Uterine fibroid.
Uterine fibroids, or fibromyoma (leiomyoma), are benign tumors that develop in the muscular layer of the uterus. They are among the most common gynecological conditions in women, accounting for approximately 12–25% of all gynecological diseases.
Uterine fibroids usually appear as rounded nodules located within the uterine tissue.
Causes of Uterine Fibroids
Hereditary predisposition;
Diabetes, obesity, and endocrine disorders;
Inflammatory diseases of the reproductive system;
Intrauterine procedures — infected abortions, dilation and curettage of the uterine cavity.
Symptoms of Uterine Fibroids
Uterine fibroids are most often asymptomatic and are discovered incidentally during an ultrasound examination. Symptoms may develop when the fibroid nodules become large and may include:
Painful, heavy, and prolonged menstruation that may lead to anemia;
Pain during sexual intercourse;
Frequent urination or constipation;
Infertility;
Spontaneous miscarriages.
Diagnosis
The simplest method for diagnosing uterine fibroids is pelvic ultrasound, which usually provides a clear assessment of both the size and location of the fibroid nodules. More complex and expensive diagnostic methods, such as MRI, are generally used only in diagnostically challenging cases.
Treatment
Treatment depends on the size and location of the fibroid nodules; however, the condition should not be left without appropriate medical monitoring and management.
- Small nodules (0.5–1.5 cm): combined oral contraceptives;
- Medium-sized nodules (1.5–3.0 cm):
— Medical therapy: selective progesterone receptor modulators; GnRH agonists;
— Surgical treatment: laparoscopy, conservative myomectomy.
- Large nodules (over 4.0 cm):
— Surgical treatment: laparotomy, conservative myomectomy with layered suturing.
- Submucosal nodules of any size require surgical treatment: hysteroscopic resection with removal of the nodules using a “cold” or “hot” technique.
*Preoperative medical therapy remains a matter of debate.