What are multiple uterine fibroids? Causes of multiple uterine fibroids and possible treatment. Effect on pregnancy

Myoma is a benign tumor that grows from connective tissue on the walls or in the uterine cavity. The incidence rate by age 35 is 35-45% among the entire female population. The peak incidence occurs in the age group of 35-50 years.

Uterine fibroids can range in size from a small nodule to a tumor weighing about a kilogram, when it is easily identified by palpation of the abdomen. Signs of the disease may not appear immediately. The more advanced it is, the more difficult the treatment and the greater the likelihood of complications.

Let's take a closer look at what this disease is, what characteristic features and symptoms, as well as what is prescribed as treatment for a woman.

Myoma: what kind of disease is it?

Uterine fibroids (fibromyoma, leiomyoma) are the most common benign tumor of the uterus, hormonal-dependent (develops with an increased content of female sex hormones estrogen).

Myoma certainly has signs of a tumor, but it also differs from it, so it is more correct to correlate it with tumor-like formations. Despite its benign nature, fibroids can cause a lot of trouble, including uterine bleeding and complications during pregnancy, so treatment must be approached responsibly.

The occurrence of uterine fibroids usually occurs in her body, but in rare cases it can also occur in the cervix. Myoma developing in muscle tissue, is considered typical, and those formed in the neck or on the ligaments are considered an atypical form of the disease.

The myomatous node begins its development from the growth zone located around the thin-walled blood vessel. In size, such growth can range from several millimeters to several centimeters; most often in women, multiple fibroids occur when several tumors form at once.

Causes

Myoma ranks 2nd in the structure of gynecological diseases. Its frequency is reproductive age averages 16%-20% of cases, and in premenopausal women reaches 30-35%.

Myoma appears as a result of mutation of a single cell. Its further division and development of the tumor is influenced by changes in hormonal levels in the body, a violation of the ratio of estrogen and progesterone. When the production of female sex hormones decreases, the tumor may disappear on its own.

The following reasons lead to uterine fibroids:

  • Hormonal disorders are a sharp decrease or increase in the level of estrogens, which are clinically manifested by various menstrual disorders.
  • Irregularity of sexual activity, especially after 25 years. As a result of sexual dissatisfaction, blood flow in the pelvis changes, and stagnation prevails.
  • Disturbance in the production of sex hormones in ovarian diseases
  • Prolonged stress, heavy physical work
  • Presence of chronic infectious diseases, such as chronic pyelonephritis, chronic tonsillitis, etc.
  • Diseases of the endocrine glands: thyroid, adrenal glands, etc.
  • Disorders of fat metabolism in the body (obesity).
  • Mechanical damage, difficult childbirth with ruptures, abortions, complications after surgery, consequences of curettage.
  • Hereditary factor. The risk of developing fibroids increases significantly in those women whose grandmothers and mothers had such a tumor.

It has been proven that women who have given birth are less likely to develop nodes. Often this tumor can appear during pregnancy. Especially if the first pregnancy is late.

Classification

I have several classifications of such formations. According to the number of nodes, uterine fibroids can be of the following types:

  • Single;
  • Multiple.

According to the sizes there are:

  • Large;
  • Average;
  • Small myomatous neoplasms.

Depending on the size of the myomatous nodes, which are compared with the duration of pregnancy, there are

  • small fibroids (5-6 weeks),
  • medium (7-11 weeks),
  • large sizes (over 12 weeks).

Depending on the size and location of the nodes, there are 3 types of uterine fibroids:

  • leiomyoma - consist of smooth muscle tissue;
  • fibroma - consists of connective tissue;
  • fibroids - consists of connective and muscle tissue.

Based on their location relative to the muscle layer – the myometrium – fibroids are classified as follows:

Interstitial uterine fibroids

It is located in the center of the myometrium, i.e. muscular layer of the uterus. It is characterized by large sizes. It is completely located in the thickness of the muscular layer of the uterine wall (occurs in 60% of all cases of the disease).

Submucosal fibroid

What it is? Submucosal or submucosal - grows in the direction of the endometrium. If such a node is partially (more than 1/3) located in the myometrium, it is called intermuscular with centripetal growth (towards the uterine cavity). It may also have a stem or a wide base. Pedicled fibroids can sometimes “fall out” of the cervical canal, becoming twisted and infected.

Subserosal

Subperitoneal (or subserous) - the node is located under the mucous membrane of the outer layer of the uterus, near the peritoneum. Subserous fibroids are divided into the following types:

  • "Type 0". A knot on a wide base is 0-A, a knot on a leg is 0-B.
  • "Type 1". Most of the node is located in the serous membrane.
  • "Type 2". Most of the tumor is located in the thickness of the myometrium.

Stages

There are three stages of fibroid morphogenesis:

  • Formation of the rudiment (active growth zone) in the myometrium.
  • Growth of an undifferentiated tumor.
  • Growth and maturation of a tumor with differentiated elements.

The rate of development of myomatous nodes depends on many factors:

  • The presence of chronic gynecological pathologies;
  • Long-term use of hormonal contraceptives;
  • Presence in the past large quantity abortions;
  • Prolonged ultraviolet irradiation;
  • Absence of childbirth and lactation in women after 30.

At rapid growth Myomatous tumor, a woman observes menorrhagic changes (excessive bleeding during menstruation), anemic signs, and hyperplastic tissue changes occur in the uterus.

An increase in tumor size does not always occur unambiguously, so the following is distinguished:

  1. Simple. Slowly growing and asymptomatic uterine fibroids of small size, often single. Often simple fibroids are diagnosed accidentally.
  2. Proliferating. It grows quickly and provokes clinical manifestations. Diagnosed as multiple uterine fibroids or single large ones.

It is usually recommended to treat fibroid nodes in young women, especially if the tumors are bothersome or interfere with pregnancy. Depending on the location of the node and its size, the doctor may first prescribe conservative therapy- taking medications, and if there is no effect, surgery.

The first signs in a woman

A fibroid can only be recognized when it has reached a sufficiently large size. As uterine fibroids grow, the first signs may appear:

  • The appearance of sharp pain of a cramping nature not associated with menstruation in the lower abdomen;
  • long, heavy and irregular menstruation;
  • constipation;
  • bleeding;
  • frequent urination;
  • heaviness and constant pain in the lower abdomen;
  • bleeding during sexual intercourse;
  • lower back pain;
  • abdominal enlargement not associated with significant weight gain;
  • frequent miscarriages.

All these signs may be present with other gynecological problems. Therefore, they are not enough to make a diagnosis. The presence of a tumor can only be confirmed by a thorough examination and ultrasound.

Symptoms of uterine fibroids

Often, uterine fibroids do not give any symptoms and are found during a routine examination by a gynecologist. Or it happens that the symptoms are quite smoothed out and are often perceived as a variant of the norm.

The growth of uterine fibroids is accompanied by the appearance of symptoms, the most common of which are:

  • Pain during the intermenstrual period, varying in duration, occurring in the lower abdomen, sometimes radiating to the lumbar region, upper sections abdomen or legs;
  • Menorrhagia is an increase in menstrual flow. Heavy bleeding is dangerous because after some time it can result. More heavy bleeding indicates that the muscles of the uterus are contracting less well, in which case medical attention is required.
  • Pelvic organ dysfunction, which are manifested by frequent urge to urinate and constipation. These symptoms occur when the subserous nodes are pedunculated, cervical, or interligamentous, as well as when large volume tumors.
  • Feeling of heaviness increases, the presence of something foreign in the stomach. Sexual intercourse becomes painful (if the nodes are located on the vaginal side). The belly grows, as during pregnancy. A sprain increases the nagging pain in the abdomen.
  • Miscarriage, infertility - occur in 30% of women with multiple fibroids.

