35-50 suffer the most from it, although such a deviation can occur much earlier.

This can seriously complicate the lives of young women who dream of a child and those who are already carrying one. To diagnose fibroids, an ultrasound scan is done, where its size and number of neoplasms are determined, after which the treatment of the disease begins.

What it is?

It is important to note that myoma is a benign neoplasm that is quite treatable. But it is very dangerous for the health and even the life of a woman, if there are a lot of them. Ultrasound determines the dimensions, which, due to the similarity of the growth process of the uterus with the same during pregnancy, are usually compared with its weeks.

On this basis, fibroids are divided into 3 categories:

A small tumor - it is no more than 20 mm in size and corresponds to 4 obstetric weeks.
Neoplasm of medium size - 20-60 mm or 10-11 weeks.
Large fibroids - over 60 mm or 12-16 weeks.

Fibroids usually grow slowly. In fact, this is a knot in the tissue of the uterus, which is formed due to repeated cell division due to pathological causes or failures. The number of such nodes is also not predictable.

According to the location of the neoplasms, the following types are distinguished:

Intramural - located in the tissue of the uterus itself.
Submucosal - a large part inside the uterus, from which it is deformed.
Subserous - with growth outside the uterine cavity.

Symptoms

Small neoplasms of 20 mm in size or a little more are practically not felt, but already at 10-12 weeks in size, the following symptoms of the disease appear:

Abundant and prolonged periods with pain, which can not be removed by painkillers. Often, due to significant blood loss, they are accompanied by anemia.
Possible uterine bleeding in the middle of the menstrual cycle.
Due to the increase in the cervix, the growth of the abdomen is noticeable.
If the neoplasm has a leg and it is twisted, then the pain in the abdomen becomes unbearable. Due to circulatory disorders in the tissues of the tumor and uterus, this is fraught with peritonitis.
Large nodes compress neighboring organs, this causes violations of defecation and urination. Pain in the lower back, heart, headaches, hot flashes, dizziness and weakness are also connected, and as a result of compression of the nerve roots in the rectum, the legs become numb.
With large sizes of subserous fibroids, ultrasound shows adhesions of uterine tissues with adjacent organs.
Pain during intercourse.
Watery-mucous leucorrhoea of dark color with an unpleasant smell.

Causes

The main culprit for the appearance and development of uterine fibroids is a hormonal failure of estrogen metabolism. Splitting by liver enzymes, these female hormones can be transformed into high-quality, low-quality or even dangerous substances. Poor quality estrogen metabolites contribute to the appearance of benign tumors. Dangerous, deforming cellular DNA, can cause their cancerous degeneration.

If the mass of such pathological changes becomes critical, then several myoma nodes appear. A significant role in their appearance is played by dysfunction of the immune system (especially if there are chronic infectious foci) and hereditary predisposition.

Other risk factors:

Prolonged stress, hard physical labor.
Lack of regular sexual intercourse.
Abortions, childbirth, complicated by trauma.
Obesity, hypertension, diabetes.
Diseases of the endocrine system.
Physical inactivity.
Long-term use of hormonal contraceptives.
Absence of childbirth by the age of 30.
Prolonged sunbathing.

Is treatment possible without surgery?

How to treat and cure large uterine fibroids without surgery should be known to those who are faced with this problem. In many cases, fibroids are treated without surgery.

This applies, first of all, to short terms, single tumors or a small number of them. And the choice of the method of treatment of large benign neoplasms is associated with the patient's well-being, her age, the place of relief of nodes and the presence of complications from other organs that aggravate the course of the disease.

The widespread introduction of new treatment methods, which will be discussed below, will significantly reduce the proportion of surgical methods in favor of conservative methods. But so far, surgical gynecology of uterine fibroids is leading among other diseases.

Due to the diagnosis of mammary nodes, almost 80% of gynecological operations are performed, in which, in most cases, the uterus is removed. And this is the trouble of a third of women after 55 years.

Popular Treatments

Is there a cure for uterine fibroids? The answer is yes, they are treated conservatively and surgically. Conservative treatment is carried out with fibroids up to 10-11 weeks. These are drug therapy, diet therapy and physiotherapy. A set of measures stops tumor growth, such treatment is especially effective in reproductive age, in periods of menopause and postmenopause.

With the ineffectiveness of conservative methods, uterine fibroids are removed, and in severe cases, together with the organ.

