What are Uterine Fibroids? | Symptoms & Treatment

What are Fibroids?

Fibroid tumors are benign (non-cancerous) growths that appear on the muscular wall of the uterus. They are the most common tumors of the body. Fibroids also go by names like leiomyoma, leiomyomata, or myoma.  They range in size from microscopic to masses that fill the entire abdominal cavity, and there is often more than one at a time. In some cases, they can be as large as a full-term pregnancy. This condition can affect women of all ages but is most common in women ages 40 to 50.

Fibroids consist of dense, fibrous tissue (hence the name ‘fibroid’) and are usually supplied blood by the uterine artery. Fibroid symptoms vary depending on their number and location in the uterus.

There are 3 different locations: intramural, submucosal, and subserosal uterine fibroids.

What is a Intramural Fibroid?

Intramural Fibroid is located in the wall of the uterus and are the most common type. They cause the uterus to become enlarged, and can cause pelvic pain, heavy menstrual bleeding, back pain, and pressure. All fibroids originate in the wall, and then often ‘migrate’ to other locations.

What is a Submucosal Fibroid?

Submucosal Fibroid is located inside the lining of the uterus and protrude inward. These cause heavy bleeding and prolonged periods and anemia.

What is a Subserosal Fibroids?

Subserosal Fibroid is located outside of the lining of the uterus and protrude outward. They have less of an effect on your period but may cause back pain or bladder pressure. Subserosal and submucosal fibroid can also grow on a stalk attached to the uterus, in which case it is called ‘pedunculated.’ The stalk may become twisted and can cause severe pelvic pain.

What are the symptoms?

While not cancerous, they can cause problems. Depending on size, location and amount, common fibroid symptoms include:

Though very common, only 10 to 20 percent need treatment, according to the University of Miami Health System. Even if you experience light symptoms, you may still need treatment and should consult a professional.

Why do I have them?

No one knows. Fibroids affect 40% of women over 35 years in America and have a higher incidence among African Americans. There is a link between uterine fibroid tumors and estrogen production. They can grow very large during pregnancy when estrogen levels are high. They sometimes improve during menopause, when estrogen levels decrease.

How do I find out if I have fibroids?

Women usually will undergo an ultrasound to determine if fibroids are present. Magnetic Resonance Imaging (MRI) is also used to determine if it can be treated with embolization and provide information about any underlying disease.

Treatment

There are many treatments available. If your fibroid surgeon recommends a hysterectomy, you may want to obtain a second opinion and be aware of all your options. Most women with symptomatic fibroids are candidates for Uterine Fibroid Emblolization but should consult with their doctor to determine if it is the right choice for them.

Uterine Artery Embolization is Non-Surgical

Uterine artery embolization (UAE), also called uterine fibroid embolization (UFE), is an endovascular procedure, meaning it is done through the arterial system. It is non-surgical and minimally invasive. It does not require general anesthesia- the groin is numbed and the patient is sedated, but still conscious enough to respond to questions.

Top 10 Advantanges of Embolization

Comparison of pregnancy outcomes in different localizations of uterine fibroids

Objective:

The basic aim of this study is to compare the pregnancy outcomes in cases with uterine fibroids located at the anterior and posterior uterine walls.

Materials and methods:

A total of 84 pregnant women with a diagnosis of uterine myoma larger than 30 millimeter (mm) in diameter were included in the study to determine the obstetric outcomes. In 64 (76.20%) patients, myomas were detected at the anterior uterine wall (group 1), while 20 (23.80%) were detected at the posterior uterine wall (group 2). All patients were followed monthly until the end of pregnancy. Demographic and obstetric characteristics were compared between the two groups.

Results:

There were no significant differences in age, gravida, parity, and myoma size between the two groups. A significant difference existed between the groups with regard to pelvic pain. Posterior located fibroids were associated with more pelvic pain (p = 0.001). No difference was observed between the two groups with regard to the rates of preterm delivery, bleeding in early pregnancy, infants with small for gestational age, and hospitalization period during pregnancy. Women with posterior located myomas had significantly higher miscarriage rates.

Conclusion:

Our findings suggest that pregnancies with uterine fibroids are at increased risk for complications. Posterior located fibroids larger than 30 mm in diameter are associated with severe pelvic pain compared to anterior located fibroids.

Uterine Fibroids | ACOG

Anemia: Abnormally low levels of red blood cells in the bloodstream. Most cases are caused by iron deficiency (lack of iron).

Hysterectomy: Surgery to remove the uterus.

Hysterosalpingography: A special X-ray procedure in which a small amount of fluid is placed in the uterus and fallopian tubes to find abnormal changes or see if the tubes are blocked.

Hysteroscopy: A procedure in which a lighted telescope is inserted into the uterus through the cervix to view the inside of the uterus or perform surgery.

Intrauterine Device (IUD): A small device that is inserted and left inside the uterus to prevent pregnancy.

Laparoscopy: A surgical procedure in which a thin, lighted telescope called a laparoscope is inserted through a small incision (cut) in the abdomen. The laparoscope is used to view the pelvic organs. Other instruments can be used with it to perform surgery.

Menstruation: The monthly shedding of blood and tissue from the uterus that happens when a woman is not pregnant.

Menopause: The time when a woman’s menstrual periods stop permanently. Menopause is confirmed after 1 year of no periods.

Pelvic Exam: A physical examination of a woman’s pelvic organs.

Progestin: A synthetic form of progesterone that is similar to the hormone made naturally by the body.

Resectoscope: A slender telescope with an electrical wire loop or roller-ball tip used to remove or destroy tissue.

Sonohysterography: A procedure in which sterile fluid is injected into the uterus through the cervix while ultrasound images are taken of the inside of the uterus.

Ultrasonography: A test in which sound waves are used to examine inner parts of the body. During pregnancy, ultrasonography can be used to check the fetus.

Uterus: A muscular organ in the female pelvis. During pregnancy this organ holds and nourishes the fetus.

Uterine Fibroids: Q&A With an Expert

So you’ve just come back from your annual gynecological exam and your
doctor told you that you might have uterine fibroids. What are fibroids?
Are they dangerous? Can they be removed? Should they be removed?

First, take a deep breath.

Fibroids

are pretty common — between 20-70 percent of women will develop fibroids
during their reproductive years. And they’re almost always (99 percent of
the time) harmless.

But that doesn’t mean you should ignore them. Fibroids can cause
complications like excessive bleeding and reproductive problems. Johns
Hopkins gynecologist

Mindy Christianson, M. D.

, who specializes in treating uterine fibroids, explains how women can
manage these common growths.

What are uterine fibroids?

Uterine fibroids are benign, or noncancerous, fibrous growths that form in
the uterus. They’re very common. They can grow on the outside of the uterus
(called subserosal fibroids), inside the muscle of the uterus (called
intramural fibroids), or into the uterine cavity (called submucosal
fibroids).

What causes fibroids?

There’s definitely a genetic component, but we haven’t found any lifestyle factors that cause uterine fibroids.

What are the symptoms of fibroids?

Some women have no symptoms at all from fibroids and don’t even know they
have them. Other women have severe symptoms. Symptoms can include very
heavy menstrual cycles. Some women have so much bleeding that they become

anemic

—that’s a hallmark symptom. Fibroids that cause severe bleeding are usually
closer to the uterine cavity.

Some women can have very large fibroids that cause the uterus to be up to
10 times its normal size. This causes what we call “bulk symptoms.” For
example, a woman may feel that her uterus is very enlarged, like she’s
pregnant. She may have related symptoms due to its bulk size, like
constipation or increased urination.

Can other issues cause these symptoms?

If a woman sees her doctor because she is having increased bleeding or a heavy menstrual cycle, the doctor will likely check for uterine fibroids, but these symptoms can also be due to things such as uterine polyps, dysfunctional uterine bleeding or bleeding caused by hormonal imbalances.

How are fibroids diagnosed?

Fibroids are typically diagnosed by ultrasound. That’s really the easiest way to see the uterus, and fibroids are usually very easily seen. The first step might be an exam by your doctor, where he or she would feel an enlarged uterus and suspect fibroids. For smaller fibroids, the only way to diagnose them is often with ultrasound. Some doctors may choose to also do an MRI of the pelvis as a way to see exactly where the fibroids are.

How are fibroids treated?

It depends on symptoms and size. For example, if a woman has fibroids
inside the uterine cavity, we may do a hysteroscopic myomectomy, in which
we look inside the uterus with a camera. At the same time, we can do a
surgical procedure to remove the fibroids if they’re just inside the
uterine cavity.

If a woman has severe symptoms, and if the fibroids are in the muscle or
outside of the uterus, surgery may be the best option. In that case,

robotic-assisted laparoscopic myomectomy

is more common. This is a minimally invasive procedure that involves making
four to five small incisions in the abdomen. We then use small instruments
attached to robotic arms to remove the fibroids through these very small
openings.

In severe cases, a woman would have an open myomectomy, which is also
called abdominal myomectomy. This surgery requires an incision either in
the bikini area or a vertical incision along the abdomen. We then remove
the fibroids through this incision.

Some nonsurgical management of uterine fibroids may include medicine that
can help suppress their growth, such as birth control pills. There’s also a
medication called leuprolide acetate, which can help shrink them.

How might fibroids might affect fertility and pregnancy?

Their impact on fertility depends on the location and the size of the fibroids, as well as the type of symptoms a woman has. Fibroids inside the uterine cavity can stop an embryo from implanting, which prevents it from growing into a fetus. Larger fibroids—about four centimeters or more—that are in the muscle of the uterus can also impact implantation. Fibroids that are inside the muscle of the uterus might block the fallopian tubes, which can cause infertility.

Sometimes fibroids can affect the mode of delivery of a baby. For instance, if a woman has a fibroid in the lower part of her uterus, it might make it difficult for the cervix to open completely, which might make a C-section difficult.

It’s really important for each woman and her obstetrician to have a game plan for delivery.

Uterine Fibroids – Brigham and Women’s Hospital

The growth of uterine fibroids is controlled by estrogen and progesterone, two of the more common female hormones. By turning off the production of these hormones or reducing the influence they have on the fibroids, it is possible to reduce the size of the fibroids significantly. Gonadotrophin releasing hormone (GnRH) is normally produced in the brain and controls the production of estrogen and progesterone. The secretion of this hormone varies from time to time, i.e. it is cyclical.