In the photo below, you can see the fibroid from different sides:

It is impossible to independently determine whether you have the disease. If the above symptoms and signs of uterine fibroids appear, you should definitely undergo an examination by a gynecologist. These signs can also be accompanied by more dangerous diseases, such as uterine or ovarian cancer, endometriosis.

Symptoms in a woman
For submucosal
  • manifested by various menstrual cycle disorders,
  • heavy and prolonged menstruation,
  • uterine bleeding, which often results in anemia.

Pain syndrome is not typical for such fibroids, but if the myomatous node falls from the submucosal layer into the uterine cavity, cramping, very intense pain occurs.
With intramural
  • appears in the middle layer of muscle tissue of the uterus and is accompanied by cycle disturbances and pain in the pelvic area
For subserous
  • It often occurs without symptoms, so the pain is minor and appears rarely: pain in the lower back, back pain, as well as urination problems and constipation.

Complications

Uterine fibroids pose a danger to a woman’s health in terms of the development of complications of the disease. With regular monitoring by a gynecologist and careful attention to her health, a woman can significantly reduce the risk of complications.

Complications of uterine fibroids:

  • necrosis of myomatous node;
  • birth of a submucosal node;
  • posthemorrhagic anemia;
  • tumor malignancy;
  • infertility;
  • miscarriage;
  • postpartum hemorrhage;
  • hyperplastic processes of the endometrium.

In order to avoid complications, you should begin treating fibroids in a timely manner (immediately after detection). Surgical intervention is rarely required and is more often associated with existing complications of the disease.

Fibroids and pregnancy

Uterine fibroids are found in 8% of pregnant women undergoing pregnancy monitoring. For most women, during pregnancy the size remains unchanged or decreases.

Danger:

  • development of fetoplacental insufficiency (changes in the structural and functional properties of the placenta, which can lead to impaired fetal development);
  • threat of miscarriage at various stages.

Most often, women with uterine fibroids are offered to give birth by cesarean section due to the risk of various complications, such as:

  • untimely rupture of amniotic fluid (this occurs due to increased tone of the muscular layer of the uterus or incorrect location fetus);
  • risk of heavy postpartum bleeding;
  • risk of premature placental abruption (most often this occurs if the fibroid is located behind the placenta).

During a cesarean section, a woman may have the tumor removed immediately so that she can plan another pregnancy in the future.

Diagnostics

The first signs of fibroids are very similar to the symptoms of other gynecological pathologies. Therefore, to make a correct diagnosis, it is necessary to conduct a series of laboratory instrumental studies. Only a correct and timely diagnosis can guarantee successful treatment and a speedy recovery.

Diagnostics include:

  • Gynecological examination. It is carried out on a gynecological chair using necessary tools. The size of the uterine body, the location of the ovaries, the shape and mobility of the cervix, etc. are taken into account;
  • Ultrasound of the pelvic organs using a vaginal probe. For better visualization, the study is performed with a filled bladder. The method is highly informative and allows you to identify the size of the tumor and its shape;
  • Laparoscopy - used only when myoma cannot be distinguished from an ovarian tumor;
  • Hysteroscopy is an examination of the cavity and walls of the uterus using an optical hysterocope. Hysteroscopy is performed both for diagnostic and therapeutic purpose: identification and removal of uterine fibroids of some localizations.
  • Biopsy. In some cases, during hysteroscopy or laparoscopy, a small sample of tissue is taken, which is then examined in more detail under a microscope.
  • Diagnostic curettage of the uterine cavity: indicated for all identified uterine fibroids in order to establish endometrial pathology and exclude uterine cancer.

How to treat uterine fibroids?

How to treat uterine fibroids? The main goal of treating fibroids is to eliminate the cause of the disease and harmful effects tumors on the surrounding tissues of the uterus, reduction in its size, growth arrest. Both medications and surgical methods.

As a rule, treatment tactics are chosen depending on the size, location and clinical and morphological variant of the tumor, the hormonal status of the patient, the state of her reproductive systems, etc. Some experts believe that there is no need to rush into surgery, but it is wiser to monitor the woman’s health before the onset of menopause.

Unfortunately, conservative treatment fibroids are effective only under certain conditions, namely:

  • relatively small size of the node (the size of the uterus does not exceed a 12-week pregnancy);
  • asymptomatic course;
  • the patient’s desire to preserve the uterus and, accordingly, reproductive function;
  • inertial or subserous arrangement of nodes having an exceptionally wide base.

If the diagnosis of uterine fibroids is confirmed, use the following groups drugs:

  1. Combined oral contraceptives containing desogestrel and ethinyl estradiol. These medications help suppress and alleviate the first symptoms of fibroids in women. However, drugs in this group do not always help to reduce tumors, so they are used only when the size of the node does not exceed 1.5 cm.
  2. Androgen derivatives: Danazol, Gestrinone. The action of this group is based on the fact that androgens suppress the synthesis of ovarian steroid hormones. As a result, the size of the tumor decreases. Use for up to 8 months continuously.
  3. Antiprogestogens. Helps stop tumor growth. Treatment can last up to six months. The most famous drug in this group is Mifepristone;
  4. Antigonadotropins (Gestrinone)– prevent an increase in the size of uterine fibroids, but do not help reduce existing sizes.

FUS ablation. One of modern methods fight against fibroids. In this case, the tumor is destroyed by ultrasound under the control of a magnetic resonance imaging scanner.

A woman receiving conservative treatment for uterine fibroids should be examined at least once every 6 months.

A set of recommendations has been developed for such patients:

  1. It is strictly forbidden to lift heavy objects, which can lead to prolapse of the uterine body and other complications;
  2. Stress that negatively affects hormonal levels is unacceptable;
  3. Increase the consumption of fruits, berries, herbs, vegetables, as well as fish and seafood;
  4. Walk more often (this helps improve blood flow);
  5. Avoid sports that place stress on the abdominal muscles (you can do free swimming and yoga);
  6. It is also worth noting that patients with diagnosed fibroids should avoid exposure to heat. This means that you need to give up long sunbathing, visiting the bathhouse, sauna and solarium, as well as hot showers.
  7. Undergo restorative treatment with vitamins 4 times a year (select the complex together with your doctor).

Surgical treatment: surgery

Mandatory indications for invasive therapy are:

  • the size of the tumor is more than 12 weeks and it puts pressure on nearby organs;
  • myomatous formations provoke heavy uterine bleeding;
  • there is an acceleration in the growth of fibroids (by 4 weeks in less than a year);
  • necrotic changes in the tumor;
  • twisting of the pedicle of the subserous node;
  • nascent submucosal myoma (emergency laparotomy is indicated);
  • combination of myomatous nodes with.

There are different options for surgical treatment of uterine fibroids. Among them, three main areas can be distinguished:

  • removal of the entire uterus and nodes;
  • removal of myomatous nodes while preserving the uterus;
  • surgical disruption of blood circulation in fibroids, which leads to their destruction.

Depending on the type of fibroid, its location, and size, the doctor chooses the type of surgery to remove the fibroid. Myomectomy today is performed in 3 ways:

  • Laparoscopy - through small holes in the abdomen
  • During hysteroscopy, a special instrument is inserted into the uterus through the vagina.
  • Strip surgery through an incision in the lower abdomen is performed very rarely.

Rehabilitation after surgery

Rehabilitation female body depends on a variety of factors:

  1. For example, if the operation was performed using an open method, then recovery process passes more slowly.
  2. The patient is offered a restriction physical activity, not forgetting that measured walking can only bring benefits and will contribute to accelerated healing.

Maintaining proper nutrition

There is no special diet, you just need to stick to a healthy diet.