Surgery is indicated in such cases:

The size of the neoplasm is at least 12 weeks.
She is developing rapidly.
Planning for pregnancy.
At the risk of developing a benign form into a malignant one.
Severe pain, in which painkillers are powerless.
Compression of the rectum, bladder and nerve roots.
Severe bleeding with the development of anemia.
Risk of peritonitis due to torsion of the tumor stem.
Violation of urination with stagnation of urine.
General intoxication and bloating.
Infertility or not carrying a pregnancy.

conservative

Conservative treatment of fibroids includes a number of methods, more on that.

Embolization of the uterine arteries

Embolization is a blockage of the blood vessels that feed the organ, preventing its blood supply. To understand the principle of uterine artery embolization (UAE), it is necessary to understand the uterine blood supply. It is fed by 4 arteries: the left and right uterine, and the same ovarian. The main load lies on the uterine arteries.

If you block them, then the power of the body will be disturbed. First of all, this will affect myomas, the protective properties of which are not perfect due to their pathological nature. But well-adapted healthy tissues will survive even in such extreme conditions. The ovarian arteries and other small blood vessels will help them in this.

A special bonus of UAE is the extremely rare recurrence of the disease, and all myomatous nodes are exposed to it. There is no need for medication here. The mini-surgery is performed under local anesthesia. First, a puncture is taken from the right femoral artery, and then, under the control of an X-ray machine, micro-balloons are alternately inserted into the veins, blocking the uterine arteries. The procedure lasts a maximum of 40 minutes, the patient does not feel pain.

Usually, after 3 months, fibroids are reduced by half, and in a year - by 2/3. The cessation of pain and bleeding during menstruation with the normalization of their duration in most patients is observed already a couple of months after UAE.

FUS ablation

This method of treatment without surgery is reduced to the removal of fibroids with focused ultrasound under MRI control. And tomography helps to reveal the degree of its decay.

The advantages of this technique:

Bloodlessness, no side effects, pain, intoxication.
There is no need for anesthesia.
Guaranteed preservation of the organ and its functionality.
Efficiency with large nodes, their rapid reduction by a factor of three.
Elimination of the symptoms of the disease, the absence of relapses.
Possibility of outpatient treatment, fast rehabilitation after the procedure.

Disadvantages of the method:

Significant cost of equipment and high cost of the procedure.
One-time exposure is possible for a maximum of 2 knots.
Limited use in obesity and cicatricial tissue changes.
The duration of the treatment session and the patient's uncomfortable posture during it.

hormone therapy

Hormonal treatment helps to restore reproduction, while the following drug groups are used:

Androgens (Gestrinone, Danazol) - their purpose is to reduce the effects of estrogens that promote the growth of neoplasms. Treatment lasts 7-8 months.
Gestagens (Utrozhestan, Norkolut) - are used for small fibroids to normalize the endometrium.
Installation of the Mirena hormonal coil, which normalizes the hormonal balance. This is achieved through a daily portion of the hormone, which is able to delay the growth of the tumor. It works for 5 years and still has a contraceptive effect.
Combined drugs (Janine, Regulon, Yarina) - they are effective for small tumors and are prescribed for a period of more than 3 months.

Folk remedies

It is not possible to list all effective folk remedies, this is only a small part of them:

Broccoli seed sprouts. The indole-3-carbinol contained in them destroys tumor cells without affecting healthy ones. Sprouts grown from seeds to a height of 4 cm in a box of sand are ground with the addition of vodka. For a week, you need a glass of the drug, which is drunk in a spoon three times a day before meals. The course of treatment is up to 12 weeks.
Tincture of the fruits of Vitex-Sacred. Soak half a glass of ground raw materials in 0.5 liters of alcohol diluted by half in the dark for 3 weeks, shaking daily. Add 10 parts of vodka to the filtered product, shake well. It is dissolved in the mouth for a couple of minutes, 25 drops per spoon of water twice a day - after waking up and before going to bed. The treatment course is at least 2 months.
Golden mustache tincture. Keep about 30 joints in half a liter of vodka for 2 weeks in the dark. In the morning, on an empty stomach, dissolve with 2 tablespoons of water, starting with a dozen drops, also in the evening 40 minutes before dinner. Every day, increase the dose by a drop at a time, bringing it to 35. Then, drop by drop, to the original amount. After the third course, introduce an additional one more dose. There are 5 of them in total, but after the first two, take a week break, and then a ten-day break.