When a synthetic version of GnRH (called GnRH agonist) is given to women, there is an initial 2 week period of stimulation of hormone production, but then the system becomes oversaturated and the production of estrogen and progesterone shuts down temporarily. GnRH agonists are usually injected into muscle in long-acting formulations that have an effect for one or three months. They can also be given using a daily nasal spray. Common GnRH agonists include Lupron, Zoladex and Synarel. In three months, GnRH agonists can shrink to uterine size by one third and the fibroid size by half. In addition, vaginal bleeding usually stops completely.

Symptom relief from pressure or bleeding is therefore common. Unfortunately, GnRH agonists have significant side effects, such as nights sweats, hot flushes, irritability, vaginal dryness and difficulty sleeping. In addition, long term use is associated with significant bone loss (estrogen stimulates bone formation). Because of this it is not recommended to use GnRH agonist longer than 6 months. It is possible to reduce the side effects of the GnRH therapy by using a very low dose of estrogen or progesterone (add back therapy).

It is generally recommended to wait at least four weeks before starting the add back therapy, in order to get a maximum effects on the fibroids. Because GnRH agonist therapy can only be used for a short period of time and because the effects are quickly reversed, GnRH agonist therapy is mostly used to reduce the size of uterine fibroids before surgery. This will make it easier for the surgeon to remove the uterus or fibroids at the time of surgery. The maximal effect on uterine size is reached at three months and therefore it is not necessary to treat women longer than that preoperatively.

There is an intense search going on for a suitable long term medical treatment for fibroids. One promising option seems to be medications call selective progesterone receptor modulators (SPRM). These medications interact with cell receptors that respond to progesterone and change the effect that progesterone has on cells. One of these medications called Mifepristone has been found to be effective in reducing the size and symptoms of fibroids. However, it is associated with side effects such as endometrial hyperplasia and abnormal liver enzymes. Another SPRM that shows promise is Asoprisnil. Early studies indicate that this is effective with no effect on the endometrium or liver. Time will tell if these and other medications will be effective, but the early results are very promising.

Birth control pills do not seem to be very helpful to treat symptoms associated with uterine fibroids, however they are effective in treating abnormal bleeding due to problems with ovulation. It is possible that the abnormal bleeding that the woman is experiencing might not be due to the fibroids and therefore a 3 month trial of birth control pills is appropriate in select cases.

The hormonal IUD might be effective where the uterine fibroids are small, however in the case of large fibroids it is probably not effective for symptomatic control.

Uterine Fibroids – InterMed, P.A.

By Caroline Hodsdon, MD – InterMed Women’s Health

Uterine fibroids are benign (non-cancerous) tumors that grow from the wall or smooth muscle fibers of the uterus. They are actually clones, each cell is a copy of itself — meaning that each individual fibroid has arisen from a single smooth muscle cell. No one knows exactly what causes one smooth muscle cell to start growing uncontrollably, although research is starting to identify some of the molecules that are important in regulating growth.

Fibroids are extremely common among women all over the world. They are the most common gynecologic tumor. Seventy-to-eighty percent of women have them, however, only 25 – 30 percent of those will have any symptoms. Fibroids can be microscopic or huge. The largest known weighed 70 pounds.

Their growth rate is variable even when one woman has many tumors. Some tumors enlarge, some stay stable in size and others regress- all in the same uterus. Fibroids tend to start growing in women 30-40 years old. Almost all fibroids shrink after menopause.

Risk factors

• High blood pressure can damage smooth muscle; therefore, it is associated with fibroid formation.
• Vitamin D deficiency
• Genetic predisposition
• Race — African American women have the highest rate of fibroids and Hispanic women have the lowest.
• Increased hormone exposure with early onset periods and late menopause
• Pelvic infections, such as chlamydia

Symptoms

Symptoms occur due to the location, size, and changes in pregnancy status. Pain and pressure symptoms and bleeding are the most common. Large fibroids can push on the bladder and bowel causing urinary frequency or difficulty with bowel movements. Pain with movement or intercourse can also occur with fibroids.

Bleeding occurs in 30-50 percent of symptomatic women and is the number one issue that brings women to seek care. Fibroids can cause extremely heavy and prolonged periods but can also cause bleeding in between menses. Very small fibroids (1-2 cm) can cause symptoms if the fibroid is in a critical place, pushing into the cavity of the uterus. Occasionally fibroids within the cavity of the uterus cause problems such as infertility or miscarriage.

Most fibroids are small, not bothersome and do not require treatment.

In our next blog, we’ll discuss treatment options for symptomatic fibroids.

Is fibroid location associated with hemorrhage and complication rates following laparoscopic myomectomy? | Gynecological Surgery

Abdominal myomectomy was first introduced by Boney in 1931 [5], and it had been the only surgical procedure for years until endoscopic techniques were described. Abdominal myomectomy is still a proper procedure for multiple and giant myomas. Semm described laparoscopic myomectomy in 1979 for subserosal myomas [6]. In the beginning of the 1990s, laparoscopic myomectomy began to be performed in intramural myomas. Laparoscopic myomectomy has less hemorrhage, fewer adhesions, and shorter recovery time when compared with laparotomic myomectomy. In a retrospective study with 1001 patients, Paul and colleagues showed that hemorrhage and blood transfusion are the most seen complications in laparoscopic myomectomy [7]. In a prospective study including 2050 laparoscopic myomectomy between the years 1998 and 2004, the overall complication rate was found 11.1%. The most seen complication was hemorrhage, and mean hemoglobin drop was 1.5 g/dl [8]. In a study about predictors of hemorrhage in laparoscopic myomectomy; the hemorrhage risk was found associated with the duration of surgery, the largest diameter of fibroid, the cumulative fibroid weight, and the number of the suture [9]. There are numerous studies about the prediction of hemorrhage risk in laparoscopic myomectomy, but none of them mention whether the location of fibroid is associated with the risk of hemorrhage or other complications. Based on these concerns, in our study, we planned to detect whether hemorrhage and complication rates vary according to the location of the dominant fibroid. In our study, the median fibroid size was 6.7 cm, similar with Sizzi’s large case serial (6.4 cm) [8]. Our median hemoglobin drop was 1.5 g/dl in the fundal group, 1.3 g/dl in the anterior group, and 1.3 g/dl in the posterior fibroid group. The results were similar with other studies. Except for four patients (laparo-conversion), all the myomas were enucleated by laparoscopy, and all the patients had no severe bleeding. There was no bowel or urinary tract injury.

There are two factors associated with hemoglobin drop in LM. These are appropriate dissection cleavage during myomectomy and fast suturation after myomectomy. If the surgeon could not find the fibroid capsule properly, there would be more hemorrhage during dissection. Finding the proper cleavage may be difficult in some degenerated fibroids. The second process of the operation is suturing the myomectomy incision. Suturation may be difficult depending on the location and size of fibroid. Also, if the surgeon is not advanced in laparoscopy, suturation time may be longer and it may cause more hemorrhage during the operation. If the surgeon is not advanced, there may be a need for ancillary port to make the operation with less hemorrhage. In our study in laparoscopy, we could not find the number of operations made with ancillary port.

The primary aim of the study was to obtain whether the fibroid location affects the hemorrhage rates. As the result, bleeding does not seem to vary depending on fibroid location. Although we were not able to conduct a reliable statistical comparison of complication rates due to small sample size, the observed values suggest that intramural fibroids located in the anterior wall can be more prone to have more hemorrhage than fundal or posterior wall fibroids.

There are some limitations to our study. First, all the operations were performed by 6 surgeons. Although all of the surgeons are seniors on their departments, it is better to perform by one advanced surgeon for more reliable results. Another conflicting factor is the type of the suture material. It is widely known that using barbed suture during myomectomy makes the duration of operation shorter with less hemorrhage, and it is shown that using barbed suture has no negative impact on myomectomy scar healing in a multicenter study [10]. In our study, we used both types of the suture and we could not analyze the effect of the suture type on LM complications.

The other concerning issue is morcellation. The major risk in morcellation is malignancy potential of fibroids. As known, occult sarcoma or leiomyosarcoma incidence during myomectomy or hysterectomy is 0.39% [11]. Spillage or contamination of tissues during morcellation carriages risk of dissemination of tumoral cells through the abdomen and other organs, shortens the survey of survival, and increases the recurrence risk [12]. There are numerous case reports about disseminated leiomyosarcoma and sarcoma after uncontained power morcellation during myomectomy [13], and it is shown that uncontained power morcellation is associated with high risk of mortality in women with occult sarcoma [12]. There are novel containing methods during myomectomy or hysterectomy, like morcellation in plastic bags [14]. Although there are these novel containing methods, there is still suspicion of malignancy spillage during morcellation. In our study, we morcellated all the fibroids, and plastic bag was used depending on surgeon’s choice. Plastic bag was used in approximately 30% of the cases. There was just 1 patient in 219 with unexpected pathology result with stump (smooth tumors with uncertain malignant potential). There was no recurrence during 6 years follow-up of this patient. Patient selection, age, and ultrasound findings are important factors for excluding malignancy, but occult sarcoma or leiomyosarcoma may be present even without any finding [15]. Thus, laparoscopic myomectomy should be performed under contained morcellation according to the novel studies. But recently, surgeons leave laparoscopic myomectomy because of these unclear issues, and laparotomy rates begin to increase. After FDA report against the use of power morcellation, Multinu et al. showed that laparotomy rates in hysterectomy/myomectomy operations significantly increased and minor complication rates increased 20%. They advised balancing against the potential harms of morcellation during a shared decision-making process between clinician and patient [16].

90,000 Symptoms, diagnosis, treatment of fibroids and prevention

Uterine myoma (leiomyoma, fibroids) – a benign tumor from the muscle and connective tissue of the uterus.

According to most scientists, myoma occurs as a result of dysregulation of myometrial cell growth. There are many reasons for the formation of nodes, the main ones are hormonal disorders and damage to the tissue of the uterus itself (when scraping the uterine cavity, abortion, prolonged wearing of an intrauterine contraceptive, an inflammatory process in the uterus). Aggravating factors include hereditary predisposition, stress, unfavorable environmental situation.

Myomatous nodes can be of different sizes – from a few millimeters to tens of centimeters, occur both singly and multiple. The nodes located in the thickness of the uterine wall are called interstitial. If the nodes grow towards the abdominal cavity, protrude above the surface of the uterus, then they are called subserous, if towards the uterus, then submucous.

Symptoms

In 30% of patients, uterine fibroids are asymptomatic. The manifestations of the disease depend on the size, location and number of myomatous nodes. Patients may complain of heavy, prolonged, painful menstruation, clotted menstruation, intermenstrual spotting and bleeding, pain, and a feeling of heaviness in the lower abdomen. Myoma of the uterus can lead to dysfunction of neighboring organs (constipation, impaired emptying of the bladder, miscarriage and infertility).

