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Ovarian fibroma is a tumor-like formation connective tissue, having a benign character, but at the same time not introducing hormonal imbalance in the body. The frequency of detection of such a disease is 10% of all cases of identified tumor pathologies of this organ. The main risk group in in this case are women over 40. But this does not exclude the possibility of its appearance in young girls.
Such an anomaly often takes the form of a roundness with a flat surface, or in the form of nodules. In some cases, the size of the neoplasm can reach 12 cm. Those types of fibroids, inside which there are pseudocavities, due to edema, have a soft and elastic consistency, and in the case of deposition of calcium salts in them, on the contrary, they become hard.
In addition, due to the presence of a leg at the formation, they have a movable shape. The ovarian fibroma grows extremely slowly, however, the dystrophic changes occurring in the tissues can cause the acceleration of this process.
Alas, the exact and specific reasons for the development of fibrosis have not yet been determined. However, it is generally accepted that it appears from the ovarian stroma, although there have been cases when such a pathology grew from fibrous tissue, which has a nonspecific character.
Based on observations, women who have an unfavorable premorbid background are more susceptible to the development of such a disease. It can also be a disease of the endocrine system, lowered immunity, or the presence of chronic inflammation in the female genital organs.
Types of education
Studying the structure of pathology in a macroscopic form, it is possible to identify several of its forms. So, the first is a limited formation, which has a capsule that clearly separates it from other tissues. The second is a diffuse form, when the ovarian tissue is affected, but the formation of a capsule does not occur. Often, ovarian fibroma develops precisely of the second type, but at the same time, histologically, they practically do not differ from each other.
This is due to the fact that such formations consist of two main components:
- Fibrous substance;
- Cellular elements.
The main difference between them is only in the ratio of these elements. Often, the tissues of the neoplasm are edematous, in addition, they may have cysts. In the case of tissue dystrophy, the growth of pathology accelerates. In addition, ovarian fibroma can cause certain complications, such as:
- Hemorrhage;
- Malignancy;
- Torsion of the legs of the cystic formation;
- Development of inflammation with suppuration inside the tumor;
- Necrosis.
This disease is accompanied by such pathologies as, as well. They have a similar etiological development. Fibroids are not large sizes usually do not provide negative impact on the ovaries, moreover, they do not prevent a woman from conceiving and carrying a child.
Diagnostic methods
Also, if necessary, a blood test is performed for tumor markers and also a general one. In the case when, after the diagnosis, the doctor still has doubts about the diagnosis, then it is carried out to deliver an accurate diagnosis.
Therapies
Laparoscopy When ovarian fibroma was nevertheless identified, it is necessary to carry out treatment. It makes no sense to use conservative methods for this, which is due to the fact that such an anomaly cannot be resolved. Therefore, it is the operational methods that are used. By type and scale surgical intervention many factors affect, ranging from the age of the patient and the growth of education, to the presence of any other diseases. Minor anomalies are removed with gentle methods through the use of laparoscopy. In this case, the formation is simply excreted from the ovary.
As for the removal of large anomalies, when the ovarian tissue begins to squeeze, tissue proliferation occurs, and over time, the formation of a cyst capsule. Due to this, complete atrophy of the follicle occurs, which requires the removal of the entire ovary. For those women who are already in the premenopausal period, doctors are advised to perform surgical removal of damaged appendages
In this case, any special measures prevention to prevent the development this disease, do not exist today. His treatment is favorable and only 1% of the operated patients had a chance of malignancy of the pathology.
Ovarian fibroma - benign tumor ovary. In gynecology, ovarian fibroma occurs in about 10% of all benign ovarian tumors. It happens that fibroma occurs even during puberty, but women are mainly susceptible to it during premenopause and menopause, i.e. between the ages of 40 and 60.
