A broad-based node on the fundus of the uterus. Interstitial and intramural myomatous nodes. Traditional medicine

Content

According to clinical studies, uterine fibroids are diagnosed in 85% of women. This fact allows us to classify this pathology as one of the most common diseases of the female genital area.

Uterine fibroids are called hormone-dependent tumors that grow in the muscle layer of the anterior or posterior wall of the uterus. The disease is typical for women 30-45 years old.

Myoma is located in various parts of the uterine wall. It can have both nodular and diffuse forms. Most tumor-like formations are located in the uterine body in the form of nodes, for example, along the anterior wall. Only 5% of myomatous nodes are localized in the cervical part.

Many women, having heard about subserous nodes, are interested in what it is.

Uterine fibroids located outside under its serous membrane, it is subserous.

Subserous nodes of the uterus form on the surface of the organ and progress towards the pelvic cavity.

Subserous nodes can grow:

on a leg;
on a wide base.

Subserous nodes are often multiple in nature. According to their size, neoplasms can be:

small;
average;
big.

Typically, the subserous node grows within five years to a size determined by instrumental methods. However, under the influence of negative factors, rapid growth in education can be observed.

The volume of uterine fibroids, in particular of the subserous type, is determined by gynecologists in weeks of pregnancy.

Reasons for appearance

It is believed that the growth of subserous uterine fibroids is due to hormonal imbalances. Among the factors provoking the disease are also:

surgical interventions in the woman’s history;
genetic predisposition;
inflammatory diseases of the genital organs;
long-term use of COCs;
pathologies of the thyroid gland and adrenal glands;
stress;
absence of pregnancy, childbirth and lactation up to 30 years.

Experts distinguish several stages of the formation of subserous uterine fibroids.

There is active growth of a tumor from the smooth muscle elements of small blood vessels, characterized by increased permeability of the vascular wall.
The stage of rapid progression of fibroids, which can only be determined microscopically.
A subserous myomatous node can be diagnosed during an examination by a gynecologist.

As a result of hormonal fluctuations Excessive proliferation of smooth muscle cells or their excessive reproduction occurs.

During histological examination, deformed cells are detected, while the connective tissue remains unchanged.

Kinds

The pathology has several clinical forms. Experts classify subserous nodes as:

leiomyoma, consisting of smooth muscle cells;
fibroids, including a significant amount of connective tissue;
bizarre leiomyoma, in which giant cells with large nuclei are identified;
epithelioid cell leiomyoma with unclear boundaries;
leiomyolipoma, characterized by the content of fat cells.

Subserous nodes may differ in different localization.

Intramurally located. Intramural subserous tumors develop externally and are relatively harmless. Neoplasms localized intramurally do not lead to uterine deformation. It is believed that intramural subserous nodes also do not cause infertility.
Interstitial-subserous. Nodes located interstitially form inside the anterior or posterior wall of the uterus. The formations differ in their development into the pelvic area and are mixed. As a rule, this pathology leads to an increase in the uterine body. In this case, a large node on the anterior or posterior wall of the uterus can negatively affect neighboring organs.

Interstitial subserous nodes, for example, of the anterior wall of the uterus, often become the cause of surgical interventions. While intramural fibroids have a more favorable prognosis.

Clinical picture and complications during the development of subserous nodes in the uterus

Subserous nodes, which are often located intramural along the anterior wall, mostly progress without symptoms.

However, when the uterine tumor reaches a significant volume, a compression effect occurs, aimed at the tissue surrounding the tumor. As a result, various disorders occur in the internal organs located in the pelvis.

Gynecologists name several symptoms characteristic of subserous nodes, including those that form intramurally along the anterior wall of the uterus.

Changes affecting the nature of menstruation. A woman may notice an increase in the amount of bloody discharge, as well as a lengthening of the duration of her critical days.
Acyclic bleeding. With benign uterine pathology, the contractile function of the organ is impaired, which causes intense bleeding. Over time, constant blood loss often causes anemia.
Constant urge to urinate. Disorders associated with the function of the excretory system arise due to compression of the bladder, since it is located anterior to the uterus and a large uterine formation.
Pain of varying intensity. Pain sensations depend on the location of the formation. When the tumor is located intramural along the anterior wall, pain occurs only with large nodes. In this case, the pain may be localized above the pubis or lower back. Many women note that pain often occurs after intense physical activity or during menstrual periods.
Infertility and miscarriage. This sign is characteristic of the serous-interstitial type of pathology.

Long-term developing subserous nodes of the uterus can lead to various complications:

torsion of the leg of the knot;
tumor necrosis;
purulent-inflammatory processes.