Diagnostics

Diagnosis of fibroids, as a rule, is not difficult and is possible already at the stage of gynecological examination and collection of anamnesis.

The main non-invasive instrumental diagnostic methods are ultrasound, CT and MRI.

Treatment of uterine fibroids

In order to determine the treatment tactics in each specific case, it is necessary to consult a specialist.

The principal objectives of the treatment are either the removal of the tumor (surgical treatment), or the inhibition of tumor growth and regression of the neoplasm (conservative treatment).

For conservative therapy of uterine fibroids, hormonal preparations are used. The choice of the drug and the indications for the appointment are determined by the attending physician.

Indications for

surgical treatment :

– large sizes of nodes, rapid growth, uterine bleeding, submucous and centripetal growth of nodes, pain syndrome, anemization of the patient, infertility and miscarriage, subserous node on the leg.

The choice of the volume, access options and timing of surgical treatment depends on many factors (the patient’s desire to preserve reproductive and menstrual function, the size of the uterus, the number of nodes, the presence of an adhesive process in the abdominal cavity, concomitant somatic pathology, etc. )

The “gold standard” for the treatment of fibroids is myomectomy (surgical removal of uterine fibroids). The preservation of the uterus as an organ is important not only for women planning a pregnancy, but also for women who want to maintain menstrual function until natural menopause.

The operation can be performed laparoscopically and through a laparotomic access (access to the abdominal cavity, in which an incision of the anterior abdominal wall is made either horizontally above the pubis, or vertically along the midline of the abdomen).

Laparoscopy – such an access into the abdominal cavity, when instruments and a laparoscope (a thin optical system with which the surgeon receives an image of organs displayed on the monitor in the operating room) are inserted through punctures (5-10 mm).

If the myoma has submucous growth, then the optimal method for removing the node is hysteroresectoscopy (removal of the node from the side of the uterine cavity using a hysteroresectoscope).

Other treatments for uterine fibroids, such as uterine artery embolization (UAE) and FUS-ablation of fibroids (ultrasound wave treatment), are used in very limited developed countries.

Radical surgeries for uterine fibroids (removal of the uterus) are performed when the preservation of the uterus is contraindicated or impractical.

Uterine myoma

959,
Topic: Uterine fibroids, 05/17/2017 11:10:37 AM

Good afternoon, an ultrasound scan revealed a 14 mm uterine myoma, diffusely heterogeneous along the back wall on the right. Is it dangerous?

Hello!

If the myomatous node does not deform the uterine cavity, it is not dangerous! The myomatous node just needs to be observed! Detailed information by phone: 84952117178.Respectfully yours, Doctor of Medical Sciences, Professor – Ter-Ovakimyan Armen Eduardovich

947,
Topic: Uterine fibroids, 05/17/2017 11:10:37 AM

Hello, I have not given birth for 34 years. Today I was diagnosed with large uterine fibroids. Large-uchagovo-heterogeneous knot 88 by 74 mm. M-echo hyperechoic 5mm. The cervix is ​​structurally unchanged. M-echo hyperechoic, 4mm smooth contours. I propose to do lacroscopy is it possible to keep the mark with such a large myoma. Thanks for the answer.

Hello!
In any case, the uterus at your age needs to be preserved.
Carry out laparoscopy or abdominal surgery can be determined only after your internal examination.
More detailed information by phone: 8495-211-71-78.
Respectfully yours, Doctor of Medical Sciences, Professor – Ter-Ovakimyan Armen Eduardovich.

945,
Topic: Uterine fibroids, 05/17/2017 11:10:37 AM

Hello! On ultrasound on the anterior wall of the uterus in the body region, there is an interstitial-subsyrosis node of medium echogenicity, the average diameter is 12.3 mm.In the CDC mode, the node is hypovascular with fragments of capsular blood flow, and even a delay in menstruation. What to do? Can you think about pregnancy?

Hello!
If a uterine node of this size does not deform the uterine cavity, you can plan a pregnancy!
You can get more detailed information by phone: 8-495-211-71-78.
Respectfully yours, Doctor of Medical Sciences, Professor – Ter-Ovakimyan Armen Eduardovich

860,
Topic: Uterine fibroids, 05/17/2017 11:10:36 AM

Hello! I am 41g, according to ultrasound, the uterine nodular myoma, the size of the uterus is 90 * 70 * 107, in the anterior wall there is an intramural node with subserous growth of 72 * 63 along the back wall with subserous growth of 25 * 20, in the left lateral st.intramural node 24 * 12 and in the right uterine corner a node 24 * 27. Is it possible to remove the nodes of hysteroresectoscopy?

Hello!
According to WHO standards, all tumors of the female genital area after 40 years, in order to prevent cancer, are subject to surgical intervention. The faster the surgical treatment is carried out by the method of laparoscopy (removal of only myomatous nodes, while preserving the uterus), the more chances are to preserve the uterus and avoid possible complications (bleeding, compression of adjacent organs, tumor growth, etc. ).etc.).
Conservative treatment is usually not effective. Some hormonal drugs allow you to temporarily stop the growth of the tumor or slightly reduce its size. However, this tactic is considered only as a preoperative preparation. The opinion that with the help of pills, decoctions, unconventional methods, homeopathy, herbal medicine, etc. it is possible to achieve the disappearance of fibroids – wrong. The tumor grows, making it difficult to carry out the operation in the future.
You can find detailed information on our website: www.med-port.ru in links – uterine fibroids, laparoscopy.
Inquiries and appointment by phone: +7 (495) 211-71-78, 210-07-39.
Respectfully yours, Doctor of Medical Sciences, Professor Ter-Ovakimyan Armen Eduardovich.

841,
Topic: Uterine fibroids, 05/17/2017 11:10:36 AM

Hello! The diagnosis was made: uterine fibroids; on the back wall of the interstitial-subserous myomatous node: 64mm * 53 * 66mm. Please tell me if this node can be removed by the laproscopic method.
Thanks in advance.

Hello!

According to WHO standards, all tumors of the female genital area, in order to prevent cancer, are subject to surgical intervention. The faster the surgical treatment is carried out by the method of laparoscopy (removal of only myomatous nodes, while preserving the uterus), the more chances are to preserve the uterus and avoid possible complications (bleeding, compression of adjacent organs, tumor growth, etc.).

Conservative treatment is usually not effective.Some hormonal drugs allow you to temporarily stop the growth of the tumor or slightly reduce its size. However, this tactic is considered only as a preoperative preparation. The opinion that with the help of pills, decoctions, unconventional methods, homeopathy, herbal medicine, etc. it is possible to achieve the disappearance of fibroids – wrong. The tumor grows, making it difficult to carry out the operation in the future.

The scope of the operation in each case is decided individually at a face-to-face consultation (what to delete, what to keep). You can find detailed information on our website: www.med-port.ru in links – uterine fibroids, laparoscopy.

Inquiries and appointment by phone: +7 (495) 211-71-78, 210-07-39.

Respectfully yours, Doctor of Medical Sciences, Professor – Ter-Ovakimyan Armen Eduardovich.

835,
Topic: Uterine fibroids, 05/17/2017 11:10:36 AM

Hello. For a week, pains in the lower abdomen, more on the right side, are troubling. She gave birth five and a half months ago.The birth was natural. I did a pelvic ultrasound. Here is what is written: the body of the uterus in anterflexio the contours are even. Dimensions length: 46.3 mm, width: 44.0 mm, anteroposterior: 38.9 mm. The structure of the uterus – a subserous myomatous node with a size of 39.6 x 38.0 mm is determined along the posterior wall of the uterus. The posterior arch is free. Endometrium Width 11.5mm. The ovary on the right is not visualized. Earlier, a year and a half ago, there was apoplexy of the right ovary. And part of the ovary was resected. How is it that the ovary is not visible on the Uzi? Ovary on the left 27.8×16.9×26.0 mm structure – follicles up to 7.1 mm.How to treat a myomatous node. How dangerous is it?

Hello!

According to WHO standards, all tumors of the female genital area, in order to prevent cancer, are subject to surgical intervention. The faster the surgical treatment is carried out by the method of laparoscopy (removal of only myomatous nodes, while preserving the uterus), the more chances are to preserve the uterus and avoid possible complications (bleeding, compression of adjacent organs, tumor growth, etc.).

Conservative treatment is usually not effective.Some hormonal drugs allow you to temporarily stop the growth of the tumor or slightly reduce its size. However, this tactic is considered only as a preoperative preparation. The opinion that with the help of pills, decoctions, unconventional methods, homeopathy, herbal medicine, etc. it is possible to achieve the disappearance of fibroids – wrong. The tumor grows, making it difficult to carry out the operation in the future.

You can find detailed information on our website: www.med-port.ru in links – uterine fibroids, laparoscopy.Inquiries and appointment by phone: (495) 211-71-78, 210-07-39.

Respectfully yours, Doctor of Medical Sciences, Professor -Ter-Hovakimyan Armen Eduardovich.

807,
Topic: Uterine fibroids, 05/17/2017 11:10:36 AM

Dear Doctor! Here are the results of my ultrasound, what would you advise in this case.
MARINA
Ultrasound Scanner Type: LOGIQ 5PRO
Date of birth (ym-d): 1961 8 1
ULTRASONIC RESEARCH PROTOCOL NO.
The first day of the last menstruation – 29 11 2015DMC35
TRANSABDOMINAL – TRANSVAGINAL SCANNING:
The bladder is full, regular in shape, the walls are not thickened, the lumen is homogeneous, the orifices of the ureters are free.
The uterus is located in anteflexio, spherical in shape, slightly enlarged in size.
DTM – 76 mm; PZ – 65 mm; ShTM – 74 mm
M-ECHO – 17.4 mm, heterogeneous structure,
The uterine cavity is not expanded, deformed.
MYOMETRY is heterogeneous in structure.
Myometrial nodules are visualized.On the back wall of the vis-Xia interstitial hypoechoic node d 29mm;
In the area of ​​the bottom of the uterus on the right – an interstitial hypoechoic node d 22mm with centripetal growth, deforms the uterine cavity;
On the back wall of the vis-Xia interstitial hypoechoic node d 10mm;
The thickness of the mucous membrane of the endocervix is ​​7 mm, reduced echogenicity, homogeneous echo structure.
RIGHT OVARY – usually located, not enlarged,
dimensions 31 x 19 x 19 mm, with the presence of ovulated FLD16MM.
LEFT OVARY – usually located, not enlarged,
dimensions 30 x 17 x 21 mm, with the presence of FL D up to 11 mm (No. 2).m
CONCLUSION: ECHO – SIGNS OF HYPERPLASIA ENDOMETRY, UTERINE MYOMA

Hello!
Considering the above diagnoses: endometrial hyperplasia and multinodular uterine myoma, you are recommended to carry out hysteroscopy and laparoscopy.
1.In order to prevent oncological diseases and complications – endometrial hyperplasia is subject to surgical intervention by the method of hysteroscopy – under visual control (ultrasound) using an optical instrument – a hysteroscope, the uterine cavity is scraped out with subsequent histological examination. After receiving histological data on the state of the endometrium, the question of the need for further treatment is decided.