For medicinal purposes, an alcohol tincture of walnut partitions is also used - three times 20 drops for 2 months, an aqueous tincture of burdock root - half a glass 4 times a day for several months with 10-day breaks, a decoction of flaxseed - half a glass three times a day for at least a month. Infusions on other medicinal herbs are also used.

Hirudotherapy

Treatment with medical leeches can normalize blood circulation in the pelvis, eliminate congestion. The salivary enzymes of the worms have an antitumor effect and can even out hormonal imbalances.

The duration of the procedure is half an hour, 10 sessions are practiced with a 2-3-month break. Small bite wounds heal in a couple of weeks.

Physiotherapy

This method of treatment helps to normalize the hormonal background, the menstrual cycle and the functions of the nervous system, and prevents the nutrition of the tumor.

The following types are effective:

Radon and iodine-bromine baths. They act through the skin and nerve receptors, increasing immunity, reducing estrogen production, improving metabolism, helping to relieve inflammation and normalize ovarian function.
Electrophoresis is practiced with fibroids less than 12 weeks old and their slow growth from 5-7 days of the menstrual cycle. At 15-20 procedures (except for the days of menstruation), potassium or sodium iodide is used.
Magnetotherapy - with the help of a special apparatus placed on the abdomen where the tumors are localized. The procedure lasts 10 or more minutes, and the course consists of a dozen sessions.

douching

This is the introduction of drugs into the vagina using a rubber pear or Esmarch's mug.

A few recipes:

Soda: 2 tablespoons per 2 liters of warm water - daily for up to six months.
Borova uterus: infused decoction of 2 tablespoons of crushed leaves in a liter of boiling water (cook for a quarter of an hour).
Pharmacy chamomile or calendula: 3-hour infusion of a spoonful of dry raw materials in a glass of boiling water.
Celandine: simmer a chopped spoonful of leaves for a quarter of an hour in a glass of boiling water, use daily for up to six months. Soak the dried celandine root in a glass of boiling water with the addition of a spoonful of honey for a quarter of an hour. The procedure is carried out twice a day.
Golden mustache tincture: before going to bed every day, ten drops per liter of warm water for 3 weeks with a week break.

Method contraindications:

pregnancy;
menstruation;
after an abortion or any gynecological surgery.

Patient reviews

Opinions of patients about the possibility of treating fibroids without surgery:

In order for myomatous nodes to cease to be one of the most pressing gynecological problems, you need not so much - to undergo ultrasound diagnostics annually and visit a gynecologist at least twice a year. And if they are detected, immediately begin the treatment prescribed by the doctor, preventing the growth of the neoplasm.

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What is submucosal uterine fibroids: is it possible to treat without surgery and reviews of women

Myoma is a neoplasm of a benign order that develops directly in the cavity of an organ or on its walls.

Most often, fibroids are diagnosed in women over 30 years old, but the trend towards a decrease in the age category is increasing every year.

The disease appears due to uncontrolled and rapid cell division, which is associated with excessive synthesis of female sex hormones.

The size of the myoma formation is usually determined in obstetric weeks, that is, the size of the tumor is calculated in the same way as the size of the uterus during pregnancy.

What it is?

This is a benign formation that occurs in the tissues of the uterus, and its growth is directed to the cavity of the organ.

Unlike other myomatous tumors, submucosal fibroids grow quite quickly, have fairly pronounced symptoms, and often provoke a malignant formation.

Another name for submucosal fibroids is submucosal uterine leiomyoma, of all fibroids, this form accounts for about 30% of cases.

The relationship between submucosal fibroids and infertility is very close - every fifth woman who is diagnosed with infertility, nodes in the uterus - this is the only reason that prevents the onset of conception.

The submucosal node, formed from connective and muscle tissue, has an extensive network of blood vessels. The size of the node can reach 25 cm.

Education types

Any fibroid can be single or multiple, that is, it can consist of one node or several.

Submucosal fibroids are classified as follows:

type 0 - the fibroids are entirely located in the uterine cavity, and are connected to the wall of the organ through a stem;
type 1 - such fibroids do not have a leg, and the node is connected to the muscle layer of the organ;
type 2 - the formation is located inside the uterine wall, and protrudes slightly into the uterus;
type 3 - the tumor is also completely inside the uterine wall, however, its upper part is covered not by muscle fibers, but by the mucosa.