Externally, ovarian fibroma is a round formation with a knotty or even surface, reaching 10-12 cm in size.If there are pseudocavities, then the consistency of the fibroid is tightly elastic, when calcium salts are deposited, the fibroma is solid, and with pronounced edema, it is soft. Mostly ovarian fibroma is mobile and unilateral, has a leg. If we consider the formation on the cut, then it has a white or grayish White color, with a small number of vessels. If a woman's tumor has been observed for a long time, then she may have hemorrhages, foci of necrosis and ischemia. Histologically, fibroma consists of bundles of spindle-shaped cells of connective tissue, which are intertwined in different directions.
Forms of ovarian fibroids
There are two forms of ovarian fibroids:
- Delimited, when the neoplasm has a clearly defined capsule, which separates it from the ovarian tissue;
- Diffuse when the ovary is completely affected.
Often, ovarian fibroids are edematous and contain cysts. As a rule, the tumor grows slowly, but with dystrophic changes, its growth can significantly accelerate. The borderline state of fibroma is considered to be an increase in its mitotic activity with a low malignant potential.
If the fibroma is small, then, as a rule, it does not have any effect on the function of the ovary and does not interfere with the onset of pregnancy and the successful bearing of the child. Cellular ovarian fibroma can recur, especially if its capsule has been damaged during surgery. Complications of the tumor include necrosis, torsion of the leg, the possibility of malignancy and suppuration of the tumor.
The main reasons for the development of ovarian fibroma
It is difficult to establish the exact reasons for the development of ovarian fibroids, but it is reliably known that the risk factor is the unfavorable hormonal background of a woman, including due to endocrine disorders (violation of reproductive and menstrual functions), various inflammation of the ovaries and appendages (oophoritis, adnexitis), a decline in the body's immune forces ...
Often, ovarian fibroma is combined with an ovarian cyst, uterine myoma, so we can talk about common etiological factors in the development of these diseases.
Ovarian fibroma symptoms
If the size of the fibroma is up to 3 cm, and the ovary continues to function fully, then for a long time there may be no symptoms of ovarian fibroma at all. As the education grows, signs of Meigs syndrome (pleurisy, anemia, ascites) begin to be observed, manifested by pain, periodic abdominal distention, rapid fatigue and general weakness, shortness of breath, tachycardia.
Ascites is frequent symptom ovarian cysts, which occurs when the transudate is released from the formation into the abdominal cavity. Hydrothorax occurs due to the ingress of ascitic fluid from abdominal cavity into the pleural through the slit of the diaphragm. It happens that ovarian fibroma is accompanied by cachexia and polyserositis (mainly with malignant transformation education). In many ways, the symptoms of ovarian fibroma and the severity of the disease depend on the degree of compression of adjacent organs by fluid.
With hemorrhages and necrosis in the tumor appear severe symptoms irritation of the peritoneum.
As a rule, with fibroma, the menstrual cycle is not disturbed. If ovarian fibroma is combined with other diseases of the female genital organs, then the symptoms of ovarian fibroma may be joined by those symptoms that are characteristic of another disease.
Diagnostics of the ovarian fibroma
Since fibroma can be asymptomatic for a long period of time, it is often discovered by chance during examination or surgery for another disease.
The diagnosis of ovarian fibroma is made on the basis of an examination by a gynecologist, clinical data, laboratory diagnostics(tumor markers CA-125, NOT 4, general analysis blood), as well as instrumental studies (CT of the pelvic organs, MRI, ultrasound). If necessary, do also histological examination removed tumor tissue.
Ovarian fibroma treatment
As a rule, medical (conservative) treatment of ovarian fibroids is not performed. The tumor must be removed by surgery. The nature of the operation depends on the size of the fibroma, the patient's age, the condition of the uterus and the second ovary, various pathologies internal organs.
If the tumor is observed in a young woman and has a small size, then the advantage in the treatment of ovarian fibroma is given to laparoscopic removal of the tumor while maintaining generative and menstrual functions. Doctors recommend premenopausal women to exercise complete removal appendages. If the ovaries are affected on both sides, doctors try to keep part of one of them.
Ovarian fibroma prognosis and disease prevention
Mostly the prognosis of ovarian fibroma is favorable, and the probability of malignancy of the tumor is no more than 1%. After the end of the rehabilitation course of treatment, a woman can plan a pregnancy.
