Myoma of the uterus

Myoma of the uterus is a benign tumor that originates from the smooth muscle tissue of the uterus. The development of the tumor is associated with abnormalities in the hypothalamic-pituitary region and increased production of estrogens. There are interstitial, subserous and submucous uterine myomas. Nodules can be located in the body (95%) and neck (5%) of the uterus.

Symptoms, course. Usually occurs in women older than 30 years. The disease is manifested by cyclic bleeding (menorrhagia), against which acyclical uterine bleeding (metrorrhagia) is often observed, caused by the development of a submucosal node or a combination of a tumor with dysfunctional uterine bleeding. If the tumor grows in the direction of the bladder and rectum, then there are symptoms of depression of these organs. Tumor growth is relatively slow. Palpation is painless, the tumor is dense, tuberous.

Complications: torsion of the legs of the subserous node, necrosis of the node (usually interstitial and submucous), hemorrhage. When the tumor legs are twisted, a picture of the acute abdomen arises. Necrosis is characterized by abdominal pain, fever, chills, tenderness and softening of the knot. If suspected of submucosal location of the node, uterine probing, hysteroscopy and hysterosalpingography are used. Differential diagnosis is performed with uterine sarcoma, cystoma and ovarian fibroids. To differentiate the uterus tumor from an ovarian tumor, the cervix should be moved with the help of superimposed bullet forceps: if the tumor originates from the uterus, then it follows the movement of the cervix.

Treatment depends on the patient's age, tumor growth rate, symptom severity, site localization and the presence of complications. Women with small tumors (up to "12 weeks gestation") without bleeding need a systematic examination by a gynecologist. Conservative therapy is indicated for small tumors and moderate menorrhagia. Apply drugs that reduce the uterus (cotarnine chloride, methylergometrine, calcium chloride, pituitrin). Carry out hormone therapy: at a young age, progesterone or combined estrogenogestagens. In the second phase of the menstrual cycle (see Bleeding uterine dysfunctional) after 45 years, androgens are prescribed: methyltestosterone 5 mg under the tongue 3-4 times a day for 12-14 days, on the 24-26 day of the cycle of cotarnine chloride at 0.05 G 3 times a day. The treatment course is repeated 5-6 times. Indications for surgical treatment: rapid tumor growth; Abundant uterine bleeding leading to anemia; Symptoms of compression of adjacent organs; Submucous myoma; Myoma of the cervix; Necrosis of the tumor node; Torsion of the knot. The operation can be palliative (nodulation) or radical (amputation or extirpation of the uterus).