With torsion of the leg and subsequent necrosis, symptoms of an “acute abdomen” appear, which are accompanied by severe pain, loss of consciousness, drop in pressure, and vomiting. !!! This complication requires immediate surgical intervention.

Diagnostic and treatment methods

It is worth noting that such a formation as the uterus requires mandatory observation and treatment. Most benign neoplasms occur latently, which indicates the need for timely diagnosis.

The disease can be suspected during a gynecological examination. Using palpation, an experienced doctor identifies a spherical enlarged uterus and palpates large formations. To confirm the diagnosis, instrumental research methods are necessary:

gynecological ultrasound;
laparoscopy.
diagnostic hysteroscopy.

The main way to diagnose the disease is gynecological ultrasound. When prescribing therapy, hormonal testing may be required.

Treatment of the disease is determined by the growth rate, size and type of tumor. The age of the patient, as well as her reproductive plans, are of significant importance when choosing treatment tactics.

For small volumes of fibroids, some doctors use a wait-and-see approach. However, this approach can lead to further progression of the disease.

The gold standard in the treatment of uterine fibroids is a combination of medical and surgical tactics. Drug therapy is advisable for fibroids for up to 12 weeks in the absence of severe symptoms. As part of conservative or drug therapy, the patient is recommended the following hormonal drugs:

antigonadotropins;
gonadotropin releasing hormone agonists.

Conservative tactics also involve the use of anti-inflammatory and hemostatic agents. The goal of the drug technique is to stabilize the growth of uterine fibroids and reduce its clinical manifestations.

The main method of treating uterine fibroids, in particular those localized intramurally along the anterior wall, is to remove them using various surgical techniques.

Indications for surgical treatment are:

rapid progression of fibroids;
cancer alertness;
neoplasms exceeding 12 weeks;
frequent bleeding;
intense pain.

Surgical intervention is performed using the following methods:

organ-preserving treatment through laparotomy and laparoscopic myomectomy, UAE and FUS ablation;
radical surgery using hysterectomy or extirpation of the uterine body.

Despite the benign nature of subserous uterine fibroids, it requires competent diagnosis and subsequent adequate treatment.

A disease such as fibroids is diagnosed quite often; one of its most common forms is when the myomatous node is located on the anterior wall of the uterus. As a rule, for most women this feature of the disease means practically nothing, however, it is extremely important to distinguish between the types of nodes and their locations. This is necessary in order to know what exactly can be expected from a particular form of the disease. That is why we will consider in detail the features of the location of the seal on the anterior wall of the uterus.

What does fibroid mean for a woman?

This disease is one of the most common; the frequency of its diagnosis in middle-aged women is approximately 5 cases per 100 people. Very often, the form of the disease that involves the appearance of formations in the body of the uterus is diagnosed. But sometimes formations are diagnosed in the neck of the organ.

For quite a long time, middle-aged women were considered the main risk group for developing this disease. But recently the frequency of its diagnosis in younger women has increased by 20%.

The disease itself can be characterized as the formation and development of a benign tumor. Many experts believe that its appearance is associated with the influence of hormones, namely excess estrogen.

Causes

Most experts think that it is excess estrogen that provokes the appearance of fibroids. But some also believe that it can occur due to a hereditary predisposition.
In addition, scientists were additionally able to establish a number of factors that may affect its appearance:

Artificial termination of pregnancy.
Mechanical influence.
Development of gynecological diseases.
Unbalanced diet.
Excess body weight.
Psychological factors.
Diseases of the cardiovascular system.

Signs

Most women who have had this disease note that uterine fibroids go away without any special symptoms. However, the development of such a disease as fibroids can be determined by certain signs:

Problematic menstruation.
Pain in the lower abdomen.
Pain during sexual intercourse.
Pain in the lumbar region.
Urinary disorders.
Infertility.

For successful treatment, it is very important to diagnose the disease at the initial stages of its development, so if you find signs that may indicate its formation, you need to seek advice from a specialist.

This disease has several forms in which it can manifest itself; most often, experts subdivide them depending on their location:

Subserous type. This type is characterized by the fact that the seal can be in several places at the same time. As a rule, it is found on the outer surface and under the shell.
Submucosal type. The seals characteristic of this type are located under the mucous membrane of the uterus.
Interstitial type. It is characterized by the appearance of a fairly large compaction in the muscle layer.
On a leg. This type is one of the most specific. Characteristic seals grow on a narrow base. This type of fibroid occurs quite rarely; the reasons for its occurrence are completely unknown. Most often treated by removal.