2. According to WHO standards, all tumors of the female genital area after 40 years, in order to prevent cancer, are subject to surgical intervention. The faster the surgical treatment is carried out by the method of laparoscopy (removal of only myomatous nodes, while preserving the uterus), the more chances are to preserve the uterus and avoid possible complications (bleeding, compression of adjacent organs, tumor growth, etc.).etc.).

Conservative treatment is usually not effective. Some hormonal drugs allow you to temporarily stop the growth of the tumor or slightly reduce its size. However, this tactic is considered only as a preoperative preparation. The opinion that with the help of pills, decoctions, unconventional methods, homeopathy, herbal medicine, etc. it is possible to achieve the disappearance of fibroids – wrong. The tumor grows, making it difficult to carry out the operation in the future.

The scope of the operation in each case is decided individually at a face-to-face consultation (what to delete, what to keep).You can find detailed information on our website: www.med-port.ru in the links – uterine fibroids, hysteroscopy, laparoscopy.
The consultation is free.

Inquiries and registration for a consultation by phones: +7 (495) 211-71-78, 210-07-39.

Respectfully yours, Doctor of Medical Sciences, Professor – Ter-Ovakimyan Armen Eduardovich.

713,
Topic: Uterine fibroids, 05/17/2017 11:10:36 AM

Hello. By ultrasound in 2015. along the posterior wall, through all layers with subperitoneal growth, a node 45 * 28 * 45 of a cellular structure with increased blood flow along the periphery.In 2014, the node is 30mm. Is it possible to remove the node by laparoscopy? How much should you have when applying for the operation (from and to)? What examinations should be done at home? How long does it take to make an appointment with a nonresident patient? How long is in the hospital? Thank you for your answer.

Hello!
Considering the above conclusion of ultrasound – uterine fibroids, it is recommended that you perform laparoscopy – removal of only the myomatous node, while preserving the uterus.
The cost of laparoscopy is determined only at an in-person consultation, depending on the volume of the operation.We have a city clinical hospital and we work at government prices. An indicative price list of prices is presented on our website: www.med-port.ru
Nonresidents are accepted in our clinic out of turn, you need to call a week before your expected arrival
by phone: +74952117178 and sign up for a consultation.

708,
Topic: Uterine fibroids, 05/17/2017 11:10:36 AM

Myoma 78 is organ-preserving surgery possible?

Hello!
Considering the above diagnosis and the size of the myomatous node (78 mm), you are recommended to perform laparoscopy.The scope of the operation (what to delete, what to save) is determined only at a face-to-face consultation.

706,
Topic: Uterine fibroids, 05/17/2017 11:10:36 AM

Good afternoon, Armen Eduardovich!
I am 46 years old. According to the results of ultrasound of the pelvic organs, I have found echo signs of multiple uterine fibroids. Myometrium with intramural nodes in the posterior wall of the uterus
16 mm and 14 mm (closer to the bottom on the left). The uterine cavity is deformed by a submucous-interstitial node 16 * 13 * 16 mm along the anterior wall on the left in the middle cavity.Nabotovy cysts. Signs of adhesions in the small pelvis. Regression of the persistent follicle on the right.
Do I need surgical treatment?
Can I get a consultation with you (free of charge), I live on the outskirts of the Moscow region (160 km from Moscow)?

Hello!
According to WHO standards, all tumors of the female genital area after 40 years, in order to prevent cancer, are subject to surgical intervention. The faster the surgical treatment is carried out by the method of laparoscopy (removal of only myomatous nodes, while preserving the uterus), the more chances are to preserve the uterus and avoid possible complications (bleeding, compression of adjacent organs, tumor growth, etc. ).etc.).
Conservative treatment is usually not effective. Some hormonal drugs allow you to temporarily stop the growth of the tumor or slightly reduce its size. However, this tactic is considered only as a preoperative preparation. The opinion that with the help of pills, decoctions, unconventional methods, homeopathy, herbal medicine, etc. it is possible to achieve the disappearance of fibroids – wrong. The tumor grows, making it difficult to carry out the operation in the future.
The scope of the operation in each case is decided individually at a face-to-face consultation (what to delete, what to keep).Currently there are PROMOTIONS – CONSULTATION WITH A PROFESSOR – FREE OF CHARGE!

705,
Topic: Uterine fibroids, 05/17/2017 11:10:36 AM

Good day. Please help me figure out what to do. I am 33 years old, there were no pregnancies, now we are planning a pregnancy. 3 years ago ultrasound revealed a fibroid, 1 node, the local gynecologist said the node is small, nothing needs to be done. Seiachs did an ultrasound scan in a paid clinic:
Clinical diagnosis: uterine fibroids 6-7 weeks, endometrial hyperplastic process.Conclusion: ultrasound M-echo 8 mm on the 8th DC, 74 * 60 * 68 in the bottom and on the right subserous-interstitial node D 39 mm, in the posterior wall 1) m / m D9 mm 2) interstitial-subserous D 19 mm and D 30 mm
What to do – trying to get pregnant or need treatment? What kind of examination to pass?

Hello!
Myoma of the uterus is not a factor of infertility, however, if a woman sets the task of getting pregnant, it is imperative to remove myomatous nodes (by the laparoscopic method – removal of only myomatous nodes, while preserving the uterus), since pregnancy provokes tumor growth and leads to complications both during pregnancy and and during the birth itself (miscarriages, bleeding, etc.)etc.).
Conservative treatment is usually not effective. Some hormonal drugs allow you to temporarily stop the growth of the tumor or slightly reduce its size. However, this tactic is considered only as a preoperative preparation. The opinion that with the help of pills, decoctions, unconventional methods, homeopathy, herbal medicine, etc. it is possible to achieve the disappearance of fibroids – wrong. The tumor grows, making it difficult to carry out the operation in the future.

721,
Topic: Uterine fibroids, 17.05.2017 11:10:35

Hello! I am 28 years old, today I was on an ultrasound scan I was told that I have a 14mm uterine fibroid in the left corner. It will affect my first pregnancy, I was given an ultrasound scan for 6 weeks and 2 days

Hello!
Considering the above diagnosis – uterine myoma 14mm. and pregnancy 6 weeks, you are recommended to be under the supervision of an obstetrician-gynecologist at the antenatal clinic and to carry out dynamic ultrasound control of the myomatous node.

703,
Topic: Uterine fibroids, 17.05.2017 11:10:35

Hello! The doctor would like to consult you. I have uterine fibroids. As I found out, the first time I did an ultrasound of the small pelvis in 2008, the conclusion of an ultrasound doctor: Sumbucous growth of the node, size of the uterus 6-7 weeks. An ultrasound of 2014, the uterus became 12 weeks old, the node grows up to 7 cm.Since I had multiple operations with complications and peretonitis. Doctors say that laparotomy should be done because there is an adhesive process in the small pelvis, one kidney and one machete. Disturbed only by abundant menstruation, no pain, no constipation, what you say as a doctor.Is it possible to have laparotomy and how much will it cost in your clinic? Thanks in advance!

Hello!
Considering the above diagnoses (large myomatous uterine nodes, adhesions), surgical treatment is recommended.
The method of operative (surgical) intervention and the scope of the operation are determined only at an in-person consultation: examination, ultrasound, etc.

729,
Topic: Uterine fibroids, 05/17/2017 11:10:35 AM

Hello, I have a fibroid about 6 cm in size, on the wall of the uterus, they suggest doing a strip operation to remove it. I would like to clarify whether it is possible to remove myoma of this size laparoscopically?

Hello!
Considering the above diagnosis – uterine fibroids with a diameter of 6 cm and a reproductive age of 24 years, it is subject to surgical treatment by the method of laparoscopy (removal of only the myomatous node, while preserving the uterus).

myomatous node and pregnancy,
Topic: Uterine fibroids, 05/17/2017 11:10:35 AM

Good day!
Can you please tell me, I’m 26 years old, I have a second pregnancy 24 weeks., on the second ultrasound, a 19x12x20 myoma was found on the front wall, the doctors began to intimidate, miscarriage, I do not give birth. What can I do, you can somehow treat it. The truth is that they will be caesarean during childbirth. Thanks in advance.

Hello!

You don’t have to do anything at all. A myomatous node of such a small size cannot affect the course of pregnancy, especially in this period.

Respectfully yours, Armen Eduardovich.

More uterine fibroids and pregnancy.

analyzes for fibroids,
Topic: Uterine fibroids, 17.05.2017 11:10:35

Armen Eduardovich, good afternoon! How long are tests and examinations valid for preparation for surgery for fibroids (laparoscopy)?

Different assays are valid in different ways. From a month to three.

removal of myomatous nodes,
Topic: Uterine fibroids, 05/17/2017 11:10:35 AM

Hello,
Please tell me if it is possible to save the uterus with large nodes: in the bottom 54x42mm and on the back wall 65x47mm. Submucous myoma 16mm.Exchange of the uterus: 80x58x74
Interested in pregnancy. 38 years

Answer of Professor Armen Eduardovich Ter-Hovakimyan.
It is necessary to carry out two operations simultaneously, laparoscopy – to remove large myomatous nodes, while preserving the uterus and hysteroresectoscopy – to remove a 16mm submucous node.

442,
Topic: Uterine fibroids, 05/17/2017 11:10:35 AM

Hello. I want to receive treatment in your clinic. I was diagnosed with uterine fibroids, submucous node 4cm.tried to get it away. but it did not help. now they say you need to completely remove the uterus. I don’t want me only 33. what should I do.