  • First of all, it is diverse and balanced diet, corresponding to the energy needs of a woman, with the inclusion of vitamins and microelements.
  • Food is taken 5 times a day; overeating and long breaks between meals are not allowed.
  • A healthy diet involves eliminating frying and using baking, stewing or boiling when preparing dishes.
Allowed products for fibroids Prohibited Products
The basis of the diet should be the following products:
  • vegetable oil – sunflower, flaxseed, rosehip, corn, etc.;
  • any fruits, herbs, vegetables, berries;
  • dark varieties of bread, with the addition of coarse flour and bran;
  • cereals, legumes;
  • fish products, mainly sea fish;
  • fermented milk products (fresh);
  • nuts, seeds, seeds;
  • high-quality varieties of green and black tea, herbal tea;
  • compote or jelly based on berries or fruits.
 Undesirable foods should be excluded from the diet:
  • margarine, oil mixtures (spreads), limited butter;
  • fatty meat, lard;
  • sausages, smoked products;
  • hard cheese with a high percentage of fat, processed cheese, sausage cheese;
  • baked goods and baked goods made from white flour;
  • sweets, including cakes, ice cream, cream pies.

Folk remedies

Before you start using folk remedies for fibroids, be sure to consult with your doctor.

  1. Tampons with burdock root juice are applied topically. Add honey, sea buckthorn and St. John's wort oil, mumiyo to the juice and mix thoroughly. The tampon is placed overnight for 21 days.
  2. Sea buckthorn berry oil. To do this, make cotton swabs, soak them in oil and place them in the morning and evening. The course lasts 2 weeks. It can be repeated if necessary.
  3. Take 4 tsp. flax seeds, pour half a liter of boiling water and simmer over low heat for 10 minutes. At this time, stir the broth. When it cools down, drink half a glass, 4 times a day. The course lasts 15 days, then take a break for 15 days, and repeat the course.
  4. Tincture of partitions walnut . You can buy it ready-made at the pharmacy and use it according to the instructions, or you can prepare it yourself: pour 30 grams of partitions with vodka (1 glass) and leave in a dark place for 3-4 weeks. Take 30 drops 30 minutes before meals with a glass of water. The course is 1 month, 2 weeks break and can be repeated.
  5. Prepare an infusion of several flowers by brewing them with a glass of boiling water for 10 minutes. You need to drink it in the morning before breakfast, for a long time. The duration of admission is determined by the herbalist. Calendula infusions are used for douching. This plant can be used internally in the form of a pharmaceutical tincture.
  6. Finely chopped boron uterus grass(50 g) pour 500 ml of vodka. Leave for ten days in a dark place, shaking regularly. The first ten days take the infusion one teaspoon once a day, the next ten days - one tablespoon. Then take a break for ten days and repeat the treatment.
  7. Using tampons gives good results, soaked in medicinal liquids. Shilajit should be diluted with water in a ratio of 2.5:10. Soak a cotton pad in the prepared solution and place it in the vagina. At the same time, mumiyo should be taken orally at a dose of 0.4 g. Therapy should last 10 days, after which a break of 1 week must be taken. Afterwards you can repeat the course.

Forecast

With timely detection and proper treatment of uterine fibroids, the further prognosis is favorable. After organ-preserving operations in women in reproductive period pregnancy is likely. However, the rapid growth of uterine fibroids may require radical surgery to exclude reproductive function, even in young women.

Prevention

Main preventive measures boil down to the following:

  • proper nutrition with a predominance of fresh vegetables and fruits;
  • taking vitamins and microelements that contribute to the normal synthesis of sex hormones;
  • active lifestyle, playing sports;
  • regular sexual intercourse;
  • annual preventive examinations with a gynecologist with ultrasound.

We found out what uterine fibroids are and what treatment is most effective. Remember, when visiting a doctor regularly, if a tumor occurs, it will be found at the very beginning, while its size is small and the woman does not even suspect the presence of fibroids. Timely detection of a tumor will allow it to be cured without the use of surgical means and maintain the ability to bear children.

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Multiple nodular uterine fibroids: what is it?

Multiple (numerous) uterine fibroids are the presence in the reproductive organ of two or more benign nodes, consisting of hypertrophied cells of the middle layer of the uterus - the myometrium.

Mixed uterine fibroids: what is it?

Multiple nodes of uterine fibroids can be located in completely different layers: both in the subserous, in the myometrium and intramurally.

This pathological condition is sometimes called mixed uterine fibroids, since the nodes are localized in different places of the organ and can give completely diverse symptoms, mixed, characteristic of both subserous localization of the tumor and submucosal one. This pathology is not uncommon, but rather, on the contrary, about 70% of uterine fibroids found in women are multiple. Previously it was believed that this disease is more pathognomonic for women in age group after 35 years, however, at present, morbidity statistics are inexorably growing and indicate a rejuvenation of morbidity. So nowadays, even at the age of 20, doctors make such diagnoses.

Multiple fibroids in one uterus can be characterized by both different localization and sizes: small ones have sizes not exceeding two centimeters, medium ones - from two to six centimeters, and large ones - respectively, more than 6 centimeters.

Etiological factors that influence the increased sensitivity of myocytes can be inflammatory processes, traumatic factors, medical interventions on the organs of the woman’s reproductive system, and genetic factors.

The pathogenesis of such neoplasms is also hormonal in nature, which consists in the influence of an increased estrogen background on the compromised muscle cells of the uterus.

Myomatous nodes have two stages of development, characterized by different sources estrogenic effects: thus, at the initial stage, the growth of nodes occurs due to a general altered hormonal background with a component of hyperestrogenism, when subsequently such formations become independent of the general hormonal background, and autonomously synthesize estrogens, which support the development of these nodes.

The clinical picture of this pathological condition depends on the size of the formation, as well as the anatomical location of the myomatous nodes.

Multiple small uterine fibroids

If the size of the nodes of even multiple fibroids is insignificant, then there may be no clinical symptoms at all. Such fibroids can be an accidental discovery during a routine examination by a gynecologist or during a preventive examination ultrasound examination.

The symptoms mainly depend on where the nodes are located: if there is a submucosal node, then the symptoms can manifest themselves in the form of heavy menstruation, uncharacteristic for a particular woman, and cramping pain in the lower abdomen. Such blood loss leads to increased blood loss, which is not physiological, but pathological. And as a result, complications such as posthemorrhagic anemia develop, that is, a decrease in the level of hemoglobin in a clinical blood test.

There are also complaints of fatigue, fatigue, and decreased performance.

Why are multiple large uterine fibroids dangerous?

A striking manifestation of myomatous nodes is pain, which can be either slightly expressed or quite intense. Pain can be caused by both multiple uterine fibroids with a subserous node, which compress nearby organs and nerve plexuses, and submucosal fibroids, especially on a thin stalk, which turn over time into new ones. With this type of myomatous neoplasms, the pain becomes cramping in nature, sometimes dagger-like, piercing. Treatment of such fibroids should be carried out as quickly as possible in a surgical manner to prevent disruption of the node’s nutrition, and subsequently its necrosis. there are also signs of compression of neighboring organs, which have clinical symptoms of constipation, intestinal colic, intestinal obstruction, cystitis, frequent urination, on the contrary, lack of urination, also with large tumors, the outflow of urine from the kidneys may be disrupted, thereby causing a clinical picture of pyelonephritis, hydronephrosis, accompanied hyperthermic reactions, pain in the lumbar region from the affected organ.

What is multiple uterine fibroids and pregnancy: can it occur?

One of the common complaints women have when they have uterine fibroids is infertility, despite repeated attempts to conceive a child, none of them are successful.
Of course, this situation requires immediate treatment, since the more the process is started, the worse the consequences will be for the woman’s reproductive system and her childbearing function.