There are no specific ways to prevent this disease. As a precaution, it is recommended to conduct an ultrasound of the pelvic organs and visit a gynecologist once a year.
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Or the ovaries.
Ovarian fibroma, like fibroids in other organs, usually develops asymptomatically, however, upon reaching a significant size, characteristic symptoms of the pathological process appear.
Concept and statistics
The share of fibrous formations in gynecology accounts for about 10% of the total.
The most susceptible to such neoplasms are women of premenopausal and menopausal age (40-60 years old). Ovarian fibroma is a tumor that does not have hormonal activity.
In appearance, such tumors are rounded seals with a nodular or smooth surface. Such ovarian formations can grow up to 12 centimeters or more and are predominantly one-sided. Such tumors, as a rule, have a pedicle, so they are mobile.
On the cut, the fibrous formation has a whitish-gray or white color, the tumor is poor in vascular network.
If the fibroma was formed quite a long time ago, then in its middle there are dead areas with ischemia, hemorrhages, degenerative lesions. From a morphological point of view, the tumor is formed from connective tissue cells.
Forms
Experts distinguish several fibrous varieties:
- Diffuse fibroma - affects the entire ovary;
- Limited tumor form - is a capsule with contents, which fences it off from the rest of the ovarian tissue.
Fibrous formations often swell and have cystic cavities with liquid contents inside, then they are called cystadenofibromas.
Usually fibrous formations grow slowly, however, under the influence of dystrophic changes, they begin to grow very quickly. Often, such tumors are accompanied by cystic processes in the ovarian tissues, which are formed for similar reasons.
The small size of fibrous formations usually does not affect ovarian functionality, and does not interfere with conception, pregnancy and successful delivery.
Reasons for development
As in the case of uterine fibroma, ovarian tumor has an uncertain etiology, however, the risk of pathology increases in the presence of an unfavorable state of health of the patient, contributing to the development of various diseases (premorbid background).
This can include pathologies of the endocrine system, including violations of reproductive and menstrual functions, pathologically low immune status, inflammatory processes in the ovaries or appendages (adnexitis, oophoritis, etc.).
In general, among probable causes fibroids in the ovaries can be distinguished:
- Lowered immune status;
- Pathological processes in the genitourinary system and genitals;
- Inflammatory lesions of the appendages or ovaries of chronic origin;
- The presence of endocrine pathologies;
- Genetic predisposition;
- Age features;
- Menstrual irregularities, etc.
Often, ovarian fibroma is accompanied by pathologies such as ovarian cyst or. Therefore, many experts believe that these diseases have common etiological factors.
Ovarian fibroma symptoms
Usually, ovarian fibroma develops latently. With sizes less than 3 cm, ovarian functions are usually not impaired, therefore there is no symptomatology.
When the mass begins to grow, the patient experiences the onset of symptoms such as Meigs syndrome, which includes pleurisy (inflammation of the pulmonary membrane), anemia, and (fluid accumulation in the peritoneum).
Similar conditions are manifested:
- General weakening of the body;
- Tachycardic manifestations;
- Bloating in the abdomen;
- Soreness;
- Excessive fatigue;
- Shortness of breath.
If the tumor secretes transudate into the retroperitoneal space, then ascites occurs. In exceptional clinical situations, ovarian fibroma is accompanied (extremely severe depletion) or polyserositis (inflammatory lesions of the serous membranes), but this picture is usually observed with malignancy of the tumor process.
Usually, menstrual changes and cycle disorders with ovarian fibroma are absent. If the pathology is combined with other genital diseases, then the clinical picture is a complex of their signs.
Diagnostics
Fibrous ovarian masses are usually found on occasional gynecological examinations because the tumor for a long time develops latently.
After a gynecological examination, the patient is sent to laboratory research, instrumental procedures such as ultrasound diagnostics, magnetic resonance imaging or low-basal organs, etc.
If necessary, an additional histological examination of the biomaterial obtained from the tumor through laparoscopic diagnostics is carried out.