Hello! According to WHO standards, all tumors of the female genital area, in order to prevent cancer, are subject to surgical intervention. The faster the surgical treatment is carried out by the method of laparoscopy (removal of only myomatous nodes, while preserving the uterus), the more chances are to preserve the uterus and avoid possible complications (bleeding, compression of adjacent organs, tumor growth, etc.).etc.). In our clinic, the size and location of myomatous nodes are not a limitation for laparoscopy – removal of only myomatous nodes, while preserving the uterus.

Respectfully yours, Professor Armen E. Ter-Hovakimyan.

728,
Topic: Uterine fibroids, 05/17/2017 11:10:35 AM

Good day! I am 49 years old and I have a multinodular uterine myoma. The size of the uterus together with the myomatous node is 6.7x12x 5.8 cm. In the bottom, a subserous node measuring 8.5×6.7×6.1 cm is determined. Myometrium of a non-homogeneous structure due to multiple (about 9) intramural myomatous nodes up to 2.3 cm in size.The uterus is enlarged up to 12 weeks. Hysteroresectoscopy was performed. Histology without oncopathology. Menstruation is normal. No pain. After curettage, I take Regulon for 1 month.
1) Do I need to stop taking Regulon before surgery due to the risk of thrombosis?
2) can I save the uterus and have a conservative myomectomy (laparotomy)?
3) if it is necessary to remove the uterus, preserving the ovaries and cervix, is it desirable to put a mesh?
Best regards, Elena

Hello!
According to WHO standards, all tumors of the female genital area after 40 years, in order to prevent cancer, are subject to surgical intervention.The faster the surgical treatment is carried out by the method of laparoscopy (removal of only myomatous nodes, while preserving the uterus), the more chances are to preserve the uterus and avoid possible complications (bleeding, compression of adjacent organs, tumor growth, etc. ).
Conservative treatment is usually not effective. Some hormonal drugs allow you to temporarily stop the growth of the tumor or slightly reduce its size. However, this tactic is considered only as a preoperative preparation.The opinion that with the help of pills, decoctions, unconventional methods, homeopathy, herbal medicine, etc. it is possible to achieve the disappearance of fibroids – wrong. The tumor grows, making it difficult to carry out the operation in the future.
The scope of the operation in each case is decided individually at a face-to-face consultation (what to delete, what to keep).

myoma or ectopic,
Topic: Uterine fibroids, 05/17/2017 11:10:34 AM

Hello, I am 27 years old, I gave birth, but for 6 years I have not been able to get pregnant. The loop was always fine.There was a delay of 2 weeks. Did an ultrasound .. the doctor said that I either have fibroids or ectopic hCG negative. Indicators of ultrasound: the body of the uterus is 45 posterior, 34 wide, 48, the structure is homogeneous, In the area of ​​the tubal angle on the right, a hypoechoic homogeneous formation of 15 mm d is visualized, with insignificant peripheral blood flow in the CDC. M-echo is 7 mm. Endometrium phase II. Echo signs of fibroids. At the next appointment, the doctor said that I had myoma on the leg, I need to be tested and get ready for the operation. Is everything so critical, is there an urgency in the operation?

Hello!
To identify and eliminate the cause (s) of infertility, you need to be examined in a highly qualified clinic:
one.Examination, ultrasound.
2. Hysterosalpingography (HSG) (X-ray of the uterus and fallopian tubes) is a purely diagnostic method.
3. Hormonal and infectious status.
4. Spermogram.
5. Laparoscopy is both a diagnostic and a therapeutic operation, which is quite effective in a female infertility clinic. The first stage of the operation – diagnostic – allows you to identify almost all causes of infertility and assess the nature and degree of pathology. The second stage – therapeutic – allows you to eliminate these causes.
Myoma of the uterus is not a factor of infertility, however, if a woman sets the task of becoming pregnant, it is imperative to remove myomatous nodes (by the laparoscopic method – removal of only myomatous nodes, while preserving the uterus), since pregnancy provokes tumor growth and leads to complications both during pregnancy and and during the birth itself (miscarriages, bleeding, etc. ).
Conservative treatment is usually not effective. Some hormonal drugs allow you to temporarily stop the growth of the tumor or slightly reduce its size.However, this tactic is considered only as a preoperative preparation.
The opinion that with the help of pills, decoctions, unconventional methods, homeopathy, herbal medicine, etc. it is possible to achieve the disappearance of fibroids – wrong. The tumor grows, making it difficult to carry out the operation in the future.
Respectfully yours, Armen Ter-Hovakimyan.

whether to remove the uterus ?,
Topic: Uterine fibroids, 05/17/2017 11:10:34 AM

Hello! I am 44 years old. Latest ultrasound results on the 18th day of the cycle:
the uterus is enlarged 78 * 88 * 93 mm.Myomotous nodes in all departments: Along the front wall-2.8 cm., 1.5 cm .. At the bottom-1.9 cm .. Back wall bottom-2.7 cm .. Back wall 1.3 cm., 1.1 cm .. Central department 1 , 8cm .. retrocervic node 2.1cm.
Endometrium: 9 mm thick, clear contours.
The uterine cavity is not expanded. The cervix is ​​determined. Dimensions 36 * 33 * 34mm. The shape is barrel-shaped due to the knot. The primary canal is not dilated.
The left ovary is 27mm long, 18mm thick, 5.5 in volume, with 0.2 follicles.
The right ovary is 32mm long, 21mm thick, and has a volume of 6.5.with follicle 0.3
No complaints. Menstruation without delay, without pain, ends on day 5 (not profuse). Please tell me what to do? I don’t want to remove the uterus.

Hello!
According to WHO standards, all tumors of the female genital area after 40 years, in order to prevent cancer, are subject to surgical intervention. The faster the surgical treatment is carried out by the method of laparoscopy (removal of only myomatous nodes, while preserving the uterus), the more chances are to preserve the uterus and avoid possible complications (bleeding, compression of adjacent organs, tumor growth, etc.).etc.).
Conservative treatment is usually not effective. Some hormonal drugs allow you to temporarily stop the growth of the tumor or slightly reduce its size. However, this tactic is considered only as a preoperative preparation. The opinion that with the help of pills, decoctions, unconventional methods, homeopathy, herbal medicine, etc. it is possible to achieve the disappearance of fibroids – wrong. The tumor grows, making it difficult to carry out the operation in the future.
You can find detailed information on our website: www.med-port.ru in links – uterine fibroids, laparoscopy.
Inquiries and appointment by phone: (495) 211-71-78, 210-07-39.
Respectfully yours, Doctor of Medical Sciences, Professor -Ter-Hovakimyan Armen Eduardovich.

whether to perform an operation to remove fibroids,
Topic: Uterine fibroids, 05/17/2017 11:10:34 AM

Hello! I’m 47 years old. I had an ultrasound scan on the 19th day of the menstrual cycle. Uterus: 115x78x102 mm (dimensions with the node). The structure of the myometrium is heterogeneous. On the left rib, a subseroid fibromatous node of a heterogeneous structure: 90×67 mm.With CDK, the blood flow is preserved, weak; in the area of ​​the bottom of the inter. knot d22 mm, on the right edge of the inter. subser. fibroids. knot 43×50 mm, on the back wall 2 knots d17 and d20 mm. In the right corner there is a knot d13 mm. M-echo 11.6 mm, homogeneous endometrium.
Right ovary: 30×22 mm. It contains small follicles d5-7 mm
Left ovary: 31×19 mm. It contains small follicles d5-8 mm.
Ultrasound – multiple nodular uterine fibroids up to 11-12 weeks. Polyp of the cervical canal. They offer a strip operation to remove fibroids together with the uterus, is it possible to do a laparoscopy (I have very high blood pressure)? How urgent is it to be operated on. Is it possible not to have an operation at all?

Hello!
According to WHO standards, all tumors of the female genital area after 40 years, in order to prevent cancer, are subject to surgical intervention.The faster the surgical treatment is carried out by the method of laparoscopy (removal of only myomatous nodes, while preserving the uterus), the more chances are to preserve the uterus and avoid possible complications (bleeding, compression of adjacent organs, tumor growth, etc. ).
Conservative treatment is usually not effective. Some hormonal drugs allow you to temporarily stop the growth of the tumor or slightly reduce its size. However, this tactic is considered only as a preoperative preparation.The opinion that with the help of pills, decoctions, unconventional methods, homeopathy, herbal medicine, etc. it is possible to achieve the disappearance of fibroids – wrong. The tumor grows, making it difficult to carry out the operation in the future.
The scope of the operation in each case is decided individually at a face-to-face consultation (what to delete, what to keep).
You can find detailed information on our website: www.med-port.ru in links – uterine fibroids, laparoscopy.
Inquiries and appointment by phone: (495) 211-71-78, 210-07-39.
Respectfully yours, Doctor of Medical Sciences, Professor – Ter-Ovakimyan Armen Eduardovich.

793,
Topic: Uterine fibroids, 05/17/2017 11:10:34 AM

Good day! I am 32 years. I am 13 weeks pregnant. Ultrasound revealed at the right corner of the uterus – interstitial myomatous node 30 mm. Can this somehow affect the course of pregnancy and what to do in such a situation?

Hello!
Considering the above diagnosis – uterine fibroids and pregnancy of 13 weeks, you are recommended to be under the constant supervision of the obstetrician-gynecologist of the antenatal clinic, to monitor the size of the myoma node by ultrasound dynamics.Add. information: http://med-port.ru/disease/beremennost-i-mioma-matki/

myomatous nodes,
Topic: Uterine fibroids, 05/17/2017 11:10:33 AM

Hello! I am 27 years old and I did not give birth! In 2010 I got pregnant, but unfortunately I could not bear it at 5 months, the pregnancy spontaneously terminated, the doctors say that the uterine fibroids were to blame, it was formed during my pregnancy! Now I am afraid of getting pregnant, tell me please, can I get pregnant with myoma with a diameter of 35 mm.? Our doctors say that it is necessary to do a lane operation, but I don’t want to because I don’t want to have a suture a second time, or rather, I’m afraid! Please answer my question!

Answer of Professor Armen Eduardovich Ter-Hovakimyan

Hello! If a woman sets the task of becoming pregnant, it is imperative to remove myomatous nodes (by the laparoscopic method – removal of only myomatous nodes, while preserving the uterus), since pregnancy provokes tumor growth and leads to complications both during pregnancy and during childbirth itself (miscarriages, bleeding etc. etc.).

Pregnancy after fibroids,
Topic: Uterine fibroids, 05/17/2017 11:10:33 AM

Good day.

My wife could not get pregnant for a long time, during numerous examinations they found progressive uterine fibroids, the doctor advised to do laparoscopy as soon as possible. He promised that the uterus could be preserved during the operation. Please tell me how likely it is to get pregnant after this operation? (this will be the second pregnancy). How long after it is possible to conceive?