To identify such a pathological process, a set of clinical and laboratory examinations must be prescribed to confirm or refute this pathological process. These include a gynecological examination by an obstetrician-gynecologist, an ultrasound examination with both an abdominal and vaginal probe, Doppler ultrasound of blood flow in the nodes, and magnetic resonance imaging. Minimally invasive technologies are also used, such as hysteroscopy and laparoscopy, which, in turn, can be both diagnostic and therapeutic.

Treatment also depends on many parameters of myomatous formations.

If multiple uterine fibroids are diagnosed, treatment without surgery can be carried out for small fibroids. For significant size, compression of adjacent organs, and symptomatic fibroids, surgical treatment is indicated.

Multiple uterine fibroids: symptoms

Symptoms or clinical manifestations multiple uterine fibroids can be:

  • Menorrhagia – increased uterine bleeding;
  • Acyclic uterine bleeding - bleeding that does not start according to the cycle schedule;
  • Pain in the lower abdomen from minor discomfort in the lower abdomen to dagger-like piercing pains;
  • Posthemorrhagic iron deficiency anemia;

Signs of impaired function of adjacent organs as a result of their compression by large uterine fibroids: constipation, defecation disorders, impaired urine outflow and dysuric manifestations.

Signs of multiple uterine fibroids

All signs of uterine fibroids depend on its location in the uterus, where exactly the tumor is localized: in the body or cervix, intramural or subserous. And also the size of fibroids plays a huge role in the appearance of its symptoms.

So large subserous fibroids begin to manifest themselves with significant pain in the lower abdomen, pressure on anus, constipation, and frequent urination.

Submucous fibroids can be suspected by such a sign as an increase in menstrual blood loss, that is, a woman’s periods become more abundant and after their end the woman feels significant weakness and fatigue.

How to treat multiple uterine fibroids?

Treatment of a diagnosis such as multiple uterine fibroids can be of three types:

  1. Conservative therapy;
  2. Surgical treatment;
  3. Combination therapy;

Conservative therapy consists of using medications such as:

  • Combined oral contraceptives, drugs that combine estrogen and progestogen;
  • Gonadotropin-releasing hormone agonists;
  • Gonadotropin-releasing hormone antagonists;
  • Gestagens both in the form of capsules and in the form of intrauterine devices;
  • Antiestrogenic drugs;

Surgical treatment can be performed in three ways: laparotomically, laparoscopically, hysteroscopically, and operations are divided into:

Organ-preserving surgical interventions that make up the organ itself - the uterus. These include myomectomy - removal of only myomatous formation.

Radical – involves removal of the uterus or part of it (defundation, supravaginal amputation or hysterectomy).

Only a doctor should prescribe therapy in each case, taking an individual approach; with a diagnosis of multiple uterine fibroids, treatment with folk remedies only delays the process and aggravates the patient’s condition.

Multiple uterine fibroids: surgery, reviews

Removal of multiple uterine fibroids is indicated for small tumors and the expected effect after such an operation. To remove the myomatous node separately, conservative myomectomy is chosen; approaches are also selected depending on the size of the tumor. With its impressive size, of course, the doctor chooses a laparotomy approach, and if it is minor, laparoscopy. For submucosal localization, hysteroresectoscopy is performed.

However, the opinion of doctors is the same in case of multiple uterine fibroids - removal of the uterus is effective. Such surgical interventions can be performed laparotomically or vaginally. There are combined surgical interventions that involve performing the laparoscopic part of hysterectomy followed by the vaginal stage.

In modern medical technologies, an innovation has appeared in the tactics of treating fibroids - embolization of the uterine arteries. The point of this procedure is to introduce emboli (in other words, blood clots) into the vessels feeding the tumor. As a result of the cessation of blood circulation, necrosis occurs in them and this myomatous formation decreases.

Also, a non-invasive method for removing fibroids is currently FUS ablation - the use of an ultrasound wave of a certain frequency, which is aimed at the myomatous formation, as a result of which the tissues are heated to a temperature of 60 degrees and the tumor tissues are simply necrotic. Due to non-invasiveness this method Doctors increasingly prefer this method.

But we repeat that only a doctor can adequately evaluate all the data from objective research methods and choose the tactics of surgical intervention in each specific case, taking into account all the nuances of a particular woman.

Is it possible to get pregnant with multiple uterine fibroids?

Of course, it is possible, however, it is worth noting that everything depends on the size of the myomatous tumor and its location. These characteristics of the neoplasm appear in all questions regarding this diagnosis.

If the uterine fibroids are small in size, have a subserous location, and have several nodes, pregnancy is quite possible. However, if we are talking about a large submucous fibroid that deforms the uterine cavity, as well as a fibroid that is located in the cervix or close to the internal uterine os, then the chances of pregnancy are in this case very small. Large tumor sizes also negatively affect the gestational period, as they can cause complications such as placental abruption, its dysfunction, chronic fetal hypoxia, ultimately leading to retention syndrome intrauterine development and fetal distress. In the most dire cases, there may be a threat of termination of pregnancy, the threat of premature birth, as well as antenatal death of the fetus.

A very important point is monitoring Doppler indicators of blood flow in the vessels feeding the tumor. Since there may be complications associated with malnutrition of the node and their necrosis.

Who gave birth with multiple uterine fibroids, reviews?

With this diagnosis, the delivery plan can be chosen either through natural birth canal, and by caesarean section. If the tumors are small in size and do not interfere with the birth process, then natural delivery is completely indicated. But if the tumor is located in the area of ​​the internal pharynx and cervix, then such childbirth is impossible and the woman must be delivered by caesarean section.

The detection of 2 or more fibroids in different parts of the uterine wall is considered to be a prognostically unfavorable variant of the disease. Multiple uterine fibroids may be a reason for surgical intervention, especially if the size of the tumor rapidly increases or in the presence of uterine bleeding. Timely diagnosis and drug treatment will help preserve the reproductive organ, but the likelihood of having the uterus removed will still remain.

Multiple fibroids - what is it?

Nodules in the muscle wall of the female reproductive organ can be single or multiple. Multiple fibroids are more than 2 benign myomatous nodes that are found in any part of the uterus. Pathology is one of the common variants of the course of the disease, but with small nodes, the woman will not always have complaints and symptoms. The first manifestations of multiple fibroids occur with the rapid growth of one of the nodes or with a general significant increase in the size of the uterus. If the pathology is asymptomatic, the doctor can identify the problem during an annual preventive examination.

Node location options

With fibroids, multiple nodes are most often found in the thickness of the uterine wall. The following localizations of fibroids are distinguished:

  • interstitial fibroids (in the wall of the uterus);
  • broad-based subserous fibroids;
  • intramural fibroids with centripetal growth;
  • isthmus.
  • submucosal and subserous fibroids on a thin stalk;
  • intraligamentary fibroids (interligamentous).

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The main symptoms of multiple fibroids

Many small interstitial nodules extremely rarely present with symptoms, and, in the vast majority of cases, become an incidental finding during ultrasound scanning. Multiple large fibroids always manifest themselves with the following symptoms:

  • pain syndrome (with the total size of the uterus more than 12 weeks of pregnancy, a painless course of the disease is very rare);
  • heavy menstruation leading to bleeding and bleeding during the intermenstrual period;
  • lack of desired conception;
  • inability to safely carry a fetus to term (miscarriage or premature birth);
  • problems with the bladder (difficulty urinating due to compression by a knot);
  • difficulties with defecation (constipation) caused by the pressure of the node on the rectum;
  • pain in the lower back similar to radiculitis (compression of the nodes of the radicular nerves in the sacral area);
  • varicose veins of the small pelvis.

Most often, 1–2 symptoms predominate, which is associated with the location and size of specific fibroids. In each specific case, the manifestations of the disease are individual - if fibroids are suspected, the doctor will refer you for examination.

