Mioma is a benign uterine tumor, which occurs in 20-40% (according to different data) of women of reproductive age. According to the prevalence of muscle or connective tissue elements in a tumor, doctors secrete myoma, fibroma, leiomyoma, although more often they say just “myoma”. The exact medical name of the disease is “leiomyoma”. The size of the tumor (it is denoted both in centimeters and in the weeks of pregnancy), its location and the number of nodes (there are single and multiple myomas) are important for choosing the treatment tactics. The most frequently diagnosed sub-cerose and intramural location of the tumor. In the first case, the nodes are located under the peritoneum and protrude above the surface of the uterus. In the second case, they are in the thickness of the uterine wall, between the muscles. Submucose (in the uterine cavity) location is much rarer, but accompanied by a brighter clinical picture. There are also retroperitoneal and interstitial myomas, they are rare.
Who is at greatest risk?
It has been proven that the main initiators of myoma growth are changes in the ratio of estrogen hormones to progesterone in the body. There are embryonic and traumatic theories of the disease. Scientific research also confirms the role of an inflammatory factor, provoking the growth of nodes. Women with hereditary predisposition, endocrine gland diseases, disorders of fat metabolism on the background of low physical activity, chronic inflammatory diseases, multiple surgical interventions on the uterus (abortions, scraping) are most at risk. Increases the risk of myoma and irregular sex life. In general, the tumor is more common in women living in the metropolis, who are more exposed to chronic stress, in women engaged in mental work.
How is myoma diagnosed?
Regular gynecological examination at least once a year, which, unfortunately, many women neglect, is the main method of diagnosis and detection of uterine diseases. In many cases, even large myoma does not cause anxiety and does not manifest itself in any way. Additional methods of diagnosis are ultrasound examination, which is used to clarify the size of the tumor, the number, location and features of nodes.
What is the danger of myoma? How high is the risk of benign tumor degeneration into malignant tumor?
Myoma can cause serious inconvenience to a woman, worsening her quality of life. Prolonged, profuse and painful menstruation, uterine bleeding outside the menstrual schedule contribute to anemia – hemoglobin falls, there is a general weakness, fatigue, dizziness, shortness of breath, reduced efficiency, loss of appetite. Large-size myomas can lead to a violation of the functions of neighboring organs that they squeeze. This can result in frequent urination and constipation, pulling or whining pains in the lower abdomen of varying degrees. Myoma is often combined with other benign diseases of small pelvic organs – endometriosis and endometrial hyperplasia, uterine polyps, ovarian cysts and uterine tube diseases. For women diagnosed with myoma, it is advisable to determine the condition of the thyroid and mammary glands. Studies show that in more than 70% of patients leiomyoma develops against the background of thyroid pathology, in 30-70% (according to different data) against the background of mastopathy. There is no need to be afraid of benign tumor degeneration into malignant tumor, studies show that the so-called “malignization” of leiomyoma occurs only in 0.3 – 0.7% of cases, and mainly in the presence of cancer heredity.
Methods of myoma treatment. When is surgery necessary? Is it necessary to remove the uterus?
In addition to the size, location and features of the nodes, the choice of treatment tactics is influenced by the age of the patient and her plans for reproductive function, the presence of somatic pathology, associated gynecological diseases. That is why the approach to each patient is strictly individual. The surgical intervention is not always shown. If the tumor is single and small, more often than not, surgery is not always necessary. It may be prescribed a conservative treatment aimed at normalizing the hormonal background. In this case, it is very important to constantly monitor the patient in the antenatal clinic and control the size of the nodes by ultrasound. During menopause, myoma may decrease until it disappears.