Hello Alexey.
Modern technologies really allow in most cases to save the uterus when removing fibroids. Our clinic uses the technology of argon plasma coagulation, which allows you to preserve the reproductive ability of a woman to the maximum. This, of course, increases the chances of pregnancy. Conception is possible after the end of the recovery period.

Do I need to remove uterine fibroids ?,
Topic: Uterine fibroids, 05/17/2017 11:10:33 AM

Hello.
I would like to know if the presence of uterine fibroids requires its removal if the woman does not plan to have more children? The fact is that for 5 years I have been observed with this diagnosis, I need to undergo constant examinations, however, since the fibroid does not grow in size, the doctor says that it is not necessary to remove it, that it is not dangerous. Is it so?

Hello Oksana.

The decision to remove uterine fibroids should be made taking into account various factors: the presence of other diseases, the presence / absence of necrosis, taking into account the peculiarities of the growth of the node, etc.e. Also, the decision to remove it is usually made if conservative therapy does not give results. If your specialist has decided not to remove fibroids, then it does not threaten your health.

Submucous node
Topic: Uterine fibroids, 05/17/2017 11:10:33 AM

Dear Armen Eduardovich, hello!
I am 36 years old, planning a pregnancy. I have a multinodular uterine myoma. According to the results of ultrasound on the anterior wall of the interstitium – submucous node with a diameter of 20 mm, 10 mm interstitial.on the back wall. On the right edge – intersec. Diameter 30 mm. The doctor recommends hysteroscopy, then myoectomy, hormonal treatment and then planning a pregnancy. Shouldn’t I try to get pregnant without all these manipulations?

Precise removal of the submucous node is recommended. You don’t need any hormone therapy, except OK for the rehabilitation period. In the best variant, it is necessary to carry out both hysteroresectoscopy and laparoscopy at the same time, and recommend pregnancy after 4 months.
Respectfully yours, Professor A.E. Ter-Ovakimyan

Laparoscopy, myomectomy (subserous node of myoma, node diameter more than 3 cm, interstitial nodes) – 2nd category of complexity

Laparoscopy, myomectomy (subserous fibroid node, node diameter more than 3 cm, interstitial nodes) – 2 category of complexity

Laparoscopy myomectomy.

Myoma of the uterus (fibroma, leiomyoma) – benign tumors of the uterus, which are quite common in women of childbearing age, during the period of perimenopause.In most cases, fibroids are small and not bothersome, but sometimes fibroids can grow large, causing clinical symptoms.

Symptoms Symptoms of uterine fibroids include: pain in the lower abdomen, bleeding, various urinary disorders, menstrual irregularities.With large fibroids, signs of anemia (weakness, fatigue, dizziness) may appear. by laparoscopic and laparotomy, resectoscopic removal of myomatous nodes with preservation of the uterus, as well as removal of the uterus with various access.The scope and access of surgical treatment is decided at the consultation of a gynecological surgeon and is purely individual.

Myomectomy is a surgical operation performed on the body of the uterus to remove a benign tumor (fibroid) from its muscle wall. The operation involves the removal of fibromatous nodes, while the body of the uterus is preserved, and, accordingly, the reproductive function is not disturbed. Myomectomy is usually performed in young patients.

Laparoscopic myomectomy is performed when the fibroid is located on the outside of the uterine stem (legs) or subserous nodes are attached close to the outside.

An operation performed with a laparoscope refers to organ-preserving surgical interventions, which means the preservation of a woman’s reproductive function.

Laparoscopy is a modern method of surgery, in which operations on the internal genital organs are performed through small (usually 0.5-1.5 cm) openings on the anterior abdominal wall. Laparoscopic access is the most gentle method of surgical intervention, leading to rapid rehabilitation of patients, minimizing the likelihood of postoperative adhesions.

The operation on the pelvic organs is carried out from several small incisions, where special instruments are inserted. Previously, the abdominal cavity is filled with sterile gas, which allows the internal organs to move away from each other. The review is carried out using a video camera, which is also introduced into the abdominal cavity.

Using the inserted instruments, the surgeon removes the myomatous node, the node bed or its leg is sutured, the uterine wall is restored.

The myomatous node (nodes) are removed from the abdominal cavity after grinding with a special instrument – a morcellator. All removed tissues must be sent for histological examination.

After examination and cleansing (sanitation) of the abdominal cavity, control of the absence of bleeding, the instruments are removed. Gas is removed from the abdominal cavity. During laparoscopic operations, our MC Paracelsus uses equipment from the company Karl Storz (manufacturer number 1 in the world of laparoscopy), electrocoagulation is performed with a bipolar electrode, which eliminates the patient’s electrical trauma during the operation, minimizing thermal trauma to the internal genital organs. Today there are a number of special gels that the surgeon inserts into the abdominal cavity to prevent adhesion

The main advantages of the laparoscopic method for the removal of uterine fibroids:

-performing several small incisions, which significantly reduces the period of rehabilitation and recovery of the patient’s body, as well as eliminates the formation of scars;

– minimal pain syndrome in the postoperative period;

– low probability of bacterial and infectious infection of the operating area, since during the procedure the abdominal cavity is not opened;

Indication: 1. Subserous and subserous-interstitial uterine myoma. Examination for surgical intervention and the validity of the examination results: You can undergo the entire scope of the preoperative examination in Our MC Paracel in one day!

• colposcopy-12 months
• Ultrasound of the pelvic organs
• Ultrasound of the veins of the lower extremities – 3 months Ultrasound of the abdominal cavity, kidneys and bladder, retroperitoneal space
• Swab for flora, bacteriological culture from the cervical canal -10 days
• Oncocytology from the cervix – 6 months
• General urine analysis – 10 days, Fecal occult blood analysis – 10 days.Complete blood count and reticulocytes -10 days,
• Electrocardiogram with decoding -14 days,
• Blood for HIV, Hepatitis B, Hepatitis C, Syphilis 3 months.
• Biochemical blood test: general, direct, indirect Bilir., Total protein, albumin, urea, glucose, creatinine, uric acid, AST, ALT, alkaline phosphatase, blood sodium and potassium, cholesterol, blood pH -10dn
• Coagulogram – 10days
• Blood group and Rh factor
• Fluorography – 6 months.
• Mammography -24 months (after 36 years), ultrasound of the mammary glands (up to 36 years) -12 months
• Consultation of a therapist, anesthesiologist and other specialists, if indicated. According to indications, other examinations may be added. Anesthesia: These operations are performed under endotracheal anesthesia. With this method of anesthesia, the patient is completely relaxed, sleeps during the operation. Pain sensations after waking up are minimized by the administration of special drugs. Contraindications:

Planned intervention is not performed for clinically significant blood clotting disorders, acute infections, decompensated somatic diseases (hypertension, unstable angina pectoris, severe diabetes mellitus, severe anemia). After the surgical treatment in Our MC Paracelsus, from the 1st postoperative day, the patients begin physiotherapy, which has a beneficial effect on the postoperative course, prevents the formation of adhesions and improves the healing processes of the scar on the uterus.

Subserous, submucous, intramural uterine myoma and their treatment

• What are the symptoms of uterine fibroids?
• What complications can it lead to, and how dangerous is it?
• How to treat fibroids and is surgery necessary?

These questions cannot be answered unequivocally, because fibroids are different. It is important to understand where the node is located, how it grows, what size it is, and how many such nodes are in the uterus.Let’s try to understand the main types of fibroids and talk about how to treat them.

Submucous (submucous) uterine myoma

Such nodes are located under the mucous membrane and grow into the uterine cavity. Submucous fibroids are the most unpleasant in terms of symptoms, since they lead to profuse menstruation, during which a woman loses a lot of blood, uterine bleeding, infertility, miscarriages, and premature birth.

A small node, only 2-3 cm in diameter, can lead to severe symptoms.Sometimes the bleeding is so severe that a woman has to be hospitalized and given a blood transfusion.

Chronic bleeding in submucosal fibroids leads to anemia. Typical manifestations of this condition: pallor, constant feeling of fatigue and weakness, headaches and dizziness, shortness of breath, tinnitus, fainting, heart palpitations.

Subserous myoma

Unlike submucous, subserous nodes are usually “quiet”. They can grow large without causing symptoms.When talking about giant myomas, the size of “melon” or “watermelon”, usually we are talking about subserous nodes. They grow outward into the abdominal cavity – there is much more space there than in the uterine cavity.

When the subserous myomatous node, which can be located on the anterior or posterior wall of the uterus, reaches a large size, it begins to squeeze the adjacent organs: the bladder, rectum. The woman is worried about frequent urination, constipation.

Intramural myoma

Intramural, or interstitial myoma of the uterus is located in the thickness of the organ wall.By and large, all nodes initially grow as intramural, closer to the cavity or outer surface of the uterus, but then begin to protrude mainly into the uterine cavity or towards the abdominal cavity, depending on the nature of growth.

Until an interstitial myoma reaches a critical size, it usually does not cause symptoms. In the future, it can begin to protrude into the uterine cavity and lead to uterine bleeding, like submucosal nodes.

Classification of the International Federation of Obstetrics and Gynecology

The division of myomatous nodes into three types – submucosal, intramural and subserous – is a somewhat simplified classification.In fact, fibroids can take different positions, to varying degrees, protrude into the uterine cavity or into the abdominal cavity. In order to cover all options, a special classification has been developed by the International Federation of Obstetrics and Gynecology. In accordance with it, ten types of fibroids are distinguished:

Submucous nodes:

1. Type 0 – submucosal myoma on the pedicle, which is located in the uterine cavity.
2. Type 1 – the node protrudes into the uterine cavity by more than half.
3. Type 2 – the node protrudes into the uterine cavity by less than half.

Other types:

4. Type 3 – intramural myoma, which does not protrude into the uterine cavity, but is adjacent to its mucous membrane.
5. Type 4 – intramural myoma, which is located in the thickness of the muscles.
6. Type 5 is an intramural subserous node that protrudes from the outside on the surface of the uterus by less than half.
7. Type 6 – intramural subserous node, which protrudes from the outside on the surface of the uterus by more than half.
8. Type 7 – subserous node on the pedicle, which is completely above the surface of the uterus.
9. Type 8 – myoma, which has a specific localization (for example, in the cervical region).
10. Hybrid nodes that affect both the lining of the uterus and its outer surface. They are designated by two numbers.