Treatment
Treatment of fibrous formations in the ovary is carried out using operational methods... Since such neoplasms are not able to resolve, then conservative therapy meaningless.
In accordance with the size of the fibroma, the presence of complications, age-related and organic characteristics of the patient, the type of surgical intervention is selected.
To get rid of small formations, it is usually used when the fibroma is husked, and the ovary is completely preserved, as well as its functionality.
If the fibroma has reached a large size, then it is removed together with the ovary. If at the same time the age of the patient has approached the premenopausal period, then it is recommended to remove the appendages as well.
If the fibroma is bilateral, that is, the tumor process affects both ovaries, then a part of the one that is less affected by the formation is necessarily left.
Forecast and prevention
In general, the prognosis of ovarian fibroid tumors is positive, the probability of malignancy is minimal - only 1%. Only pregnancy will have to be postponed until complete cure and the end of postoperative rehabilitation.
There is no specific prevention of ovarian fibroids, so the annual visit is considered the main measure. antenatal clinic with conducting ultrasound examination small-scale organs. This is the only way to timely detect the development of a pathological fibrous process in the ovaries.
The video shows the operation to remove ovarian fibroids by the laparoscopic method:
The disease, which occurs in 2% -4% of cases, is one of the factors of infertility. Therefore, every woman should be aware of its symptoms, methods of treatment and prevention.
A tumor of connective tissue fibers, which has a benign nature that does not show activity, is called ovarian fibroma. This disease affects about 10% of women, the peak incidence occurs during menopause (over 40 years), sometimes it occurs in more early age... The size of the tumor can reach 12 cm. In these cases, fibroma often develops only on one of the ovaries (fibroma of the right ovary or left). Degeneration of a tumor into a malignant form occurs only in 1% of cases.
The fibroma of the right ovary (the left can also be affected) is a neoplasm that has an oval or round shape, with a flat surface, sometimes covered with peculiar nodules. If swelling is present on the tumor, then it is soft. The presence of calcium salts makes the fibroid hard. She has a leg, so the ovarian fibroma is mobile. Tumor growth is slow, but dystrophic changes can accelerate this process.
Under a microscope, fibroid cells look like a bundle of fibers intertwined with each other. They produce collagen, a protein in connective tissue.
Often, ovarian fibroma can be combined with a cyst or occur on the background of fibroids. It can be part of complex tumors - cystadenofibromas and adenofibromas. In this case, you need to consult a doctor with extensive experience and high qualifications.
Depending on the structure, there are 2 types of tumors:
- Limited form. It is located in a capsule that separates the fibroma from the ovarian tissue.
- Diffuse form (most common), develops without a capsule and completely affects the ovary.
Causes of occurrence
The exact reasons for the appearance of ovarian fibroids are still being studied, but doctors consider the most likely the malfunction of the reproductive organs, diseases of the endocrine system. They also include hormonal disorders, chronic diseases genitourinary system, inflammatory processes resulting from abortion. Women with a family history of tumors of the mammary gland, uterus, ovaries (more than 30% of them) are also predisposed to the disease. The risk groups, which include women, have been identified:
- Lowered immunity;
- With diseases of the reproductive organs: ovaries, appendages;
- Having pathologies of the endocrine system;
Ovarian fibroma symptoms
If the diameter of the tumor has not reached 3 cm, then the ovary is functioning normally. Therefore, no symptoms are observed in this case. But, if the size is exceeded, then such clinical manifestations will appear:
- Frequent urination or urge to use the toilet due to squeezing of the bladder;
- Constipation due to the proximity of the ovary to the colon;
- Lower abdominal pain;
- Dyspareum, that is, soreness during intercourse (the tumor capsule is stretched);
- With a duffy growing fibroma, in rare cases, there may be a violation of the menstrual cycle;
- Facial hair growth, as well as baldness on the head (since the tumor can produce androgens - male sex steroid hormones);
- One tenth of patients have Meigs syndrome (anemia, ascites, pleurisy).
