About 20 % of women after age 30 are affected with uterine fibroids. But by age 35 already 35–45% women suffer from fibroids. In other words, according to various data estimated, every second or third woman in age of fertility is affected with myoma uteri.
Classification of uterine fibroids
Subserosal fibroid: nodule is located in the outer portion of the uterus, at its surface, underneath its peritoneal lining that separates the uterus from the organs of the abdominal cavity.
Interstitial (or inramural) fibroid: nodule is located within the muscular wall of the uterus.
Submucosal (or slibmucous) fibroid: nodule is in the uterus, underneath the mucous lining. It often distorts the uterine cavity.
What causes uterine fibroid?
Now hormonal disorders are considered as the essential factor for development of fibroids. Matter of concern as well: - genetic predisposition; - accompanied diseases (obesity, primary hypertension); - consumption of red meat and alcohol (especially beer).
What are the symptoms of uterine fibroid?
The most specific symptoms: heavy and prolonged menstrual periods (menorrhagia), pressure and pain located in the lower part of the abdomen and lower back pain. Anaemia may be resulted from growth of myoma and heavy blood loss during prolongated periods. In case of big myomatic nodule, functional disorders of adjacent organs (urinary bladder and the rectum) may take place. It may cause infertility as well.
How is uterine fibroid diagnosed?
The most informative method to diagnose uterine fibroid is ultrasound examination. In some cases magnetic resonance tomography is applied in order to exclude diagnoses of other diseases.
How is uterine fibroid treated?
Treatment of uterine fibroid may be conservative, surgical and combined (conservative + surgical). The choice of way of treatment is determined for sizes and number of nodules as well as the level of manifestation of symptoms.
Gonadotropin-releasing hormone (GnRH) agonists) suppress secretion of hormones of the pituitary gland. As result, the level of estrogens is decreased in blood. In its turn, it causes reducing sizes of fibroid nodules.
Ulipristal is an agent from the group of selective progesterone receptor modulators. It suppresses susceptibility to progesterone that contributes to growth of fibroid nodules.
Mifepristone is an agent of the same group. Recently many researches have proves its high efficiency for treatment of uterine fibroids. In respect of broadly used before oral contraceptives and progestins (synthetic version of progesterone) clinical researches have not only demonstrated absence of medical efficiency for uterine fibroid but also they have accelerated growth of nodules (for example, Duphaston).
Until recently hysterectomy (removal of the uterus) and conservative myomectomy (surgical removal of fibroid nodule) have been the only methods of treatment of uterine fibroids. Currently more modern, minimally traumatic and highly-efficient methods have been developed for removal of fibroid nodules.
Laparoscopy is applied for removal of subserosal (subperitoneal) nodules. In the course of such operations a number of punctures are made in the abdomen, and through such punctures the instruments that are necessary for removal of uterine fibroid are introduced. Hysteroresectoscopy is applied for removal of submucous (under mucous) nodules. In such case instruments are introduced without incisions: through the vagina and the uterus.
Uterine artery embolization is a modern method of treatment of uterine fibroid when blood flow in the uterine arteries supplying fibroid is occluded. For this purpose a puncture is made in the femoral artery, and then a catheter is introduced, through such a puncture. Using the catheter polymeric spheres (the embolizing agents) blocking the vascular supply are led to the necessary uterine artery. As result, uterine fibroid shrinks after a number of days or weeks. It is a minimally invasive procedure that needs no narcosis (only slight sedation) and allows preserving the uterus so it preserves reproductive female function.
FUS-ablation of myoma is heating and further destruction of uterine fibroid with focused ultrasound (FUS). It is a relatively new method, but its efficiency has already been proved. It is almost painless procedure with short period of recovery. If it is found that you have uterine fibroid it is important to obtain comprehensive information about its possible course and methods of treatment. Highly-qualified specialists of our Clinic inform you about the most modern achievements of global medical practice and help you to choose the most appropriate treatment of uterine fibroid.