Causes

The reasons for the formation of a submucosal node are the following:

imbalance in hormones;
late start of the menstrual cycle;
pathological changes in the ovaries;
overweight or sudden weight loss;
too strong physical exertion on the body or their absence;
frequent stressful situations;
unfavorable ecological situation;
poor or inadequate nutrition;
the presence of infectious diseases in chronic forms;
too frequent change of sexual partners;
difficult childbirth, caesarean, the presence of an intrauterine device, abortion;
genetic predisposition;
lack of sexual intercourse;
sexually transmitted diseases;
problems in the work of the endocrine glands, especially the thyroid and adrenal glands;
long-term use of oral contraceptives;
lack of orgasms;
inflammatory processes;
no childbirth before 30 years;
prolonged exposure to the sun, including a visit to the solarium.

Symptoms

The early stages of submucosal fibroids may not manifest themselves in any way, and are diagnosed only during a gynecological examination or with the help of hardware diagnostics. As soon as the myomatous node reaches a certain size, it is impossible not to notice the manifestations of submucosal fibroids.

Menorrhagia or polymenorrhea is a severe blood loss during menstruation that occurs due to contractile dysfunction of the uterus.

Between periods, women may observe the presence of blood clots, which provokes the development of anemia. Patients complain of problems with hair and nails, tachycardia, fatigue.

Submucosal fibroids provoke cramping pain, which can be felt not only in the lower abdomen, but also in the lumbar region. Large growths can compress the intestines or bladder, which can cause constipation or frequent urination.

An increase in the size of the patient's abdomen is an external sign of the presence of submucosal fibroids, this phenomenon occurs due to the rapid growth of the node.

Other types

Uterine fibroids differ according to different criteria.

By location:

Abdominal or subserous - located on the outer surface of the organ, and exerts pressure on the abdominal cavity. This type of fibroids can be of three types - type 0 (the presence of a leg), type 1 (a slight touch of the tumor of the organ), type 2 (most of the formation is located in the wall of the uterus).
Intermuscular or intramural - localized in the tissues of the muscles. This is the most common type of fibroid. A characteristic feature is a change in the contour of the organ due to squeezing the internal space.

Also, uterine fibroids differ in appearance:

Nodular fibroids are rounded smooth formations that can consist of either one node or several. This is the most common type.
Diffuse fibroids - muscle tissue increases, but there is no clearly formed node. This phenomenon is most often observed in the presence of chronic inflammatory processes.

Fibroids differ in size:

small myoma - up to 2 cm;
medium - up to 6 cm;
large - more than 6 cm.

Classification in relation to the axis of the uterus looks like this:

corporal - education in the body of an organ;
cervical - tumor growth is directed to the vagina;
isthmus - mainly causes problems with urine output.

Given the variety of uterine fibroids, the treatment of each patient should be individual, therefore, a doctor's consultation is necessary to select the right therapy.

Diagnostic methods

To determine the presence of education in the uterus allows a routine gynecological examination. To accurately determine the size, classification and localization of fibroids, an ultrasound examination of the organ is prescribed.

Hysteroscopy is a very informative research method, which is carried out using a special optical apparatus.

In addition to diagnosis, some fibroids may be removed during this procedure.

It may also be assigned:

transvaginal ultrasound;
angiography;
x-ray examination;
MRI or CT.

Since anemia often develops with submucosal fibroids, a low level of hemoglobin can be detected in a clinical blood test.

Is treatment possible without surgery?

The main method of treatment of submucosal fibroids is, of course, its surgical removal, but in the early stages it is possible to use hormonal drugs.

This treatment is most often prescribed to women over 40 years old, as they are close to menopause, or women who are planning a pregnancy.

Conservative treatment

Medical treatment is indicated in the following cases:

tumor size does not exceed 12 obstetric weeks;
slow growth of education;
age after 40-45 years;
pregnancy planning.

As a rule, the following drugs are prescribed:

androgen derivatives;
gestagens;
gonadotropin analogues.

As for specific drugs, they should be prescribed by a doctor. It can be Gestrinon, Triptorelin, Zoladex and others.

Complexes of vitamins, as well as drugs that will eliminate anemic syndrome, will not interfere.

Drug treatment is aimed at preserving the childbearing function of a woman, since after surgery the chances of pregnancy are reduced.

Tumor size for surgery

The sizes of fibroids for surgical intervention are determined by the attending physician. As a rule, surgery is indicated for fibroids larger than 12 obstetric weeks.