Diagnostic methods

The basis of a quick and effective examination is transvaginal ultrasound scanning. The ultrasound doctor will detect all myomatous nodes measuring 5 mm or more on the monitor screen. If necessary and according to indications, the following studies are carried out:

  • Doppler ultrasound to assess blood flow in the uterine nodes;
  • MRI with contrast;
  • hysteroscopy;
  • laparoscopy;
  • aspiration of the endometrium to exclude oncopathology;
  • colposcopy.

Carrying out a standard examination scheme helps to make an accurate diagnosis and choose the optimal method of treatment for multiple uterine fibroids.

Treatment tactics for multiple fibroids

The choice of treatment tactics for multiple uterine fibroids is influenced by the following factors:

  • woman's age;
  • potential desire to conceive and bear a baby in the near future;
  • presence of symptoms - bleeding and severe pain;
  • overall size of the uterus;
  • suspicion of cancer.

With multiple uterine fibroids, treatment depends on the symptoms - when a woman cannot be relieved of the problem with medications, the doctor will suggest surgical intervention. The most commonly used types of operations are:

  • embolization of uterine vessels to reduce the size of nodes;
  • laparoscopy with removal of the subserous node;
  • hysteroresectoscopy for submucosal localization;
  • conservative myomectomy of a large node;
  • hysterectomy (subtotal or total) if it is impossible to use organ-preserving techniques.

Drug treatments are ineffective, and traditional methods are unacceptable: multiple uterine fibroids are optimally treated with surgical methods. Medicines are used at the stage of preoperative preparation, when it is necessary to reduce the size of fibroids. With minimal suspicion of malignant degeneration, one should not waste time on medications - confirmation of this fear is an indication for hysterectomy.

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After a woman is diagnosed with uterine fibroids, she begins to think about whether she needs to change her lifestyle. This disease, like any other, has absolute prohibitions....

Almost every third woman has been diagnosed with uterine fibroids. It is known that benign tumors have many types and subtypes. Each type differs in the manifestation of the clinical picture, growth characteristics, shape and size....

An experienced gynecologist can determine the size of the myomatous lesion already during examination on a gynecological cross. To clarify the parameters of the nodes, an ultrasound examination is necessary....

Subserous, or subperitoneal, uterine fibroids are a benign gynecological pathology, accompanied by the formation of myomatous nodes under the outer serous membrane of the uterus....

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Zhumanova Ekaterina Nikolaevna

Head of the Center for Gynecology, Reproductive and Aesthetic Medicine, Ph.D., Doctor highest category, Associate Professor of the Department of Regenerative Medicine and Biomedical Technologies of the Moscow State Medical University named after A.I. Evdokimova, board member of the Association of Aesthetic Gynecologists ASEG.

  • Graduated from the Moscow Medical Academy named after I.M. Sechenova, has a diploma with honors, completed clinical residency at the Clinic of Obstetrics and Gynecology named after. V.F. Snegirev MMA named after. THEM. Sechenov.
  • Until 2009, she worked at the Clinic of Obstetrics and Gynecology as an assistant at the Department of Obstetrics and Gynecology No. 1 of the MMA named after. THEM. Sechenov.
  • From 2009 to 2017 she worked at the Federal State Institution “Treatment and Rehabilitation Center” of the Ministry of Health of the Russian Federation
  • Since 2017, he has been working at the Center for Gynecology, Reproductive and Aesthetic Medicine of Medsi Group of Companies JSC.
  • Defended her dissertation for the academic degree of candidate medical sciences on the topic: “Opportunistic bacterial infections and pregnancy"

Myshenkova Svetlana Aleksandrovna

Obstetrician-gynecologist, candidate of medical sciences, doctor of the highest category

  • In 2001 she graduated from the Moscow State Medical and Dental University (MGMSU)
  • In 2003, she completed a course of study in the specialty “obstetrics and gynecology” at the Scientific Center for Obstetrics, Gynecology and Perinatology of the Russian Academy of Medical Sciences
  • He has a certificate in endoscopic surgery, a certificate in ultrasound diagnostics of pathologies of pregnancy, fetus, newborn, in ultrasound diagnostics in gynecology, a certificate of a specialist in the field of laser medicine. He successfully applies all the knowledge acquired during theoretical classes in his daily practice.
  • She has published more than 40 works on the treatment of uterine fibroids, including in the journals “Medical Bulletin” and “Problems of Reproduction”. He is a co-author of methodological recommendations for students and doctors.

Kolgaeva Dagmara Isaevna

Head of pelvic floor surgery. Member of the scientific committee of the association for aesthetic gynecology.

  • Graduated from the First Moscow State Medical University named after. THEM. Sechenov, has a diploma with honors
  • She completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov
  • Has certificates: obstetrician-gynecologist, specialist in laser medicine, specialist in intimate contouring
  • The dissertation is devoted to surgical treatment genital prolapse complicated by enterocele
  • The sphere of practical interests of Dagmara Isaevna Kolgaeva includes:
    conservative and surgical methods of treating prolapse of the walls of the vagina, uterus, urinary incontinence, including the use of high-tech modern laser equipment

Maksimov Artem Igorevich

Obstetrician-gynecologist of the highest category

  • Graduated from Ryazan State Medical University named after academician I.P. Pavlova with a degree in general medicine
  • Completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology Clinic named after. V.F. Snegirev MMA named after. THEM. Sechenov
  • Has a full spectrum surgical interventions for gynecological diseases, including laparoscopic, open and vaginal access
  • The scope of practical interests includes: laparoscopic minimally invasive surgical interventions, including single-puncture access; laparoscopic operations for uterine fibroids (myomectomy, hysterectomy), adenomyosis, widespread infiltrative endometriosis

Pritula Irina Alexandrovna

Obstetrician-gynecologist

  • Graduated from the First Moscow State Medical University named after. THEM. Sechenov.
  • She completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
  • She is certified as an obstetrician-gynecologist.
  • Possesses skills surgical treatment gynecological diseases on an outpatient basis.
  • He is a regular participant in scientific and practical conferences on obstetrics and gynecology.
  • The scope of practical skills includes minimally invasive surgery (hysteroscopy, laser polypectomy, hysteroresectoscopy) - Diagnosis and treatment of intrauterine pathology, cervical pathology

Muravlev Alexey Ivanovich

Obstetrician-gynecologist, gynecological oncologist

  • In 2013 he graduated from the First Moscow State Medical University named after. THEM. Sechenov.
  • From 2013 to 2015, he completed clinical residency in the specialty “Obstetrics and Gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University named after. THEM. Sechenov.
  • In 2016, he underwent professional retraining at the State Budgetary Institution of Healthcare of the Moscow Region MONIKI named after. M.F. Vladimirsky, specializing in Oncology.
  • From 2015 to 2017, he worked at the Federal State Institution “Treatment and Rehabilitation Center” of the Ministry of Health of the Russian Federation.
  • Since 2017, he has been working at the Center for Gynecology, Reproductive and Aesthetic Medicine of Medsi Group of Companies JSC.

Mishukova Elena Igorevna

Obstetrician-gynecologist

  • Doctor Mishukova Elena Igorevna graduated with honors from the Chita State Medical Academy with a degree in general medicine. She completed clinical internship and residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
  • Mishukova Elena Igorevna has a full range of surgical interventions for gynecological diseases, including laparoscopic, open and vaginal access. He is a specialist in providing emergency gynecological care for diseases such as ectopic pregnancy, ovarian apoplexy, necrosis of myomatous nodes, acute salpingoophoritis, etc.
  • Mishukova Elena Igorevna is an annual participant in Russian and international congresses and scientific and practical conferences on obstetrics and gynecology.

Rumyantseva Yana Sergeevna

Obstetrician-gynecologist of the first qualification category.

