Quite often, women can hear the phrasethat uterine myoma at reproductive age can not be treated. "Itself will take place" - a common phrase of women observed in antenatal clinic about this disease. Is it really? It is such a harmless fibroid itself regresses in the future? Let us try to understand this as an example of answers to frequently asked questions about uterine fibroids.
Why and who is more frequent uterine fibroids?
It has long been marked by the presence of inflammatory Usdiseases of the pelvic organs with the development of uterine fibroids. Not necessary. But they are often "hand in hand". And since the continuous increase in the number of women who have not only inflammatory diseases, but also diseases, sexually transmitted diseases, is increasing, respectively, and the number of women with uterine myoma.
Often the occurrence of uterine fibroids is associated withlate onset of menarche (first menstruation), the presence of a large number of sexual partners, a large number of abortions (sometimes one) a history of cesarean section or other abdominal operations on the uterus and appendages. The risk group may also include women using intrauterine devices for a long time contraception (Spiral), wrong and irrationalselected hormonal contraceptives ... inherently myoma is a kind of a mirror, a reflection of what was once, or is currently in a woman's body has failed.
At the same time you, dear reader, our website,You must know and understand that the risk groups listed above are not binding for the appearance of uterine fibroids. The disease can develop in a completely healthy woman, and did not develop in women related to several risk groups.
Since that is a benign fibroidtumor, most of the muscle layer of the uterus, the study of its nature goes on, as we continue the study of its methods of conservative, non-surgical treatment.
As suspected uterine fibroids?
First of all it is necessary to pay attention toage. Despite progressive "rejuvenation" of the disease, though often it occurs in women older than 27-30 years. During this period, many women think of the children and are trying to become pregnant. Here and raises the first problem - conception It does not, violated the reproductive function.
In this regard, a woman often startsuse uncomplicated methods of calculating ovulation days. Here, the second problem - often difficult to detect ovulation in mind or non-permanent, or impaired or absent menstrual cycle.
Realizing that the doctor can not do without, womanIt refers to a gynecologist. And as soon as the first taking on palpation of the abdomen above the vagina she found hilly education, as a rule, the size of about 12 weeks.
The gynecologist sends a ultrasonography "Discoveries." It is also possible laparoscopic and hysteroscopic study. So it is diagnosed.
As a further need to observe a woman with uterine fibroids?
- The main thing to know every woman is a periodic monitoring at the antenatal clinic with mandatory ultrasound every 3-6 months from the time of diagnosis.
- What follows is a more detaileda survey in order to clarify the diagnosis of uterine fibroids (localization of components, their size and structure, the presence of other complications and comorbidities). Localization of fibroids is most important, because here and there is a question about the choice of further treatment.
- Then define the direct tactics of treatment - conservative (non-surgical), combined (surgery + drug therapy), surgery.
- Conducting medical therapy for the prevention fibroid growth.
- The general improvement of the body, treatment of opportunistic diseases, inflammatory diseases of the pelvic organs, because they could cause possible complications.
Driving conservative treatment of uterine fibroids
The main criterion in choosing the method - the presencea complete picture of the disease. In this case, an important revelation in a conversation with the gynecologist, the confidence, the knowledge that a doctor can help the patient only if it is known.
So, the main purpose of medical treatment -slow down the growth of fibroids and avoid surgery. Because fibroids occurs on the background of hormonal imbalance, menopause treatment is carried out before the period when it can actually decrease as a result of age-related involution processes in the myometrium.
Also, conservative therapy is conducted inWhere the presence of pathology of other organs or systems do not allow recourse to surgery. In such cases, the operation is carried out only for health reasons (site necrosis with the clinic of acute abdomen, is born myoma node with heavy bleeding).
Food. It is best to limit the nutritional fats and carbohydrates,protein foods, on the contrary, must be ingested in sufficient quantities. When violations of the gastrointestinal tract, many recommend eating on an empty stomach in the morning vegetable juices (potatoes, beets, carrots, cabbage), as well as fresh fruit juices (apple).
It should be eating foods that are rich in iodine, especially in endemic goitre regions: seaweed, squid, shrimp and others.
Useful vegetable oil and soybean oil containing unsaturated fatty acids, arachidonic acid and vitamins of group B.
Phytotherapy. For readers of our site and want to point it is important to remember that the use of herbal medicine alone, as the main method of treatment of uterine fibroids is not allowed.