Surgical intervention

To date, there are the following methods of surgical removal of fibroids:

Hysteroresectoscopy is the least traumatic surgical method, in which a special instrument with a camera is inserted through the genital tract into the uterus. Myoma is removed in layers, and healthy tissues remain intact.
Laparoscopy. In this case, several small punctures are made in the abdominal wall, and the tumor is removed using a laparoscope. Most often, such an intervention is prescribed for the interlayer location of fibroids.
Embolization of arteries. This intervention is based on blocking the uterine artery, as a result of which the formation ceases to receive nutrients, and gradually degrades.
Hysterectomy is the complete removal of the uterus along with the formation. In some cases, the tubes and ovaries may also be removed.
Myomectomy. The knot is unscrewed and removed through the cervical canal. It is indicated for large formations on the leg.
FUS-ablation - removal of the tumor by ultrasound.

Reviews

Consequences

Complications and negative consequences most often occur in the absence of proper therapy or when a woman tries to treat fibroids on her own.

The most common complications are:

prolapse of the node through the cervix;
anemic syndrome and spontaneous heavy bleeding;
torsion of the fibroid stem, which leads to the development of tissue necrosis;
development of persistent infertility;
degeneration of a tumor into a malignant formation.

Conclusion

Even in the very recent past, a woman of reproductive age, having heard the diagnosis of "submucosal fibroids", understood that she would never have children. The fact is that the treatment of fibroids was possible only with the complete removal of the uterus. Today, women still have this fear.

However, modern medicine has reached such a level that the treatment of fibroids in such a cardinal way is used only in advanced and complex cases. Basically, fibroids are now treated either conservatively or with the help of organ-preserving operations, which are not an obstacle to pregnancy and childbirth in the future. Therefore, every woman should know that submucosal fibroids are not a sentence, but only in cases where treatment is carried out in a timely and competent manner.

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Why and why uterine fibroids are dangerous: symptoms, consequences and what happens when the tumor reaches a large size

Currently, unfortunately, this question is asked by many women, including at a young age.

This disease refers to quite serious pathologies that can cause huge health problems.

Modern medicine can effectively help get rid of it, but for this the tumor must be detected at an early stage. That is why knowledge of the symptoms and the clinical picture is necessary for any woman.

Essence of pathology

Uterine fibroids are benign neoplasms caused by overgrowth of smooth muscle cells. It has a spherical shape in the form of a knot. Most often, growth is found in the body of the uterus, and only sometimes (no more than 5%) in its cervix.

Most of all, the pathology affects women over 40 years old, but recently the rejuvenation of patients has been recorded - 22-24 years.

Depending on the localization of the formation in depth, the following types of pathology are distinguished:

intramural (interstitial, intramuscular) type - characterized by the localization of the tumor inside the muscle layer (myometrium). At the initial stage, it develops without noticeable manifestations, and therefore often reaches large sizes, because. remains unnoticed for a long time;
subserous (subperitoneal) type - the tumor is found next to the peritoneum, under the shell of the outer uterine layer. A dangerous option is myoma on the leg, when more than half of her body goes out into the uterine cavity;
submucosal (submucosal) type - the formation is located in the uterine cavity, under the inner uterine layer. It manifests itself sharply, characterized by uterine bleeding. Rarely reaches large sizes, tk. measures are often forced to be taken in a timely manner;
intraligamentary (interligamentous) type - the node is localized between the wide ligaments of the organ.

Reasons for prevalence

Medical statistics show that by the age of 40-45, a woman accumulates many changes that lead to the appearance of fibroids. Careless attitude to one's health provokes pathology in young women.

There are such main reasons for the prevalence of uterine fibroids:

hormonal disorders. The disease in question is recognized as a hormone-dependent pathology, because. education develops, as a rule, with a significant imbalance of female sex hormones (estrogen and progesterone). It should be noted that in girls before the onset of menstruation and in women during menopause and after it, fibroids do not form. The most serious effect is an increase in the level of estogens. This effect is caused not only by violations of the reproductive system, but also endocrine (hypo- and hyperthyroidism) and metabolic problems. In particular, the risk of disease is significantly increased by malnutrition and obesity;
damage to the muscular layer of the uterus. Violations of the structure of smooth muscle cells leads to the fact that they become the focus of tumor formation. This phenomenon can be caused by inflammatory diseases (myometritis, endometritis) and mechanical damage during abortion, difficult childbirth, medical curettage. There is a risk of prolonged use of intrauterine type spirals;
late pregnancy and failure to breastfeed the child. Pregnancy, normal delivery and lactation have been shown to reduce the risk of developing fibroids. Late pregnancy often causes pathology. It is believed that the birth of a child is normal before the age of 30 (ideally 20-23 years);
some systemic diseases. The pathology risk group includes women with diabetes mellitus, arterial hypertension, and other cardiovascular diseases;
genetic predisposition.