  • Graduated from the Moscow Medical Academy named after. THEM. Sechenov with a degree in general medicine. She completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University named after. THEM. Sechenov.
  • The dissertation is devoted to the topic of organ-preserving treatment of adenomyosis using FUS ablation. He has a certificate as an obstetrician-gynecologist and a certificate in ultrasound diagnostics. Proficient in the full range of surgical interventions in gynecology: laparoscopic, open and vaginal approaches. He is a specialist in providing emergency gynecological care for diseases such as ectopic pregnancy, ovarian apoplexy, necrosis of myomatous nodes, acute salpingoophoritis, etc.
  • Author of a number of published works, co-author of a methodological guide for doctors on organ-preserving treatment of adenomyosis using FUS ablation. Participant of scientific and practical conferences on obstetrics and gynecology.

Gushchina Marina Yurievna

Gynecologist-endocrinologist, head of outpatient care. Obstetrician-gynecologist, reproductive specialist. Ultrasound diagnostics doctor.

  • Gushchina Marina Yurievna graduated from Saratov State Medical University. V.I. Razumovsky, has a diploma with honors. She was awarded a diploma from the Saratov Regional Duma for excellent achievements in studies and scientific activities, recognized as the best graduate of Saratov State Medical University named after. V. I. Razumovsky.
  • She completed a clinical internship in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
  • He is certified as an obstetrician-gynecologist; ultrasound diagnostics doctor, specialist in laser medicine, colposcopy, endocrinological gynecology. Repeatedly took advanced training courses in “ Reproductive medicine and surgery”, “Ultrasonic diagnostics in obstetrics and gynecology”.
  • The dissertation is devoted to new approaches to differential diagnosis and tactics for managing patients with chronic cervicitis and early stages of HPV-associated diseases.
  • Proficient in the full range of minor surgical interventions in gynecology, performed both on an outpatient basis (radiocoagulation and laser coagulation of erosions, hysterosalpingography) and in a hospital setting (hysteroscopy, cervical biopsy, cervical conization, etc.)
  • Gushchina Marina Yuryevna has more than 20 scientific published works, is a regular participant in scientific and practical conferences, congresses and conventions on obstetrics and gynecology.

Malysheva Yana Romanovna

Obstetrician-gynecologist, gynecologist for children and adolescents

  • Graduated from the Russian National Research Medical University. N.I. Pirogov, has a diploma with honors. She completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the Faculty of Medicine of the First Moscow State Medical University. THEM. Sechenov.
    • Graduated from the Moscow Medical Academy named after. THEM. Sechenov with a degree in general medicine
  • She completed clinical residency in the specialty “Ultrasound Diagnostics” at the Research Institute of Emergency Medicine named after. N.V. Sklifosovsky
  • Has a Certificate of the Fetal Medicine Foundation FMF confirming compliance international requirements 1st trimester screening, 2018 (FMF)

    • Proficient in ultrasound examination techniques:

  • Abdominal organs
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  • Bladder
  • Thyroid gland
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Kruglova Victoria Petrovna

Obstetrician-gynecologist, gynecologist for children and adolescents.

  • Victoria Petrovna Kruglova graduated from the Federal State Autonomous Educational Institution higher education"Peoples' Friendship University of Russia" (RUDN).
  • Completed clinical residency in the specialty "Obstetrics and Gynecology" on the basis of the department of the Federal State Budgetary educational institution additional vocational education"Institute for Advanced Studies of the Federal Medical and Biological Agency."
  • He has certificates: obstetrician-gynecologist, specialist in the field of colposcopy, non-operative and operative gynecology of children and adolescents.

Baranovskaya Yulia Petrovna

Ultrasound diagnostics doctor, obstetrician-gynecologist, candidate of medical sciences

  • Graduated from the Ivanovo State Medical Academy with a degree in general medicine.
  • She completed an internship at the Ivanovo State Medical Academy, a clinical residency at the Ivanovo Research Institute named after. V.N. Gorodkova.
  • In 2013, she defended her thesis on the topic “Clinical and immunological factors in the formation of placental insufficiency” and was awarded the academic degree “Candidate of Medical Sciences.”
  • Author of 8 articles
  • Has certificates: ultrasound diagnostics doctor, obstetrician-gynecologist.

Nosaeva Inna Vladimirovna

Obstetrician-gynecologist

  • Graduated from Saratov State Medical University named after V.I. Razumovsky
  • Completed an internship at the Tambov Regional clinical hospital specializing in obstetrics and gynecology
  • He is certified as an obstetrician-gynecologist; ultrasound diagnostics doctor; specialist in the field of colposcopy and treatment of cervical pathology, endocrinological gynecology.
  • Repeatedly took advanced training courses in the specialty “obstetrics and gynecology”, “Ultrasonic diagnostics in obstetrics and gynecology”, “Fundamentals of endoscopy in gynecology”
  • Proficient in the full range of surgical interventions on the pelvic organs, performed by laparotomy, laparoscopic and vaginal approaches.

Uterine fibroids are a benign nodular formation that develops in the muscular layer of the organ - the myometrium.

This is one of the most common diseases among the fair half of humanity.

Appears on both the internal and external sides of the organ.

The disease can occur in several forms.

Multiple uterine fibroids

The following types of disease are distinguished:

  1. Simple. Benign growth is characteristic. The cells are healthy and do not divide.
  2. Proliferating. Muscle cells there is a lot in the organ, but there is only one growth.
  3. Presarcoma. There are multiple growths in one focus. The cell nuclei are heterogeneous, some are very large and brightly colored.

The disease is characterized by the presence of two or more.

Signs depend on location and. In the early stages, the disease does not manifest itself in any way. For this reason, many patients visit a doctor when the disease has reached advanced stages and has developed greatly.

If at the very beginning the disease is treated with medications and special procedures, then in the later stages surgical intervention is needed.

Causes

The following contribute to the appearance of the disease: :

  • Surgical interventions, abortions.
  • Pelvic injuries.
  • Stress.
  • Inflammatory processes of the genitourinary system.
  • Excess weight.
  • Late onset of menstruation.
  • Impaired metabolism.
  • Intrauterine devices.
  • Hormonal imbalance.

Factors causing disease, are still being studied in medicine. Doctors tend to believe that all of the above reasons can lead to this disease. To prevent its development, it is necessary to undergo regular examinations and visit a gynecologist. In the early stages, it is much easier and faster to cure the patient than in the later stages.

Symptoms of the disease

To see a doctor on time, you need to know about :

  • During menstruation, pain appears similar to contractions. Over time, it begins to bother me during the period between menstruation.
  • Menstruation becomes much heavier.
  • The abdomen increases in volume. Feels bloated.
  • A woman feels the urge to urinate more often than usual.
  • There is a feeling of heaviness in the stomach.

A woman experiences weakness, dizziness, nausea. If the nodes have time, constipation and pain in the abdomen occur. The patient becomes irritable, nervous, and experiences severe stress.

Kinds

According to the nature of growth, the following are distinguished: :

  • . Located in the muscle layer of the organ walls.
  • . Located under the serous film.
  • . Develops towards the endometrium.
  • Retroperitoneal. The node grows from the lower parts of the organ. It's difficult to see.
  • Interligamentous. Located between the layers of the uterine ligament.

Experts also determine the size of the nodes. If they are less than 2 cm, they are called small. Medium ones include formations 2-6 cm, and large ones more than 6 cm. There are also mixed diseases, when several tumors of different sizes appear at once..

Acceptable tumor sizes

Neoplasms are usually measured like during pregnancy:

  • Small. No more than 20 mm. Corresponds to 4-5 weeks.
  • Average: 20-60 mm. This is weeks 5-11.
  • Large: size greater than 60 mm, or more than 12 weeks.

Doctors say that the acceptable size of nodes is no more than 12 weeks. If the size is higher than this indicator, the woman is treated surgically. Medicines are powerless.