Diagnosis of the disease
The diagnosis can be made based on the results of the studies carried out, which are as follows:
- Examination by a gynecologist, who, upon examination, can detect a foreign formation;
- Laboratory research;
- Ultrasound, MRI, color Doppler mapping;
- Diagnostic laparoscopy, during which a biopsy is performed to determine the nature of the neoplasm. This will make it possible to exclude such dangerous diseases, how follicular cyst, ovarian cancer.
Ovarian fibroma treatment
Prompt intervention is the only way to get rid of the problem. It should be noted that the fibroma of the left ovary is removed in the same way as the right one. The choice of the type of surgery depends on several factors: the size of the tumor, its location, age and general condition the patient, the presence or absence of other pathologies.
If the tumor is small, then a laparoscopy of ovarian fibroid is performed. This type of operation allows you to preserve the functions (menstrual and generative) of the ovary. On average, the operation lasts about 1 hour, but, depending on the degree of damage to the ovary, the time can be reduced to 20 minutes, or increased to 1.5 hours. Immediately after the operation, the ovaries begin to function normally. For the first 1-2 days, a woman may feel some discomfort in the abdomen. This is due to the presence of gas that was used in the operation. Pain after the intervention disappears on the 3rd day on its own.
To reduce them, it is advisable for a woman to stay in bed, not to use tight underwear. If pain do not stop, then you need to consult a doctor, as these may be symptoms of the development of any complications.
It should be borne in mind that laparoscopy has a number of contraindications. It is impossible to conduct it:
- With decompensated diseases of cardio-vascular system and respiratory organs;
- In acute liver or kidney failure;
- Recently transferred infectious diseases;
- Subacute or chronic inflammation ovaries or appendages (in this case, you first need to cure the disease);
- Severe hemorrhagic diathesis.
After laparoscopy, some restrictions must be observed:
- Abstain from sexual intercourse for a month;
- Not earlier than in a month you can start sports training, do fitness;
- Do not perform heavy physical work;
- Do not lift weights for 3 months;
- Do not eat spicy, spicy and salty foods, give up alcohol.
If the ovarian fibroma is large, then it is indicated abdominal surgery, during which the entire organ is removed. And for women who have reached the period of menopause, the appendages are also removed to prevent relapse. In the case of damage to both ovaries in the less affected, it is imperative to leave some of it in order to preserve reproductive function. In some cases, chemotherapy is given before and after surgery.
After the operation, the drug longidase is prescribed, which prevents the appearance of adhesions. It is applied once every 3 days, the course consists of five injections.
To accelerate the healing of wounds after surgery, a woman is shown physiotherapeutic procedures, including electrophoresis of zinc, calcium and magnesium. The use of vitamin preparations (Multitabs, Vitrum and others) is also recommended.
Forecast and prevention
In some cases, there is a torsion of the leg of the tumor, as a result of which its nutrition is disturbed, necrosis develops. In the future, pelvioperitonitis may occur ( inflammatory process in the pelvic area, which is accompanied by severe pain in the lower abdomen, anemia, a drop in blood pressure, nausea, vomiting). The outcome of this complication is the formation of adhesions. Their localization in the area of the fallopian tubes is especially dangerous, since the risk of infertility is high.
But the most threatening complication of ovarian fibroma is the presence of fluid in the abdominal cavity - ascites.
A low percentage of degeneration into a malignant tumor, the possibility of preserving the functions of the ovary and their reproductive activity are favorable forecasts.
If ovarian fibroma is detected during the onset of pregnancy, then this will not interfere with the bearing of the fetus.
If a disease is detected before its onset, it is necessary to plan a pregnancy after treatment and consultation with a gynecologist.
Ovarian fibroma, the treatment of which has been performed, requires adherence to certain preventive measures necessary for a woman to restore normal life. These include:
- Compliance healthy way life: proper nutrition, quitting smoking and drinking alcohol;
- At least 1 time per year visit to the gynecologist: scheduled examination, delivery required analyzes, undergoing examination on an ultrasound machine;
- Refusal from promiscuous sexual intercourse.
