Uterine fibroids


Uterine fibroids – a diagnosis with which to face life for 40% of women. Many patients will suffer for years from pelvic pain, heavy menstrual periods and infertility, but did not receive adequate treatment. When symptomatic agents will no longer help, the gynecologist will suggest hysterectomy, excision to remove the uterus. The woman agreed, not knowing that gynecologists and endovascular surgeons have developed a unique method that allows you to not only get rid of the existing fibroids, but also prevent the development of new ones.

Cause and effect

The uterus is a non-pregnant woman is a hollow organ about the size of a pear. Its wall consists of three layers: the outer formed connective tissue, middle, smooth muscle and internal mucous. Under certain conditions, the middle layer (or as it is called, myometrium) can proliferate, which leads to the formation of fibroids or myomas.

Today it is considered proven that fibroids are caused by hormonal disorders: disorders of synthesis of estrogen, estrone and estriol imbalance in the various phases of the cycle, as well as under the influence of progesterone. May play a role, and chronic infectious diseases or genetic predisposition.

No matter what the impetus for the development of the disease, with the growth of myoma node (or an increase in the number of nodes), the patient is likely to begin to disturb heavy menstrual bleeding and the consequent anemia.

In advanced cases, patients complain of a feeling of heaviness in the abdomen and urinary disorders and bowel – growing, fibroid compresses adjacent organs, which leads to the development of unpleasant symptoms. But that’s not all fibroids often hinders the consolidation of the ovum in the uterus or lead to abortion, thus becoming the cause of infertility.

Waiting can not be treated

Since uterine fibroids is a very common gynecological diseases, all over the world are actively developing new methods to combat it. However, some Russian doctors still prefer to use in their work protocols and algorithms, formed when the idea of the development of fibroids were rather vague. Unfortunately, until now the most common tactics of patients with myoma is expectant. In fact, the doctor offers simply take no action until such time as the patient does not need surgical treatment – myomectomy (removal of knots) or hysterectomy (removal of the uterus entirely). If the first of these operations often leads to inability to have children, the latter by definition causes irreversible infertility. Nevertheless, and myomectomy, and hysterectomy continue to offer even young nulliparous women.

Also to combat fibroids often used hormone drugs. It should, however, bear in mind that their effectiveness is quite limited: the derivatives 19-norsteroidov (Norkolut, Primolyut Nord, Norethisterone, Orgametril, Gestrinone, Nemestran) work only if the myoma node size is relatively small, antigonadotropiny (Danazol, Gestrinone) and GnRH agonists (Zoladex, Diferelin, Buserelin) can significantly reduce the size of fibroids, but the effect of their temporary admission, shortly after the end of treatment the growth nodes resumes.

An effective and safe alternative to hormonal and surgical treatment of uterine fibroids is uterine artery embolization procedure (EMA). It is carried out as follows: the doctor inserts into the blood vessels that feed the fibroids, a special substance. clogged vessels and nodes gradually “wither.” EMA is not a surgical operation in the conventional sense of the word, it is performed under local anesthesia through a single puncture in the femoral artery, and rarely takes more than 20 minutes. does not affect the arteries that feed the healthy tissue of the uterus, uterine artery embolization, because the lumen of these vessels is much narrower, and embolic particles in them are simply not “crawls”.

After EMA fibroids, deprived of blood supply, replaced by connective tissue, dry out, and never do not grow and do not produce symptoms. At the same time for the UAE it is required to spend only one day to the hospital.

The history of the emergence of this technique. Initially EMA is used to prevent bleeding that arose after surgery on the uterus, including – about fibroids. But at some point, experts have noticed that after the EMA myomectomy is usually not necessary – components disappear by themselves. And, more importantly, almost never returned – uterine artery embolization has been extremely reliable approach in terms of relapse prevention.

Severity of symptoms plaguing a woman usually diminishes within the first week after the UAE. And most importantly, in contrast to the “big” surgery, embolization leaves the patient the opportunity to have children.