The reasons can be attributed to the wrong way of life.

The following features stand out in particular:

nutrition. Excessive consumption of refined foods and trans fats with low fiber levels leads to an increase in estrogen production. Anything that leads to the accumulation of fat reserves increases the risk of fibroids;
lifestyle hypotension;
lack of a full-fledged sexual life, prolonged abstinence from sexual intercourse, lack of orgasm during contacts provoke stagnation of blood in the venous system of the small pelvis and hormonal imbalance;
nervous overload and psychological stress;
frequent and prolonged exposure to direct sunlight, ultraviolet radiation.

Symptoms

Myoma can develop for a long time without obvious manifestations. The first signs of the disease are found when the size of the node is more than 10-15 mm.

Early symptoms include:

pain in the form of contractions in the lower abdomen, not associated with menstruation;
painful periods, provided that this was not previously detected;
excessively abundant discharge during menstruation;
discharge with blood impurities in the period between menstruation, and sometimes quite heavy bleeding;
change in the menstrual cycle (lengthening or shortening of the period);
prolonged absence of pregnancy while striving for conception.

As the tumor grows, more pronounced symptoms appear:

prolonged (more than 8-9 days), intense menstruation with painful sensations and the release of blood clots;
quite intense pain syndrome, a feeling of heaviness in the pelvic area;
painful phenomena in the lower extremities, lower back and back;
painful intercourse;
increased urge to urinate as a result of bladder compression;
an increase in the abdomen in the absence of pregnancy;
chronic constipation, as a result of tumor pressure on the intestines;
the development of anemia with increased bleeding;
weakness and dizziness, headache;
nervous manifestations in the form of neuroses, irritability.

The size of fibroids determines the degree of its development and danger. The fact is that the tumor progresses quite quickly, and an increase in size allows you to assess the stage of the disease.

Taking into account the size of the node, the following categories of pathology are distinguished:

small formation - up to 25-27 mm, which corresponds to a development period of 4-7 weeks;
secondary education - 7-11 cm, i.е. the duration of the course is 8-13 weeks;
large formations - 12-36 cm, which is formed for more than 13 weeks.

In terms of symptomatic manifestation, nodes smaller than 25 mm are difficult to detect.

Starting from 8-9 weeks of development, formations lead to characteristic signs:

from 9-10 weeks (4-5 cm) bleeding begins;
from 12 weeks (9-10 cm) the uterus increases in size, which leads to an increase in the abdomen (without a change in body weight);
from 17-18 weeks (20-22 cm) pain radiates to the legs, lower back, back, other organs (bladder, intestines) are compressed.

The impact of the tumor on women's health

Myoma, starting from a small size, can seriously affect the general well-being of a woman, which is caused by such factors:

the formation of a neoplasm is accompanied by fouling with vessels to nourish new tissues. This leads to a redistribution of blood flow and excess consumption of nutrients. As a result, female infertility and weakening of the body appear;
due to the spread of abnormal cells, the normal tissues of the uterine wall are replaced by connective tissue, leading to a decrease in elasticity and contractility. The muscle layer becomes unable to stop bleeding;
the tumor compresses the nerve fibers in the uterus, constantly innervating them, which destabilizes the nervous system;
profuse blood loss leads to anemia and a decrease in hemoglobin levels below 105 g / l. This responds with a weakening of the body, pallor of the skin, brittle nails and hair. The deterioration of oxygen supply leads to a decrease in attentiveness and concentration, memory impairment, and insomnia.

Sprawl danger

So how dangerous is growing uterine fibroids for a woman?

In the process of its progression, such serious problems are noted:

intense bleeding during menstruation and in the intermenstrual period is a direct threat to life due to blood loss and the development of anemic processes;
in the presence of fibroids on the leg, its torsion and damage is possible, requiring urgent surgical treatment;
spontaneous necrotizing of the node requires surgical intervention;
active growth of submucosal fibroids can occur with deformation (eversion) of the uterus;
the formation becomes a focus for an inflammatory reaction with suppuration of the uterus and surrounding organs.

Large fibroids cause compression of blood vessels, nerve fibers and neighboring organs. Violation in the urination system and frequent constipation can cause specific diseases. A neglected pathology leads to disruption of the functioning of the entire reproductive system.