Most often, during diagnosis, not one, but several seals are discovered. This type of disease is called multiple uterine fibroids.

Most cases of diagnosis of this disease involve multiple manifestations of nodes. Eliminating this type of disease is more difficult than a single node.

When can a node grow in the uterus?

The form of the disease, which implies the location of the compaction in the organ, is called subserous. This type of disease is also called nodular uterine fibroids.

It is characterized by the fact that the node can be located on two types of bases - thick and thin. As a rule, if a node is located on a wide base, then most often it quickly grows and begins to compress neighboring organs. At the same time, the knot located on a thin leg may begin to twist, thereby stopping the power supply. However, with insufficient blood supply to the node, necrosis develops, which leads to a number of serious complications.

As a rule, fibroids of this type can develop for quite a long time and during this entire period practically do not make themselves felt. Most often, they are diagnosed when a woman develops quite serious complications due to their development.

What do the nodes located on the front wall lead to?

Depending on the location of the seal, its effect on the body varies. As a rule, if the node is located on the front wall, then its enlargement can lead to:

Compression of the bladder.
The occurrence of problems with the ureters.
Having problems with urination.
Development of pyelonephritis.
Impaired kidney function.

If the knot on the front wall was fastened using a narrow base, it may become twisted.

As a rule, uterine fibroids with this complication are accompanied by quite severe pain. With this development of events, the woman will most likely be prescribed surgery to remove the tumor.

If a node of significant size is located on the posterior wall of the organ, then its enlargement can lead to:

Compression of the rectum.
Development of constipation.

How is the disease diagnosed?

Most often, this disease is detected during a gynecological examination. If a specialist suspects its occurrence, he may prescribe additional tests, including:

Ultrasound diagnostics.
Magnetic resonance therapy.
Hysteroscopy.
Laparoscopy.

Completing additional studies allows you to make the diagnosis as accurately as possible and determine the size and location of the seals.

How can you help yourself?

First of all, if you have been diagnosed with this disease, you should take certain measures.

It is best to immediately determine the optimal diet for yourself. It is worth excluding spicy, salty and smoked dishes from the menu. It is also necessary to strictly control the level of carbohydrates and fats.

During the treatment of the disease, you should abandon any procedures associated with thermal exposure. As a rule, visits to baths, saunas and solariums are excluded.

Also, in order not to provoke an increase in compaction, it is necessary to temporarily abandon various types of physical procedures. This applies even to those cases where massage is necessary to treat other diseases.

In addition, as prescribed by a doctor, it is possible to use drugs to normalize hormonal levels. Very often, specialists prescribe monophasic estrogen or hormonal contraceptives. Taking this kind of medicine is aimed at preventing the increase in compactions and their malignancy.

When is treatment with medication possible?

Most often, treatment with medications leads to the tumor becoming thicker and the blood flow in it decreasing. This factor, in turn, helps to reduce its size. When the initial size of the tumor was insignificant, such exposure can significantly improve the woman’s condition and reduce the symptoms. However, it is worth noting that treatment with medications is only possible under the supervision of a doctor.

If the tumor is large enough, then most likely the specialist will insist on its removal.

In this case, medication may be prescribed to reduce the risk of heavy blood loss during surgery and to prevent complications. In addition, certain medications may be used to prepare for surgery.

In what cases is surgery necessary?

The specialist will prescribe surgery without fail if the disease threatens the woman’s life or can cause serious complications.

As a rule, a specialist determines the type of operation, taking into account various factors. Most often, preference is given to minimally invasive intervention methods that help maintain the health of the uterus.

To summarize, we can say that uterine fibroids are becoming more common every year. A fairly large number of factors lead to its development, among which hereditary predisposition and changes in hormonal levels can be particularly highlighted.

In total, experts distinguish 4 forms of the disease. They are usually distinguished based on where the node is located. Most often, women suffering from the development of this disease are diagnosed with the subserous form.

With this form, the seals grow into the uterine cavity. Very often, the development of compactions on the anterior wall of the organ is detected. When significantly enlarged, nodes located in this area can lead to bladder problems. This form of the disease can be diagnosed during a routine visit to the gynecologist. As a rule, if the formation of this disease is suspected, a specialist will prescribe additional studies to clarify the diagnosis. Depending on the size of the lumps and the woman’s condition, the specialist will choose the optimal form of treatment. Most often, treatment takes place in a conservative form, however, if the compaction is large or it affects the organs, then most likely the treatment will be surgical. The form of such intervention is determined in agreement with the woman and taking into account the characteristics of the disease. Timely consultation with a doctor and proper treatment will help maintain health.

