Treatment of uterine fibroids

Uterine fibroids are benign grows formed in the muscle and connective tissues. The disease is also called leiomyomas or myomas. Uterine fibroids range in size. Some myomas are several millimeters in size, and other ones are up to tens of centimeters. Leiomyomas are usually without any symptoms.

As a rule, myoma is found during a planned visit to a gynecologist. A patient with suspected uterine fibroids should undergo comprehensive medical diagnostics and receive an optimal treatment program.

For the treatment of myoma, the specialists use drug therapy and modern non-invasive methods. In some cases, the doctors prescribe laparoscopic or cavitary operations to remove the myoma or the entire uterus.

Treatment method

Description

Advantages

Disadvantages

Hormone therapy

It leads to myoma node reducing. The doctors use this method as the independent type of treatment or to prepare a patient for surgery.

Does not require surgical intervention and special medical procedures.

Causes hormonal disorders and premature menopause. After stopping the treatment, myoma begins to overgrow.

FUS ablation

Under the influence of focused ultrasound, myoma tissues warm up and die off.

Allows to preserve the childbearing function, does not require hospitalization and anesthesia.

The development of new myomas and burn the surrounding tissues are possible.

Uterine artery embolization (UAE)

With the help of a particular substance, the flow of blood to the tumor is blocked.

Does not require surgical intervention and long-term rehabilitation. Allows saving childbearing function.

Can bring on severe pain. There is a risk of blocking nearby arteries.

Myomectomy (laparoscopic, hysteroscopic)

Removal of myoma is performed through several abdominal wall punctures or the vagina.

Minimally invasive method of uterine fibroids removal. Allows to save the uterus.

Not suitable for the removal of multiple myomas and with a specific localization of the tumor.

Abdominal myomectomy

Removal of myoma through a large incision in the abdominal cavity.

Allows to remove several myoma nodes at once and to operate concomitant pathologies.

During pregnancy, a patient requires increased attention due to the risk of disruption.

Hysterectomy

Uterus removal

There is no risk of re-development of the disease.

Hormonal disorders, the inability to become pregnant.

The choice of the appropriate treatment method depends not only on the results of the examination, which shows the localization and size of the tumor but also on a patient's age. Particular attention is paid to the desire of women to have children in the future.

Treatment of uterine fibroids during pregnancy

Most of the treatment methods of myomas are based on preserving the uterus to let a woman become a mother. But in some cases, uterine fibroids are found during the pregnancy.

50% of women diagnosed with myoma face the possible miscarriage. In this case, the tumor is not the reason for immediate termination of pregnancy.

Nodes of small size do not affect the fetus. Examination of an obstetrician-gynecologist and following all the prescriptions are enough in this case.

According to symptoms, a doctor prescribes such drugs as:

  • antispasmodics to reduce pain;
  • antiaggregants to improve blood circulation;
  • hormonal drugs to threat of miscarriage.

Indication for myomectomy during pregnancy is necrosis of the myomatous node. In case of early surgical intervention, the risk for a patient to completely lose the uterus increases.

Specialists perform removal of myoma during cesarean section in such cases:

  • nodules on the leg growing in the abdominal cavity;
  • middle or large myoma (over 6 cm in size);
  • single nodes.
Treatment of uterine fibroids during pregnancy involves the elimination of symptoms and inhibition of tumor development. Active therapy begins immediately after delivery.

Treatment of uterine fibroids at different ages of women

For treatment of myomas in women of childbearing age the following methods are applied:

  • hormone therapy;
  • symptomatic treatment;
  • non-invasive methods of tumor removal (embolization of uterine arteries, FUS ablation);
  • myomectomy.

The primary goal of the treatment is to preserve the childbearing function. Complete removal of the uterus is only used in cases of severe complications, multiple tumors, and extensive necrosis development.

For treatment of uterine fibroids in girls under 17 years, old doctors carry out myomectomy using minimally invasive methods and oral contraceptives at a low dosage. Removal of myoma is performed only in cases of the rapid development of the tumor.

If the myoma nodes do not decrease with the onset of menopause, a woman is offered a hysterectomy. Complete removal of the uterus eliminates the threat of severe bleeding and anemia. If a patient wants to retain the organ, it is also possible to perform FUS ablation and artery embolization.

Treatment options of myomas of different sizes

Due to the size benign tumors in the uterus are divided into:

  • Small myomas look like the fetus on 4-5 weeks of pregnancy (up to 2 cm);

Such uterine fibroids do not have symptoms and do not require treatment. A woman should visit a gynecologist and undergo ultrasound diagnostics 6 times a year.

  • Medium myomas look like the fetus on 5-11 weeks of pregnancy (up to 6 cm);

At this stage of the disease development, a doctor may prescribe the hormonal drugs. Uterine artery embolization and FUS ablation are also performed. If the tumor grows, a minimally invasive myomectomy is prescribed.

  • Large myomas can reach a size of 12 weeks fetus.

A large tumor has such signs as heavy bleeding and severe pain. A woman's stomach is enlarged, and the bladder is disrupted.

The only way to treat such a myoma is surgery. Depending on the degree of the uterus damage, organ-preserving myomectomy or complete removal of the uterus is used.