Also, despite the fact that in the vast majority of cases, fibroids remain a benign tumor during their entire development, in rare cases (1.6-2% of all cases of the disease), it can develop into a malignant tumor.

The development of fibroids into uterine cancer can be caused by such reasons:

excessive growth of the node;
body intoxication (including alcohol abuse);
poor quality food;
obesity;
violation of blood flow;
excessive heating of the lesion;
nervous stress;
injury.

Complications of pathology

The most dangerous complication of fibroids is the development into a malignant formation (sarcoma).

The benign course of the disease can also cause serious complications:

anemia and, against its background, dysfunction of the uterus and its appendages;
necrosis with the risk of developing peritonitis;
pain syndrome, not stopped by painkillers;
violation of urination and defecation;
neurosis and other neurological disorders;
violation of the functioning of the reproductive system, female infertility, ectopic pregnancy.

If the fibroid is not eliminated before the onset of menopause, then a sharp hormonal imbalance leads to intensive tumor growth and the development of various complications, incl. increased risk of sarcoma.

Myoma during pregnancy

Problems with conception with fibroids begin with sufficient growth.

At the initial stage, there are no serious obstacles to fertilization. With a large tumor size, the fallopian tube can be compressed and ovulation is complicated, which leads to the impossibility of conception.

Pregnancy with fibroids can occur with great complications.

Quite often, miscarriages are observed, which is explained by the following reasons:

change in uterine contractility;
violation of the blood supply to the body;
proliferation of tissues and squeezing of the fetus;
enhancement of neuroendocrine effects.

Node localization is important. When it comes into contact with the placenta of the fetus, the risk of termination of pregnancy is especially high.

Complicates fibroids and childbirth. The majority of women in labor experience prolonged and difficult labor. Nearly half of sick women are forced to experience a caesarean section.

Conclusion

Uterine fibroids, despite the benign formation, is recognized as a complex and dangerous pathology that must be identified and treated at the earliest stage.

With its progression, serious complications are possible that can undermine women's health.

At the first manifestations of the disease, it is necessary to consult a doctor, and only he will determine the necessary treatment regimen.

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Fibroids size in weeks and centimeters and weeks

Myoma is a benign tumor that grows in the uterine myometrium (the muscular layer of the organ). The age of the disease ranges from 20 to 70 years, but the majority of patients are from the middle age category.

The main reason for the formation of uterine fibroids, doctors consider changes in the hormonal background of the patient.

After uterine fibroids have been diagnosed, the question arises about its size. After all, the treatment depends on how many large tumors were found, what type they are, and on their size in weeks. In order to determine the size of uterine fibroids in weeks, you need to do an ultrasound. It is believed that large fibroids, the size of which is more than 12-16 weeks (more than 6 cm or 60 mm), must be operated without fail: such nodes are life-threatening for the patient, especially if there are many of them. Tumors less than 10-11 (2-6 cm or 20-60 mm) obstetric weeks are not subject to mandatory surgical intervention, they can be cured conservatively (medications, physiotherapy, diet).

Classification of fibroids by size

The size of the tumor is determined using ultrasound in centimeters or weeks.

Since, as the myomatous node progresses, the uterine cavity increases, as does the baby growing in it, it is customary in medicine to compare its size with the weeks of pregnancy.

To determine what size the tumor is in mm or cm, the following table of correspondence between the height of the uterine fundus and the term will help:

Term in weeks	Uterine size in cm
8-9	8-9
10-11	10-11
12-13	10-11
14-15	12-13
16-17	14-19
18-19	16-21
20-21	18-24
22-23	21-25
24-25	23-27
26-27	25-28
28-29	26-31
30-31	29-32
32-33	31-33
34-35	32-33
36-37	32-37
38-39	35-38
40-41	34-35

Based on these data, doctors differentiate uterine fibroids into three types:

Small: size up to 2 cm (up to 20 mm) - 4 weeks;
Medium tumor: size from 2 cm to 6 cm (from 20 mm to 60 mm) - 10-11 weeks;
Large fibroids: size over 6 cm (over 60 mm) - 12-16 or more weeks of pregnancy.