Diagnostic methods

Modern medicine detects the disease using the following methods:

  • . The pelvic organs are examined.
  • X-ray of the cavity.
  • . The organs of the reproductive system are examined with an optical instrument.
  • Biopsy. A smear is taken from the uterine cavity, which is later examined in the laboratory.
  • Laparoscopy. Large nodes included in the abdominal cavity.
  • MRI. It helps not only to identify the disease, but also to monitor treatment and changes in the size of nodes.

In addition to the above methods, laboratory testing is also used.. A woman takes a blood test. Regularly visits a doctor who monitors the treatment process.

Multinodular fibroids and pregnancy

This is a dangerous condition that provokes complications. Increasing growths interfere with the growth and development of the fetus. The situation becomes dangerous if there are more nodes: the risk of miscarriage increases. Knots also cause the baby to be positioned incorrectly. This leads to difficult labor and caesarean sections.

Conservative therapy

The goal of therapy is to suppress the growth of small tumors and prevent the appearance of new ones. They are prescribed to reduce the production of estrogen.

Among the most effective: Danazol, , Norkolut. Hormonal contraceptives are often prescribed for treatment, for example,. It suppresses ovulation, which significantly reduces and slows down the process of tumor development. Doctors recommend taking Zoladex. It reduces the production of pituitary hormones and is effective in the fight against fibroids.

CAREFULLY!

The drugs are prescribed by a doctor and taken in strictly prescribed dosages. The duration of treatment is also determined by the specialist.

Surgical treatment

If the nodes have reached large sizes, it is useless to take medications; they will not be able to eliminate the disease in the later stages. An organ operation is required, which is performed by experienced specialists on a designated day. The pathology is treated surgically if the tumor size exceeds 12 weeks.

Modern medicine eliminates tumors in several ways:

  • Hysteroscopy. A gentle procedure that does not injure the genitals will allow you to have a child in the future. An optical device and tools are used. The method is suitable for removing only small nodes. Treatment is recommended for young women.
  • . During the process, the abdominal cavity is pierced in several places. This is done to insert instruments and remove the tumor. Longer procedure.
  • - a microsurgical operation that leads to drying out of the nodes. They do not receive nutrition and decrease in size, then they are eliminated.
  • . Ultrasound and an MRI capsule are used. Instruments are not inserted into the small pelvis or organ, but the technique is very effective. Leads to complete elimination of the disease. It can only be used by women who will no longer give birth in the future. The treatment is very radical and is suitable for patients aged 45-50 years.
  • Hysterectomy. The most serious, lengthy operation. Suitable only if the nodes are too large and other treatment methods are powerless. Not only painful lesions are removed, but also... Doctors recommend this method only as a last resort.

The most appropriate method is chosen by the doctor after diagnosing the disease. It all depends on the age of the patient and the stage of the organ disease.

Is treatment possible with folk remedies?

Myoma with a subserous node is a serious disease; its treatment requires effective drugs.

- a dubious method that is not able to save a woman from an illness, but can only alleviate her condition: relieve pain, weakness. This method can only be supportive therapy, but not the main one. In any case, before using folk remedies, you should consult a doctor: allergic reactions are possible.

Burdock root is effective in treating disease. To do this, 5 g of crushed dry root is poured into 500 ml of boiling water. The product is infused for at least 12 hours. After this, it is recommended to strain the solution and use 100 ml 3-4 times a day as douches.

To relieve pain and improve the patient’s condition, it is recommended to use a decoction of motherwort. To do this, pour one teaspoon of herb into 250 ml of boiling water. The solution is placed on low heat for 5 minutes, then removed from the heat and left to brew for 2 hours. Then you can strain the medicine, take 100 ml 15 minutes before meals in the morning and evening.

Helps to remove painful sensations St. John's wort infusion. To do this, pour two tablespoons of dry herbs into 500 ml of boiling water. Leave the solution for at least 2 hours and then strain. Drink it half a glass twice a day.

Effective against disease folk remedy prepared with flaxseeds. You need to mix 4 tablespoons of seeds with 500 ml of boiling water. The mixture should be simmered over low heat for 5 minutes, then allowed to cool and set for 2 hours. The finished medicine is taken half a glass for 30 minutes before meals 3-4 times a day.

Doctors remind that warming baths and compresses are prohibited. They lead to worsening of the condition. Herbs are taken either internally as infusions and decoctions, or in the form of douches. Treatment should be discussed with a gynecologist.

Consequences

You need to understand that the consequences of the disease without proper treatment can be very serious.:

  • Infertility.
  • Uterus removal.
  • Miscarriage.
  • Serious deterioration in overall health.

To prevent such consequences, it is recommended to do a timely examination of internal organs and seek help from a doctor. Cured leiomyoma - health and long-term women. The disease can be stopped and cured. If appropriate measures are taken in time, a woman can become a mother and become completely healthy.

Disease prevention

The main rule of prevention is regular visits to the gynecologist, examination of internal organs. As soon as signs of illness appear, you should consult a doctor and do not self-medicate.

Disease prevention methods also include:

  • Refusal bad habits.
  • Moderate exercise.
  • Proper nutrition.
  • Walks in the open air.
  • Planning pregnancy before age 35.
  • Breastfeeding a baby.
  • Normalization of body weight.

NOTE!

It has been proven that breastfeeding significantly reduces the development of the disease and the growth of nodes. Prevents the occurrence of knots. This means that women are advised to give up artificial formulas and enjoy motherhood, thereby taking care of themselves.

It is important to maintain a healthy lifestyle, do not smoke, do not drink alcohol. This is the key to longevity and disease prevention. It is recommended to eat right, do not forget about vitamins, and take care of yourself. Myoma is a serious disease that requires immediate treatment. You cannot rely on fate and postpone treatment of emerging nodes until tomorrow. At the first signs of illness, you should immediately go to the hospital. Timely treatment can save women's health.

Useful video

From the video you will learn about multiple uterine fibroids, says Professor Armen Eduardovich Ter-Hovakimyan:

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Article outline

Benign formations for a long time do not give any signs of themselves, but if they are not treated, unpredictable complications arise. Multiple uterine fibroids are manifested by the formation of two or more nodes that grow from the muscle tissue of the reproductive organ. Pathology can be suspected after the formation reaches 5 cm or more. What it is, how to treat it and what methods there are, we’ll figure it out in the article.

What it is

Multiple uterine fibroids are a cluster of benign formations growing from the myometrium. The nodes are localized in different places, have a small or large size, and differ in shape. Usually in women the disease is diagnosed in late stages, so treatment is only possible through surgery.

Multinodular fibroids most often grow in the body of the uterus, but are sometimes observed in the cervix, grow into the peritoneum, ligamentous apparatus. The main task of a gynecologist after detecting tumors is to preserve fertility and the ability to give birth to children. For this, there are some gentle methods or drugs for non-advanced stages.

Statistics

According to statistics, multinodular uterine fibroids are detected in 12-25% of cases of diagnosis of gynecological pathologies. Peak development is reproductive and premenopausal age. Today, doctors are alarmed that the pathology is increasingly being diagnosed in young women under 33 years of age. Girls under 20 years of age rarely encounter the disease, in approximately 0.9-1.4% of cases. According to the results of recent studies, it has been established that the prevalence of multinodular formations has reached 85%.

How are they classified?

Experts identify the following types of pathology:

  1. Intraligamentary fibroids are a rare type of nodule in which they grow outward from the uterus, growing between the ligaments that hold the internal organs small pelvis. Treatment is carried out surgically.
  2. Submucosal – located in the endometrial mucosa, causing intense pain, strong growth of the uterus, defecation and urination disorders. The symptoms are quite clear, so identifying the problem is not difficult.
  3. Subserous - grows outside the body of the uterus, and can also occur in the pelvic area. The species is difficult to diagnose, as it is practically asymptomatic. If there is no treatment, pain appears in the lower back and lower abdomen. This is due to the pressure of the nodes on the nerve endings.
  4. Intramural - myomatous nodes affect the muscular (middle) layer of the uterus. The pathology is accompanied by cycle disorders, pelvic pain, and significant enlargement of the uterus.

