Myoma of the uterus is a benign hormone-sensitive neoplasm growing from immature muscle cells of the uterus. It is one of the most common benign tumors, affecting more and more young women in recent years.
Despite the fact that fibroids are detected in 80% of women, only a third of them show itself with various symptoms. But even in the absence of pronounced signs, the disease can progress, and small fibroid nodes can provoke systemic changes in the female body.
Is removal of the uterus indicated for all women with this pathology? No.
What should a woman pay attention to in order not to miss this disease? What signs of uterine fibroids require surgical treatment? Let’s talk about this in more detail.
Clinical manifestations of uterine fibroids can be very different:
prolonged heavy menstruation;
irregular uterine bleeding;
lethargy, shortness of breath, dizziness, tachycardia;
violation of urination;
signs of intoxication of the body (headache, weakness, nausea, fever, lack of appetite);
The symptoms that accompany the disease depend on the location of the tumor.
With the growth of submucous (under the mucous membrane) nodes in the uterine cavity, the anatomy of the organ is disturbed, and the patients complain of bleeding and miscarriage. In connection with the noticeable blood loss, many women develop anemia, which manifests itself as weakness, dizziness, decreased performance, and headaches. With this arrangement of the node, the fertilized egg is often difficult to attach to the walls of the uterus.
With the growth of subserous nodes towards the abdominal cavity, the function of neighboring organs may be impaired, in connection with which constipation and frequent urination occur. Often, patients experience pain in the abdomen. If the node is large, its nutrition may be disturbed, which is accompanied by severe pain and intoxication. The development of such a serious complication as peritonitis (inflammation of the peritoneum) is possible. If the myomatous node is located on the pedicle, the danger is its torsion – in this case, the patients also complain of intense pain.
Large tumors located in the ligament of the uterus can provoke a violation of the outflow of urine from the kidneys. Without timely treatment, hydronephrosis (dropsy of the kidney) and irreversible damage to this organ can occur.
According to statistics, every third woman diagnosed with uterine fibroids has impaired reproductive function. Every fifth patient suffering from primary infertility has fibroids. Thus, the relationship between this disease and the difficulty of getting pregnant is clear.
In the diagnosis of fibroids, the doctor is helped by non-invasive instrumental research methods, such as ultrasound, CT and MRI.
Surgical treatment of fibroids
The choice of the volume of surgical intervention depends on various factors, which include the patient’s age and the presence of reproductive plans, the location and size of fibroid nodes, concomitant diseases of the pelvic organs and the psychological state of the woman.
During the operation, doctors can use laparotomic, laparoscopic or vaginal access, each of which has specific indications for use.
With large multiple nodes, patients are offered the removal of fibroids by laparotomy access. Today, medicine uses modern techniques to minimize blood loss during surgery and tissue trauma. Doctors remove fibroid nodes without damaging the surrounding uterine muscle, which is very important to preserve reproductive function.
It is also important to note the use of anti-adhesion barriers, which reduce the risk of postoperative complications and, as the name implies, the formation of adhesions. Their use reduces the risk of infertility and bowel complications.
This method is recommended for lowering the pelvic organs. In addition, the vaginal approach is relevant for removing the uterus. Due to the fact that such an intervention is much easier to tolerate than others, it is possible to use it during operations for patients with a burdened history (the presence of chronic diseases). This method is also good because in the presence of contraindications to general anesthesia, you can limit yourself to spinal anesthesia.
Hysteroresection of the submucous node
With this method, the myomatous node is removed from the side of the vagina, cutting it piece by piece using a loop to which an electric current is supplied. The operation is performed under intravenous anesthesia and takes 20 to 40 minutes. Ease of implementation makes it the “gold standard” in the treatment of such neoplasms.
Laparoscopy is a method of surgical intervention for fibroids.
Modern operative gynecology adheres to organ-preserving principles. This is especially true in relation to patients of reproductive age who are planning to have a child in the future. That is why, in modern medicine, the targeted removal of fibroids is the method of choice in the treatment of women who have not entered the period of menopause.
Laparoscopy has a number of indisputable advantages over laparotomy operations: less tissue damage, minimization of the risk of adhesions and the formation of postoperative hernias, and a significantly shorter recovery period.
Laparoscopic https://en.wikipedia.org/wiki/Laparoscopy removal of myomatous nodes from the abdominal cavity is performed by morcellation. This technique allows you to extract the myoma through a puncture in small fragments. In order to prevent the spread of tumor tissue throughout the abdominal cavity, we carry out morcellation in a special sealed container bag. This container eliminates the risk of disease progression, especially if its malignant nature is detected. All openings on the anterior abdominal wall are securely sutured. Thus, we prevent the development of complications such as hernia of the anterior abdominal wall.