Symptoms and dimensions

Uterine fibroids in the early stages (size up to 2 cm or 20 mm) do not make themselves felt. But with the growth of the tumor and after it reaches a large size (a period of 10-12 weeks or 50 mm or more), the following symptoms begin to manifest themselves:

Heavy menstrual bleeding with severe pain that does not relieve pain medication;
If the tumor is large (more than 12 weeks), the uterus begins to increase and the lower abdomen swells accordingly. The weight of the patient remains at the same level;
If a woman is diagnosed with pedunculated fibroids, her torsion may cause sharp pains in the abdomen. This means that blood flow is disturbed in the body of the tumor and is fraught with peritonitis;
Large knots in the uterus (10-20 weeks or more) can compress nearby organs and cause problems with defecation (chronic constipation) and urination (frequent urination), pain in the lower back, heart and lower extremities (as well as their numbness) when squeezed nerve endings near the rectum;
Large fibroids growing on the outer layer of the uterus can form adhesions with neighboring tissues and organs, which, when moving, give pain in various parts of the body.

Diagnosis

When visiting a doctor, a woman is examined bimanually (visual-manual examination using gynecological mirrors) to determine the size of the uterus in weeks, after which she is sent for testing and ultrasound (it will accurately determine the size of the tumor itself).

In order to correctly prescribe the appropriate treatment for the situation, you need to regularly do an ultrasound examination (ultrasound) of the uterine cavity. This will reveal exactly how many fibroids are in her cavity, what size they are in weeks and centimeters, how fast they progress (how fast they grow). The fact is that the rapid growth of myomatous nodes (more than 4 weeks in 12 months) may be one of the signs of the degeneration of a neoplasm into a malignant cancerous tumor.

Regular ultrasound is mandatory even in the absence of any symptoms of fibroids: it can be small (up to 10 mm), but located in a dangerous area.

Also, to obtain comprehensive data on the size, localization, structure and type of the myomatous node, the MRI and transvaginal examination methods are used (ultrasound may be wrong), a photograph of the neoplasm is taken for subsequent examination by the attending physician.

Pregnancy and node size

Myomatous nodes of small size (up to 10 mm) will not have a significant impact on the growth of the baby in the mother's womb, however, it is necessary to monitor their condition during pregnancy (very rarely there is an intensive growth of uterine neoplasms during gestation).

Large tumors located in the submucosal uterine layer can inhibit the normal development of the baby (there is much less space in the uterus) and cause various pathologies.

In the case of localization of a myomatous node larger than 12 weeks on the back wall of the organ, when the fetus is also attached to this place, the onset of premature birth or oxygen starvation of the baby is possible.

Obstetricians are of the following opinion: with a small myomatous node growing either in the outer uterine layer or in the median muscle layer, it is quite possible to endure and give birth to a healthy baby.

Tumor treatment

Myomatous nodes are treated by various methods, depending on their type and size in weeks:

Hormone therapy is applicable in cases where the size of fibroids does not exceed a period of 12 weeks. Medicines act in the direction of inhibiting the rate of progression of the pathological neoplasm and reducing its size. Hormonal treatment is widely used in case of detection of fibroids in women of younger and middle age who want to have offspring in the future, as well as after surgery to prevent the formation of new nodes;
Symptomatic treatment:

Antispasmodic and analgesic drugs (even knots of 2-3 weeks in size can cause severe pain during menstruation);

Hemostatic agents are prescribed for fibroids of the smallest sizes (a submucosal node 4 mm in diameter can sometimes provoke intense intermenstrual uterine bleeding) with appropriate indications: long and heavy menstrual bleeding, bleeding from the genital tract during ovulation;

Surgery is indicated if the tumor has reached the size of 13 or more weeks:

Embolization of vessels;

Removal of fibroids with a laser;

Myomectomy;

Removal of the uterus, complete or partial, with or without a cervix;

Folk treatment;

Physiotherapy treatment;

Gymnastics;

Treatment with leeches.

When is surgery indicated?

If the fibroid has a value of more than 12 weeks of pregnancy;
If a woman plans to bear and give birth to a child in the future;
If there is a risk of degeneration of the myomatous node into a malignant uterine tumor - sarcoma;
If the tumor causes constant severe pain that is not stopped by painkillers and antispasmodics;
If the myomatous node compresses the bladder, rectum and nerve endings, causing a lot of inconvenience and discomfort;
If the neoplasm causes constant severe bleeding, against which the patient has anemia;
If the tumor (even if small) has a long, thin stalk: there is a high risk of torsion and peritonitis;
If the fibroid prevents normal urination (there is a constant stagnation of urine);
If, due to compression by a large myomatous node of the rectum, the patient has an extremely rare stool (1-2 times a week), accompanied by intoxication of the body and bloating with pain on palpation.

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