Classification according to the number of fibroids

Depending on the number of nodes, there are three types of fibroids:

1. Single – 1-2 nodes, which can be of different sizes.
2. Multiple. More than 3 nodes are found. Treatment usually helps to reduce symptoms, but removal of all fibroids often fails, and over time, some of them can grow large.
3. Mixed. There are many myomas, but at least one of them is large and dominant. For example, multiple fibroids with a large subserous node may be diagnosed. It can be removed, but another node may grow large in the future. Multiple and mixed fibroids are a particularly big problem in women of reproductive age, until menopause has come, since sex hormones contribute to the growth of nodes.

Which fibroids need to be operated on?

Women are worried about whether it is necessary to have an operation, and whether it will be possible to save the uterus, what are the optimal sizes of submucous uterine fibroids for surgery.

Size is actually not as important as some other factors. Main indications for treatment:

• Myoma causes problems: bleeding, miscarriages, infertility, urinary disorders and constipation, abdominal enlargement.
• A woman wants to get pregnant, but the node, due to its size and location, can interfere with the onset of pregnancy, create certain problems for the expectant mother and fetus.
• The node is growing according to the data of 2-3 ultrasounds performed with an interval of 4-6 months.

Previously (some gynecologists still adhere to this tactic), all such women were candidates for surgery. If it worked out, the surgeon removed only the fibroids; otherwise, he removed the entire uterus.

Currently, there is a less invasive method for the treatment of uterine fibroids – uterine artery embolization (UAE).

During the procedure, the doctor inserts a special catheter through a small puncture on the skin into the vessel supplying the node, through which the embolizing drug is delivered.The latter blocks the lumen of the vessels, the myoma stops receiving oxygen, dies and turns into connective tissue.

Embolization of the uterine arteries is indicated for most women with myomatous nodes, it allows you to save the uterus, conceive a child and endure pregnancy in the future. Contact us to learn more about this treatment.

90,000 Uterine fibroids. Symptoms Treatment. Prevention – health articles

Table of Contents

Uterine fibroids are one of the most common tumors of the female reproductive system.This tumor is found in 15-20% of women over 30 years old, in 40% of women over 40 years old, although at present the age of uterine fibroids is “younger” – cases of this pathology being detected in young women under 30 years old with unrealized reproductive function have become more frequent.

Myoma (leiomyoma, fibroids) – benign hormone-dependent tumor of the uterus. The development of fibroids, as a rule, occurs slowly: one muscle cell for unknown reasons begins to divide and creates tumor muscle cells, which form a node in the uterus – fibroids.

Until now, there is no consensus on the causes of the development of uterine fibroids. There are several reasons that contribute to the development of uterine fibroids, these include:

• Disorders in the production of sex hormones
• Chronic inflammatory diseases of the female genital tract (chronic salpingo-oophoritis, sexually transmitted infections)
• Abortion, intrauterine contraceptives
• Diseases of the endocrine glands: thyroid gland, adrenal glands, etc.d.
• Genetic predisposition to uterine fibroids

Fibroids classified by location:

• Typical arrangement of nodes in 95% of the body of the uterus – intramural (the tumor is located in the thickness of the uterine wall), submucous (growth of the fibroid occurs towards the uterine cavity, causing deformation of the uterine cavity) and subserous (growth of the fibroid occurs in the direction of the abdominal cavity)
• Atypical arrangement of nodes in 5% – in the cervix – cervical form, intraligamentary (interconnectional arrangement of nodes)

Clinical picture of uterine fibroids

With uterine myoma, the clinical picture is very diverse, depending on the age of the patient, the duration of the disease, the location and size of the tumor, and the presence of concomitant pathological processes.

The main symptoms of uterine fibroids are:

• Uterine bleeding (profuse, prolonged menstruation), often leading to anemization of the woman (decrease in hemoglobin)
• Drawing pains, heaviness in the lower abdomen. Pain can be sharp and cramping, worse during menstruation
• Dysfunction of adjacent organs, for example, frequent urination
• Stool retention, which leads to compression of the nodes of adjacent organs

Myoma of the uterus can be the cause of infertility, miscarriage.Uterine fibroids are often combined with endometriosis of the uterine body – adenomyosis.

Diagnosis of uterine fibroids

• Gynecological examination
• Pelvic ultrasound – transvaginal and transabdominal examination. Ultrasound examination of the uterus (ultrasound) reveals an increase in the size of the uterus, as well as a node of uterine fibroids even in the early stages of the development of the disease, when the size of the fibroid does not exceed 1 cm in diameter
• MRI of the small pelvis (if necessary)
• Hysteroscopy (for submucous fibroids), hysterosalpingography

Treatment of uterine fibroids

So how to treat uterine fibroids? Treatment of uterine fibroids depends on the woman’s age, the size of the uterine fibroids, and the woman’s reproductive plans.In some cases, the treatment of uterine fibroids is carried out with the help of hormonal drugs, in other cases, surgical intervention is necessary (removal of the tumor – myomectomy, removal of the uterus – hysterectomy, etc.)

Conservative treatment of uterine fibroids

Conservative treatment of uterine fibroids prevents an increase in the size of fibroids and helps preserve the uterus, allowing you to give birth to a child in the future. Conservative treatment of uterine fibroids is possible in the case of small fibroids (up to 12 weeks), slow growth rates of fibroids.

The main principles of treatment of uterine fibroids without surgery are the use of hormonal drugs, as well as symptomatic treatment (treatment of anemia, elimination of pain, etc.). In the treatment of uterine fibroids, hormonal drugs are used: combined oral contraceptives, gestagens, agonists of gonadotropic releasing hormones, antigonadotropins.

Surgical treatment of uterine fibroids

Surgery for uterine fibroids is indicated for large fibroids (more than 12 weeks), rapid growth rates, severe symptoms of uterine fibroids (profuse uterine bleeding, abdominal pain, etc.)).

There are several types of operations for uterine fibroids:

• Laparoscopic myomectomy – removal of uterine fibroids using a laparoscope (an instrument inserted into the abdominal cavity through small incisions in the anterior abdominal wall). Benefits of laparoscopic myomectomy: preservation of the uterus and the possibility of getting pregnant in the future, quick recovery after surgery
• Hysteroscopic myomectomy – removal of uterine fibroids using a hysteroscope (an instrument inserted into the uterine cavity through the vagina).Hysteroscopic myomectomy is indicated for submucous uterine myoma (myoma that grows into the lumen of the uterine cavity)
• Removal of the uterus or hysterectomy is a surgical method for the treatment of uterine fibroids, which involves the complete removal of the uterus. Surgery to remove the uterus is indicated for women who do not want to give birth to children in the future, as well as for large uterine fibroids, fast-growing fibroids, the presence of several large fibroid nodes
• Embolization of the uterine artery – implies the introduction into the uterine artery of a special substance that stops blood flow through this artery, which stops the supply of uterine fibroids and leads to the death of the tumor.The disadvantages of this method of treating uterine fibroids are the possibility of infectious complications, as well as severe pain in the first few days after surgery
• FUS-ablation (FUS-ablation) of uterine fibroids is a relatively new method of treatment of uterine fibroids, which consists in the use of focused ultrasound waves. With the help of FUS-ablation of uterine fibroids, it is possible to achieve a reduction in the size of fibroids without surgical intervention. Contraindications to FUS-ablation of uterine fibroids are: a woman’s desire to become pregnant in the future, more than 5 myomatous nodes on the uterus

Prevention of uterine fibroids

Prevention of uterine fibroids consists in regular visits to the gynecologist, performing ultrasound of the pelvis, adherence to diet, sleep and rest, and reducing stressful situations.An important method of preventing uterine fibroids is timely pregnancy and childbirth.

90 054 90 000 Complicated case of atypical location of uterine fibroids – Our news

OUR WORKERS: A complex case of atypical location of uterine fibroids

In the city hospital number 15 named after O. M. Filatov recently analyzed one interesting clinical case. Patient B., 46 years old, was treated in the 12th gynecological department (base – University Clinic of the Moscow State Medical University) and was admitted for a planned surgical removal of uterine fibroids.Of interest is the cervical localization of the node (myomatous node up to 9 cm in diameter).

In a planned manner, professor, d.m.s. S.I. Kiselev performed a minimally invasive organ-preserving operation in the scope of laparoscopy and myomectomy.

The complexity of this operation lies in the atypical location of uterine fibroids, which occurs in only 5-8% of cases.

Surgical treatment of patients with atypical location of fibroids belongs to the category of traumatic, technically difficult operations and has a high risk of intra- and postoperative complications.

Due to the high professionalism of the operating surgeons, the postoperative period in this patient was uneventful, the patient was discharged on the fifth day in a satisfactory condition.

OUR REFERENCE:

Uterine myoma (also fibroids , leiomyoma ) is a benign tumor that occurs in the muscle layer of the uterus – myometrium. It is one of the most common ailments in women at the time of the late reproductive period and before menopause, reaching a frequency of 12-25% of all gynecological diseases.There is an opinion that the true prevalence of fibroids is much higher and reaches more than 70% both in Russia and abroad.

Fibroid node is a ball of chaotically intertwining smooth muscle fibers of a round shape. Most knots have diameters ranging from a few millimeters to several centimeters, but sometimes they can reach very large sizes and weights of several kilograms.

The reasons for the appearance of fibroids are not fully understood.

Surgical removal of nodes (exfoliation) and removal of the uterus have been used for many decades for the treatment of uterine fibroids.

Classification

By number of nodes:

• solitary myoma;
• multiple fibroids.

By the location of the nodes in the uterus:

• Submucosal nodes (submucous myoma) – located closer to the uterine cavity. They are relatively rare, sometimes have a thin leg and can descend from the uterus into the cervix or into the vagina; in this case, they speak of a “nascent” fibroid node.
• Intermuscular nodes (interstitial, intramural) – nodes are located in the wall of the uterus in the muscle layer.
• Subperitoneal nodes (subserous myoma) – located on the outside of the uterus, closer to the abdominal cavity. May have a base with a smaller diameter than the node itself; in this case, the term “peduncle” is used.
• Interstellar nodes (intraligamentary myoma).
• Cervical fibroids.

The most common is interstitial uterine myoma. According to various authors, its frequency ranges from 50 to 61% or more. The frequency of subserous myoma is from 26 to 35%, submucous – no more than 13%.

In 50% of cases, this disease is asymptomatic. It is more common in small, single or multiple fibroids with intermuscular and subperitoneal locations.