The most well-known plants are hemlock, aconite, mushroom, celandine. They are used predominantly toxic properties that stops the growth of tumors.
Well proven burdock roots are ground and mixed in equal parts with alcohol and honey.
If you decide to use a few herbs, then they should be alternated every 2-3 weeks.
Immunomodulatory effects has the fungus Fusarium, more specifically, its biomass. The drug is called Milife.
Considerable importance in the treatment of uterine fibroids is a vitamin, fizioterapevtichekie procedures, as well as spa treatment.
Hormone therapy. Earlier in the treatment of uterine fibroids tried to oppressovarian function. Because the most commonly used drugs were Norkolut, Danoval, Danol, Gestrinol, Depo-Provera. Yes, with their use in women of reproductive age was observed a decrease in the size of fibroids, but the abolition of renewed growth. Although such premenopausal were noted.
Currently, he is moving away from the use ofderivatives of androgens, progestins used modern, regulating menstrual function - Duphaston (10-30 mg per day), Utrozhestan (100-300 mg), appointed by the 16 to the 25 th days of the cycle.
Intermediate, even more likely, an alternative position in the treatment of uterine fibroids takes such a procedure as uterine artery embolization. Its essence lies in the cessation of blood flow in the heartmyoma node. And in the absence of food, he regresses. By catheter into the left uterine artery administered substance (usually gelfoam, 500mikron value), which is moving through the bloodstream and jammed the lumen vascular fibroids. Then everything is repeated in the right uterine artery. At the same time normal miometralnye branches of the uterine arteries are passable. The procedure is painless and the woman is discharged the next day.
Of course, as with any treatment, embolization has its complications. Most often it is:
- allergic reactions;
- hematomas and local complications of vascular puncture;
- absence of menstruation due to a violation of blood flow in the vessels of the other;
- necrosis (necrosis) of the uterus (happens very rarely). Once upon a time heard of the three cases for all 25 years of application of this method.
There, along with complications and a lot of advantages over other methods of treatment:
- sparing procedure (there is minimal interference);
- at multiple sites on the action takes place all at once;
- minor trauma;
- the absence of blood loss;
- 85-96% efficiency;
- later the vast majority of women fibroids do not grow;
- minimum period of rehabilitation after the procedure;
- do not use general anesthesia, only local;
- It does not require pre- and after surgical treatment;
- after the procedure bearing and child birth is not contraindicated.
Surgical treatment of uterine fibroids
So, if none of the above methodseither individually or in combination the effect is not given, or if there are contraindications to the persistent embolization, surgical methods are used. These seemingly simple and relatively safe. First - a uterine curettage, secondly - amputation of uterus. In the second case, the size of the operation is defined as a woman's age and the state of her reproductive function.
For example, if a married woman, having twochildren, 45 years old, childbirth is no longer planning and myoma of the uterus grows all the layers plus a fairly high risk of malignant transformation of the tumor, in this case shows supravaginal amputation of the uterus and appendages.
Another thing - the presence of fibroids in a young, nulliparous women. In this case, the surgical intervention is minimal.
Thus, the scraping is carried out the traditionalmethod used both abortion and in various diagnostic modes. The most frequent complications in this case punctures are the uterus and secondary infection.
Extirpation (amputation, removal) of the uterusproduced in those cases where it is impossible to distinguish himself myoma node, when the tumor is tightly adherent to the surrounding tissues or the uterus grows all layers. Appendages "capture" in cases where there is suspicion of malignancy of the tumor (tumor into a malignant degeneration). Here, non-specific complications associated primarily with himself postoperative period. So, when you remove the appendages is assigned to hormone therapy to suppress the inevitable hormonal imbalance.
Prevention of uterine fibroids
In conclusion, it should be said, of course, on theprevention. It should be noted that the basis for any preventive maintenance is the timely assessment and identification of risk factors. So, if a mother, grandmother, great-grandmother had a fibroid the place to be, it is necessary to 24-25 years at least 2 times a year to visit a gynecologist. Along with this it has a value of a healthy lifestyle, prevention of abortion and sexually transmitted diseases through, with the exception of insolation, especially after 40 years. When using combined oral contraceptives should choose low-dose.
Undoubtedly, even if the strict implementation of all the recommendations, the formation of fibroids. But it is important to understand that in this case there is a possibility for timely treatment and the absence of complications.