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What is uterine leiomyoma
Leiomyoma of the uterus (myoma, fibromyoma) is a benign tumor that is formed from the smooth muscles of the mucous membranes of the internal organs.
A neoplasm can occur in any organ with smooth muscle walls, but most often it is localized in the uterus. Leiomyoma is formed in the form of a single node of a rounded shape and can reach sizes from a few millimeters to a large grapefruit. It is one of the most common diseases among women and, as a rule, is benign and depends on the level of hormones (estrogen) in the body.
In a malignant tumor, leiomyoma is reborn in very rare cases, and sometimes it can disappear on its own without treatment and surgery.
Causes of uterine leiomyoma
The main reason for the formation of leiomyoma is a genetic predisposition and an increased level of estrogen in a woman’s body. Hormonal surges may be due to the following factors:
- increased production of hormones by the ovaries,
- prolonged and uncontrolled use of hormonal pills and oral contraceptives,
- obesity,
- diseases of the thyroid gland (which is also responsible for the production of hormones),
- history of abortions and miscarriages,
- inflammatory diseases of the uterus (endometritis),
- too early or vice versa late puberty,
- autoimmune diseases (systemic lupus erythematosus, toxic goiter, etc.).
Symptoms of uterine leiomyoma
Very often, leiomyoma develops asymptomatically, and a woman learns about her disease only at an appointment with a gynecologist. You may also experience the following symptoms:
- profuse bleeding during menstruation;
- spotting between periods and after intercourse;
- menstrual cycle disorders;
- pulling pain and discomfort in the lower abdomen;
- sharp weight gain;
- infertility;
- urinary incontinence.
Often, when a leiomyoma grows, the tumor begins to put pressure on the bladder, causing problems with urination, provoking kidney disease – for example, the formation of kidney stones.
Diagnostics
What modern methods of leiomyoma diagnostics are considered the most effective?
– Firstly, it is an ultrasound diagnosis of the uterus. Ultrasound examination using transabdominal and transvaginal sensors is a method of primary diagnosis of uterine fibroids and is a kind of “gold standard” method of instrumental diagnosis of this pathology, it is also widely used for dynamic monitoring of the development of the tumor process and evaluating the effectiveness of various types of treatment.
To clarify the details of the localization of the node in the uterine cavity, echohysterography is used. To assess the qualitative and quantitative parameters of the blood flow of the node, color Doppler mapping (CDC) is used.
Radiation diagnostic methods (computed tomography and magnetic resonance imaging) using ionizing radiation in gynecology are undesirable and are not routine diagnostic methods. The use of these methods is carried out according to strict indications, if it is impossible to replace them with safer methods, explains obstetrician-gynecologist of the highest qualification category Natalya Belyaeva.
Modern treatments
In modern medicine, there are several options for treating uterine leiomyoma – it all depends on how large the tumor is, where exactly it is located, what is the general health of the woman, whether she still plans to become a mother, etc.
Conservative treatment
Conservative treatment of uterine leiomyoma is usually prescribed in cases where the tumor grows rather slowly, is located in the wall of the uterus, the size of the nodes does not exceed 3 centimeters, the patient has health problems (for example, anesthesia is contraindicated for her) or she plans to give birth to a child.
In this case, the doctor prescribes hormonal drugs that inhibit tumor growth. Drugs are also prescribed to help relieve the pain symptom and remove inflammation. Treatment and medication is under the supervision of a doctor, after treatment, a woman should be constantly monitored by a doctor to see if the tumor has started to grow again.
Operative therapy
If the leiomyoma grows very quickly, and its dimensions are much larger than 3 centimeters, doctors decide on an operation. The fact is that a growing tumor begins to compress nearby organs, which can lead to serious health problems. There are three types of surgical treatment of uterine leiomyoma in a woman:
- Myoectomy – the most sparing method, in which only tumor nodes are cut out, and healthy uterine tissue is not affected. This treatment option is most preferable if a woman still dreams of becoming a mother, and drug therapy has no effect. Also, a myectomy is performed if the tumor itself is small and located on the “leg”, and it is easy enough to remove.
- Embolization of the uterine arteries – also used if the patient is planning a pregnancy in the future. The essence of the method is to block the blood supply to the fibroid nodes with the help of a special apparatus, as a result of which the leiomyoma tissues die and are replaced by connective tissue.
- Hysterectomy of the uterus – the most radical method, involving the complete removal of the uterus. It is used if the size of the tumor is too large, there is a risk of its transformation into a malignant one, or other methods of treatment do not give any results.
Prevention of uterine leiomyoma at home
The prevention of leiomyoma in women at home can be attributed to regular preventive examination by a gynecologist – twice a year. This is especially important if leiomyoma was found in close relatives in the female line. It is also very important to treat all inflammatory and infectious diseases of the reproductive system in a timely manner, monitor hormone levels, take oral contraceptives only in consultation with your doctor, and avoid abortions. It is also important to monitor your weight and quality of nutrition, excluding foods with a high content of dyes and preservatives from the diet as much as possible. Do not forget about physical activity – a healthy lifestyle is a reliable prevention of many diseases, including uterine leiomyoma.
Popular questions and answers
Answered frequently asked questions about uterine leiomyoma obstetrician-gynecologist of the highest qualification category Natalya Belyaeva.