Symptoms

The most common symptoms are heavy menstrual bleeding (menorrhagia), pressure and pain in the lower abdomen. Menorrhagias are more common in submucosal fibroids. With the growth of fibroids, menstruation gradually becomes more abundant and prolonged, often leading to the development of anemia (anemia).A feeling of heaviness or pressure in the lower abdomen is more typical for intermuscular and subperitoneal fibroids, especially with large nodes. Pain usually occurs during menstruation and is cramping, but can be constant. Pain can also have a sudden cutting character, which is noted with a very rare complication – torsion of the legs of the subperitoneal node. More rare symptoms of uterine fibroids include infertility and dysfunction of neighboring organs: the bladder and rectum.

Diagnostics

For the diagnosis of uterine fibroids, the most informative method is considered to be ultrasound, in which the fibroid is found in the form of rounded foci of reduced echogenicity (having a less dense structure than the myometrium). In some cases, magnetic resonance imaging is used for the differential diagnosis of uterine fibroids and ovarian tumors.

90,000 Treatment of uterine fibroids: what a woman needs to know

45% of women! Yes! In fact, every second woman is diagnosed with uterine fibroids sooner or later.That is why you should know what kind of disease it is and what possibilities for its treatment are presented in the modern medical market.

1. WHAT IS UTERINE MYOMA?
2. WHO IS AT RISK?
3. WAITING TACTICS
4. MEDICAL TREATMENT
5. SURGICAL TREATMENT
6. EMBOLIZATION OF UTERINE ARTERIES
7. HOW TO PRESERVE THE UTERUS AND THE POSSIBILITY OF GIVING?

WHAT IS UTERINE MYOMA?
Firstly , various types of benign tumors are combined under the term “uterine myoma”:
leiomyoma – a neoplasm of muscle fibers
fibroma – a neoplasm of connective tissue
rhabdomyoma – a benign tumor that develops from striated muscle tissue
angiomyoma – neoplasm with a well-developed network of blood vessels.

Secondly, in relation to the location to the muscle layer of the uterus, tumors are divided into:
intramural – nodes are located in the thickness of the uterine wall, between muscles
submucous – nodes are located under the mucous membrane and grow into the uterine cavity
subserous – nodes are located under peritoneum and grow above the surface of the uterus

Thirdly, in order to cover all options for the location of fibroids and the environment of its primary formation, the International Federation of Obstetrics and Gynecology introduced and uses the following classification:
Submucous nodes:
Type 0 – submucous fibroids on the pedicle, which is located in uterine cavity.
Type 1 – the node protrudes into the uterine cavity by more than half.
Type 2 – the node protrudes into the uterine cavity by less than half.
Other types:
Type 3 – intramural myoma, which does not protrude into the uterine cavity, but is adjacent to its mucous membrane.
Type 4 – intramural myoma, which is located in the thickness of the muscles.
Type 5 is an intramural subserous node that protrudes from the outside on the surface of the uterus by less than half.
Type 6 – intramural subserous node, which protrudes from the outside on the surface of the uterus by more than half.
Type 7 – subserous node on the pedicle, which is completely above the surface of the uterus.
Type 8 – myoma, which has a specific localization (for example, in the cervical region).
Hybrid and multiple nodes that affect both the lining of the uterus and its outer surface are designated by two numbers.

WHO IS AT RISK?
Unfortunately, the medical scientific community has not yet given a 100% answer as to why uterine fibroids are formed. Today, it is believed that the onset and growth of fibroids is affected by a disruption in the production of the hormones estrogen and progesterone in the body.There are also embryonic and traumatic theories of the onset of the disease, and the inflammatory factor that provokes the growth of nodes is also considered.

First of all, women in whose family have already been diagnosed with cases, as well as with diseases of the endocrine glands, metabolic disorders, chronic inflammatory diseases, multiple surgical interventions on the uterus, prone to chronic stress, with a passive lifestyle and physical activity.

If you have been diagnosed with uterine fibroids, determined its type, the most important question for you will be – HOW TO TREAT? AND HERE YOU RIGHT TO CHOOSE!

Depending on the size and growth rate, doctors use different treatment options for uterine fibroids.

WAITING TACTICS
If the node is small, the patient is most often offered a follow-up format, however, in relation to this disease, the justification of this approach is questionable. Myoma, whether it is small or not, is a disease that affects
– on the ability to give birth to a child,
– on provoking constant intense pain,
– on significant disturbances in the woman’s body: a failure in hormone production, weight gain, disturbances in the functioning of the gastrointestinal tract , disturbances in the work of the cardiovascular system, manifestations of hypertension and neuroses.
Our body is a single system. A failure in one organ always leads to consequences in others!

MEDICINAL TREATMENT
Anti-inflammatory and pain relievers, hormonal contraceptives, intrauterine devices, GnRH agonists – there are many drug treatment options for fibroids. All of them are aimed at normalizing hormonal levels, reducing the frequency and intensity of pain, reducing bleeding during menstruation, and stopping the growth of fibroids. In practice, it is not always possible to achieve the desired result.Previously widely prescribed oral contraceptives and synthetic progestogens have not been shown to be superior to placebo in clinical trials for inhibiting the growth of uterine fibroids. Many medications have a number of contraindications, so the period of their intake is limited, and after stopping, the question of the operation again arises. Unfortunately, the effect of drug treatment is temporary.

SURGICAL TREATMENT
A woman needs surgery if fibroids create serious problems:
– profuse bleeding, up to anemia, miscarriages, infertility, urinary disorders and constipation, an increase in the abdomen due to the growth of fibroids.
– if a woman wants to become pregnant, but the node, by its size and location, can prevent pregnancy.
– if the node is growing (according to two or three ultrasounds over the past six months).

Not all options for surgical intervention can save the organ. Even 20 years ago, gynecologists were sent with the above-described indicators for abdominal surgery. If it worked out, the surgeon removed only the fibroids; otherwise, he removed the entire uterus and ovaries.

Today, the following methods are used in surgical practice:

removal of fibroids only – myomectomy , in the standard “open” surgical approach – laparotomy, or less invasive – hysteroresectoscopy and laparoscopy.

Laparotomy is a complete abdominal surgery under general anesthesia and with an incision in the abdominal wall to remove fibroids. The recovery period can take several months. It is worth choosing it for the treatment of uterine fibroids only as a last resort – with the gigantic size of the uterus and myomatous nodes. If you have been diagnosed with uterine fibroids and are immediately offered to remove the nodes through an abdominal incision, get a second opinion from another specialist. Today, such radical operations are rather an exception to the general practice than the norm.

Laparoscopy, the most popular method with suitable parameters, is performed through four small (up to 1 cm) punctures in the anterior abdominal wall. It is a very delicate operation and requires careful training and high qualifications of a surgeon. The operation is performed for multiple and single fibroids of any location. Unfortunately, with multiple fibroids, the risk of recurrence starts from 30%, and the possibility of getting pregnant is no higher than 70%. It is performed under general anesthesia, which is additional stress for the patient’s entire body.

Hysteroresectoscopy is a method of removing myomatous nodes from the side of the uterine cavity, through the vagina. An instrument is inserted into the uterine cavity and, under the control of a video camera, the myomatous node is cut off layer by layer. Refers to low-traumatic operations. However, it is possible only for submucous myomas up to 3-4 cm in size.

Recurrence is one of the most common problems in fibroid surgery. In the first year, they make up only 7%, however, in subsequent years, myoma returns in almost half of the patients, which leads to repeated treatment and new surgical interventions.

removal of the endometrium – endometectomy. Relieves only one symptom provoked by uterine fibroids – profuse bleeding during menstruation. Depending on the clinical situation, it can be performed by curettage, endoscopic endometrectomy or thermocoagulation of the endometrium. The procedure is performed under general anesthesia (intravenous) or epidural anesthesia. If the patient plans to give birth to a child, endometectomy is contraindicated, because brings the chances of conception to zero.

removal of the uterus – hysterectomy. Carries with it a series of traumatic events for the physical condition and psychological health of a woman. The reason for the removal of the uterus can only be giant fibroids, precancerous condition and cancer. If the doctor recommends removal, be sure to ask the opinion of another specialist.

FUS ablation. Performed using focused ultrasound (FUS) under the guidance of MRI. Ultrasonic waves locally affect the myomatous nodes, melting them.When FUS ablation first appeared, doctors had high hopes for it. However, with further use of the method, it turned out that not all myomatous nodes are sensitive to ultrasound, and the effect was often temporary: the melted node began to grow again. Therefore, FUS ablation was gradually abandoned. In Belarus, FUS-ablation is not performed.

EMBOLIZATION OF UTERINE ARTERIES
The technique has been actively used for the last 20 years. This is a minimally invasive endovascular procedure that allows you to cure uterine fibroids and avoid removing the organ by injecting a special embolization drug into the fibroid nodes to block blood access.Like any other organ in our body, without blood flow, myoma “dies” and is replaced by connective tissue without scarring, preserving all the functions of the uterus.

EMA is recognized all over the world, hundreds of thousands of procedures are performed annually, and the results have been traced for 20 years. Class A evidence was obtained about the effectiveness and safety of UAE.And Condoleezza Rice can boast of a personal example of a successfully performed procedure, who, on the recommendation of doctors, underwent a planned operation back in 2004 and returned to work after 3 days.

HOW TO PRESERVE THE UTERUS AND THE POSSIBILITY OF GIVING? It was this issue that was a priority when the staff of the CORDIS Medical Center chose an effective method of treating fibroids for women for implementation in the center. Priority – UTERINE ARTERY EMBOLIZATION (EMA)

THE ADVANTAGES OF EMA OVER OTHER OPERATIONS ARE

• achieving a high therapeutic effect in symptomatic myoma,
• minimally invasive procedure,
• no general anesthesia,
• organ preservation,
• quick rehabilitation.

For women of reproductive age, the ability to maintain fertility is important – after UAE this function does not suffer. Unlike surgical operations, after UAE, no scars remain on the uterus, which affect the ability to conceive a child, safely bear it and give birth. After the recovery period, a woman can plan a pregnancy. Therefore, the indications for UAE are primarily your desire to preserve the uterus, the ability to avoid surgery to remove it, and your interest in pregnancy.

As in all methods of treatment of fibroids, there are indications and contraindications here, therefore, preliminary consultations with a gynecologist and an X-ray endovascular surgeon are required.

If you have been diagnosed with uterine fibroids, you have epicrisis and ultrasound of the pelvic organs in your hands, send scans or photos to [email protected] and get a free consultation with an X-ray endovascular surgeon – is UAE shown to you. We will respond within 2 business days.