Women who are diagnosed with uterine fibroids should be especially attentive to their health, since it is they who most often develop ovarian fibroma.
Every woman should know that the symptoms of ovarian fibroma and ovarian cancer are very similar. Therefore, there is no need to delay the visit to the doctor. It can be life threatening.
The exact reasons for the appearance of a tumor in the right or left ovary are unknown to medicine. They mainly affect women in the premenopausal period, or during menopause. On the initial stages(up to 3 cm in diameter) fibroma is asymptomatic and does not cause negative sensations. As it grows, it begins to squeeze the surrounding organs and tissues, which negatively affects their functionality. Ignoring such a disease can lead to infertility. Depending on the structure and location, there are 2 types of fibroids. Often only one of the ovaries is affected. The prognosis is favorable, but the removal operation is required, its delay only worsens the situation.
Ovarian fibroids are non-malignant growths that can affect a woman's reproductive function.
What is this ailment?
Ovarian fibroma is a benign tumor consisting of connective tissue. Every 10th woman becomes the owner of the disease. Ovarian fibroids often appear between the ages of 40 and 60, but earlier cases are also possible. It mainly manifests itself in one of the ovaries (right or left). Differs in a round or oval shape with clear boundaries. Fibroid sizes range from 1-12 cm in diameter. Distinctive feature- with fibroma, there is no active production of the hormone, which is typical for other formations. You can diagnose the problem using special equipment, visual manifestations she does not have. They cause danger and pain as they grow, affecting and squeezing nearby organs and tissues. Fibroma belongs to a group with a low risk of developing into a malignant tumor.
Causes of ovarian fibroma
Medicine has not been able to establish the specific cause of the appearance of the tumor. Among the factors that affect the occurrence, there are:
- hormonal disbalance;
- exposure to synthetic drugs;
- endocrine system pathology;
- decrease in the functionality of immunity;
- inflammatory processes in the ovaries and appendages.
The growth of ovarian fibroids can cause hormonal imbalance, weakened immunity, problems in endocrine system. Fibroids have a similar developmental etiology with ovarian cysts and uterine fibroids.
The disease is often accompanied by menstrual irregularities and reproductive function... As a result, there is a high risk of infertility or pregnancy failure. Install clinical picture only a doctor can, after performing a series of necessary tests. Often the occurrence of fibroids is the body's response to diseases and malfunctions. It is worth being attentive to changes and undergoing a systematic examination by a gynecologist.
Symptoms and what it looks like
With a diameter of 3 cm or less, the fibroma is asymptomatic, the woman does not notice it. Subsequently, it is possible:
- menstrual irregularities;
- lower abdominal pain;
- pulling sensations in the back or abdomen;
- weight gain and volume increase;
- frequent urge to urinate due to pressure on the ureter;
- hair problems;
- problems with bowel movements.
Ovarian fibroma will affect comfort in intimate area, the regularity of menstruation.
Virtually all bodily functions are affected. The fibroma itself is round, without a capsule to collect fluid. The tumor is located on the leg, due to this, it is mobile on palpation. The edges of the fibroid are clear, not blurred, with a smooth or nodular surface. The consistency of the formation is dense and elastic. Depending on the availability of tissue, it has a soft or hard structure. Below is a table with the classification of types of fibroids of the right or left ovary.
The tumor is white or white-gray in color. It has a small number of vessels and capillaries. With the growth and development on the surface of the formation, manifestations of ischemia, spider-like capillary networks, hemorrhages are possible. The growth of fibroids is slow, but with changes in the body it can accelerate. Often provokes the onset of Meigs syndrome.
If you suspect ovarian fibroma, you should contact your gynecologist for examination.
Who to contact?
If disturbing symptoms appear (they can indicate different problems), a woman can contact a therapist, after examination he will refer to the right doctor. The main doctor who analyzes and diagnoses fibroids of the right or left ovary during examination is a gynecologist. Initially, he makes a visual characteristic, determines the necessary diagnostic and treatment methods. The surgeon removes the tumor. In the case of malignancy of the formation, the oncologist will become the attending physician.