Neoplasms can appear anywhere; they are localized in the uterus, grow into the cervix, or are simultaneously located in several places.

To size

Depending on the overall size of the nodes, fibroids are:

  • Small sizes - up to 20 millimeters;
  • Medium – up to 60 millimeters;
  • Multiple uterine fibroids big size– from 60 millimeters.

As it became clear, formations can be of various sizes and are localized in any areas of the reproductive and genital organs.

Causes

Cell mutation occurs due to circulatory disorders, damage to the uterus, inflammation, but mainly the following factors contribute to the formation of a tumor:

  1. Taking contraceptives (oral) or other medications.
  2. Abortion, installation of intrauterine devices or their prolonged presence in the uterus.
  3. Any disturbances in sexual life and the functions of childbirth, breastfeeding.
  4. Due to hormonal disorders.
  5. Metabolic disorders, diabetes, obesity.

To understand the real reason, the doctor needs to conduct a series of studies.

Diagnostics

Instrumental imaging is used to determine and confirm pathology. Most often, a woman needs to undergo the following studies:

  • Palpation, conversation with the patient;
  • Ultrasound – external and internal;
  • Hysteroscopy with optical device;
  • MRI required to assess the severity of the situation;
  • Abdominal laparoscopy;
  • Biopsy, histological examination;
  • Doppler ultrasound is an ultrasound of blood vessels.

A blood test and smear are also taken, hormone levels are determined, etc.

Symptoms

Symptoms of the pathology differ depending on the type of tumor, its size and location. Fibroids do not cause menstrual irregularities, but when they grow into the uterus, heavy periods appear, accompanied by pain or bleeding between periods.

Other signs of multiple uterine fibroids are:

  1. Cramping pain during any period of the menstrual cycle.
  2. Belly growth.
  3. Heaviness, discomfort.
  4. Problems with urination and bowel movements.
  5. When a tumor is located in muscle tissue, the blood supply is disrupted.
  6. Sometimes tachycardia, shortness of breath, etc. occur.
  7. Iron deficiency anemia causes nausea headache, dizziness, fainting.

When twisting the leg, the woman notices sharp pain, tension and the occurrence of the syndrome " acute abdomen. According to doctors, the most accurate symptoms of pathology are echo signs, which are detected using ultrasound.

Treatment of multiple fibroids

Before determining treatment, the specialist must understand the characteristics of the tumor, its effect on fertility, and the clinical picture. For these reasons, fibroids require an individual approach.

Drug therapy

Conservative treatment is carried out before operations, but when the stage is initial, removal can be avoided. The use of drugs is advisable as long as the tumor does not exceed 2 centimeters. The woman is prescribed medications based on gonadotropin-releasing hormones of the hypothalamus, which suppress the functioning of the ovaries - Buserelin, Goserelin.

During application, the formation resolves, but under negative factors it can grow again. To restore hormonal levels, progesterone antagonists and antiestrogens are used. Treatment of multinodular uterine fibroids lasts from 3 months to six months.

What operations are prescribed and when?

Surgery is prescribed in cases where the tumor reaches the appropriate size (more than 2 cm). Also, removal is necessary in case of active growth of nodes, heavy bleeding, severe pain syndromes, anemia. Surgery is necessary for infertility, miscarriages, pressure of formation on organs, and the danger of torsion of the leg.

In practice, the following removal methods are:

  • Myomectomy - performed through an incision in the peritoneum or under the navel. The method preserves reproduction;
  • Hysteroresectoscopy through the vagina for submucosal flow;
  • – destruction of fibroids with a drug that stops their nutrition;
  • Hysterectomy – indicated for women who have given birth, involves partial removal of the uterus.

Tactics are selected individually, only the doctor decides what needs to be done in this situation. Surgeries during pregnancy are indicated for deformation of the uterus, large size nodes, and danger of normal fetal development.

Traditional therapy

Used as an additional treatment or in the initial stages without active development. Therapy without surgery involves preparing tinctures and drops.

  1. Borovaya uterus - take 5 tbsp of raw material, pour in 0.5 vodka, leave the liquid for 2-3 months in a dark place, shaking occasionally.
  2. Flax seeds - pour 4 tsp of seeds into half a liter of boiling water, boil over low heat, take 3-4 times a day for 2 weeks. After drinking the decoction, you should not eat for 30 minutes.
  3. Potato juice - a solution for douching is easy to prepare. Take equal amounts of potato juice and celery juice, combine, squirt once a day.

Treatment folk ways long-term, therefore, in the absence of effect and complications, you should consult a doctor.

Multiple uterine fibroids and pregnancy

Pregnancy with multiple uterine fibroids is rare, since the formations prevent seminal fluid from passing through the fallopian tubes. Small nodes do not affect the progress of conception. If fertilization does occur, the node comes into contact with the placenta or grows actively, there is a risk of complications.

Women often ask their doctor if they can get pregnant if they are diagnosed with multiple fibroids. The answer will depend on the stage of the pathology, progression and other nuances. Conception is possible, as is the risk of miscarriage.

Multiple myomatosis and adenomyosis

Uterine fibroids in combination with adenomyosis and myomatosis occur secretly. When both pathologies develop simultaneously, treatment becomes more difficult. Usually medicinal methods are powerless here, so the most gentle operation is selected. The main goal of a specialist is a radical cure of diseases while preserving reproduction.

During menopause

During the climatic period, fibroids can not only shrink, but also begin to actively grow. Typically, after menopause, a woman feels better. If spotting secretion with blood is observed, you should definitely see a specialist.

During menopause, pathology appears due to the high content of estrogens and gonadotropins. If drug treatment does not produce results, removal surgery (myomectomy) is indicated.

Oncology

Despite the risks, oncology occurs rarely, only 1.5% -5 cases. Sometimes fibroids develop together with endometrial cancer (2%). Precancerous stages appear due to inattention to one’s health and ignorance benign tumors developing together with concomitant diseases.

Contraindications

A woman with fibroid nodes must follow some rules:

  • Do not lift weights, refuse to work on your feet;
  • Don't overwork yourself;
  • It is advisable to avoid drinking drinks before bed, this also applies to water;
  • Avoid stress;
  • Not to accept hormonal drugs and contraceptives;
  • Do not perform abortions, curettage, etc.

If you monitor your own condition and visit a gynecologist on time, many health problems can be avoided.

Prevention

For prevention, doctors recommend spending less time in the scorching sun, not having abortions, eating right, choosing one sexual partner, controlling hormonal levels, getting checked regularly, giving up bad habits and drug use. oral contraceptives. Preventive actions consist of eliminating provoking factors.

Consequences

In the presence of multiple fibroids, it is important to carry out the correct treatment in a timely manner, otherwise there is a risk of complications, including removal of the reproductive organ and oncology. Constant uterine bleeding causes anemia with critical hemoglobin levels. Large formations compress neighboring organs, which disrupts the functions of the intestines and urinary system.

Olga, 34 years old

A couple of years ago I removed fibroids that were 8 weeks old. I used UAE and was very worried about complications, but everything went well. The uterus is healing, there is a chance for a subsequent pregnancy. In general, the methods now are good, there is no need to be afraid of surgery.

Ksenia, 30 years old

I have not given birth, and here is the diagnosis, the clinic said that for now you can try conservative treatment. The therapy lasted 4 months, I managed to cure uterine fibroids with drugs.

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