DISEASES OF FEMALE GENITAL ORGANS : MYOMA (FIBROIDS) OF THE UTERUS [MUOMA (FIBROMYOMA) UTERI] - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
The etiology and pathogenesis are poorly understood. Uterine fibroid is a benign tumor, growing mainly out of the elements of the body wall of the uterus.
Mono - and metrorrhagia (polymenorrhea), pain, fluid serous leucorrhoea.
There are the following forms:
One or more nodes associated with the outer surface of the uterus, more or less on a long stalk; the uterus appears to be dense, enlarged, movable. This includes intraligamentary fibroids.
Subserous fibroids, protruding above the surface of the uterus and is located between the leaves of the broad ligament; in its growth is a lateral tissue of the pelvis, pushing the uterus.
The uterus is enlarged, the shape is close to spherical; neck ajar; the neck is smoothed, your finger can palpate the lower pole of the tumor, or she is born into the vagina.
The uterus is enlarged, dense (non-uniformly), often rough. Observed changes of the heart (myoma heart is lowering the functional capacity of the heart). Anemia. Swelling of the feet. Often occurs without General and local symptoms.
Complications. Necrosis and infection of the tumor. Mucous, or mixomatous, rebirth, sarkomatoznoe rebirth (rapid growth, softening, deterioration of the General condition). Combination with cancer of the body of the uterus. When the nascent fibromyoma - inversion of the uterus. Infertility.
Recognition based on the above. If you suspect submucous fibroids - sounding of the uterine cavity. To distinguish from pregnancy (reaction Ashheyma-Condeca), polyps, tumors of the ovary, cancer.
Prediction in the absence of malignant transformation is good.
In the absence of painful symptoms, noticeable rapid growth, the threat of twisting the legs of a tumor associated with fibroid infertility (young age), treatment is not required, it is only necessary continuous monitoring of the patient. Fibromyoma of the uterus, accompanied by painful manifestations (pain, dysfunction of adjacent organs, rapid growth, large size of the tumor, uterine bleeding), need for surgery (supravaginal amputation, complete removal of the uterus, with a single node in young women - Filumena). In subsequent restorative treatment. In women aged over 40 years with bleeding on the ground fibromyoma shown radiotherapy. Contraindication for radiotherapy are: submucosal location of the tumor, the combination of a fibromyoma with long-term healing of the cervical erosion, diagnosis is uncertain of the nature of the tumor, absence of uterine bleeding. The technique of radiotherapy on the layout area of each ovary 200 - 250 g (at a depth of 10 cm), with an input field (right and left) on the skin of the abdomen. Subsequent restorative treatment.