Uterine fibroids are a benign formation of smooth muscle, chaotically intertwined fibers, accounting for up to 25% of all diseases of the female genital area. The most common type is interstitial fibroid of the muscular layer of the uterus. About 35% of all diagnosed formations are subserous, submucosal is less common, and very rarely - fibroids in the interligamentous space, the cervical area. Smooth muscle formations can develop in single or multiple nodes; multiple nodules are more often diagnosed.

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The disease is getting younger every year - it is found in young women, and there are cases of fibroids being detected in girls. Most often, myomatous nodes are diagnosed in women over 35 years of age, as well as in menopause. The menopausal period is characterized by hormonal changes, during which the balance of hormones is disrupted, which becomes one of the reasons for the growth of smooth muscle nodes of the uterine wall.

Factors that influence the development of the disease include frequent abortions, injuries to the walls of the uterus, surgeries on the reproductive organ, diseases of the genital organs, endocrine system and other factors. The real reason for the development of smooth muscle nodes has not yet been studied. Often the disease has a hereditary predisposition when it occurs in several women of the same family.

To inform women about methods of diagnosing and treating fibroids, an expert council of doctors was created who devoted themselves to studying and developing methods for treating the disease while preserving the reproductive organ. Women with fibroids can turn to expert advice and get advice; doctors will answer all questions during.

Nodes in the body of the uterus

A healthy female reproductive organ is about 9-11 cm in length in women who have given birth, the uterus is 4 to 5 cm wide. The reproductive organ has three layers - peritoneal (serous), muscular (myometrium), mucous (endometrium). The nodes in the body of the uterus consist of muscle and connective tissue. The nodes of the muscular layer of the uterus are named depending on their location:

Developing in the myometrium are the interstitial nodes of the uterus.
Formations growing towards the endometrium are submucosal (submucosal) nodes.
Smooth muscle formations growing towards the abdominal cavity are called subserous fibroids.
Between the leaves of the broad ligament of the uterus there are intraligamentary nodes.

The most common formations are the muscular wall (body) of the uterus, less often the cervix.

What is fibroid: subserous node

Subserous fibroid is a benign formation that has formed in the muscle layer and grows towards the abdominal cavity. It can be located on a wide base or a thin leg. The development of smooth muscle subserous formation at the initial stage is asymptomatic, with its growth the first signs appear - pain in the lower abdomen, often radiating to the rectum, vagina, and lower back. The most pronounced pain symptom is with a subserous node on a wide base. Single subserous formations are located in a dense capsule, which separates them from the surrounding tissues.

Subserous formation can be of several types:

Fibroid - consists of muscle fibers and a large amount of connective tissue.
Leiomyoma is bizarre - histological examination reveals giant cells with several large nuclei.
Leiomyoma - formation consists of smooth muscle cells.
Leiomyoblastoma - the boundaries of the formation are unclear, the cells of the nodes have band-forming, light eosinophilic cytoplasm.
Leiomyolipoma – degeneration processes occur in the nodular formation and mature fat cells appear.

Reasons for development

The reasons for the development of a subserous node are not fully understood; factors that influence its appearance and growth are known. Fibroids are sensitive to hormones - modified smooth muscle fibers have more receptors sensitive to the effects of hormones than healthy myometrium. The effect of steroid hormones on nodular formations leads to their rapid growth. Hormonal disruptions and imbalance of hormones are observed during pregnancy, menopause, and in obese women. Various factors contribute to the appearance and growth of nodes:

Diagnostic curettage, abortion, difficult childbirth.
Hereditary predisposition.
Chronic inflammatory processes in the female genital organs.
Ovarian diseases.
Diseases of the endocrine system.
Infertility.

The stage of development of the disease is determined by the size of the uterine node:

Small – 20 (mm).
Average – from 20 to 60 (mm).
Large – from 60 (mm) and more.

Uterine fibroids are also described in weeks of pregnancy - the size of the uterus corresponds to a specific week of pregnancy.

Subserous node on the anterior and posterior wall of the uterus

A growing subserous node along the anterior wall of the uterus can lead to the development of problems with urination, compression of the ureter, the development of kidney diseases (pyelonephritis), and impaired renal and bladder function. Growing subserous fibroids on the back wall of the uterus compresses the intestines, blood circulation in the intestines is disrupted, and constipation occurs.

Subserous node on a pedicle in the uterus

Subserous formation is often located not on a wide base, but on a thin stalk. The pedicle can be long and thin; the subserous node on the pedicle is located in the abdominal cavity. This arrangement is very dangerous - torsion of the leg or its injury can cause tissue necrosis of the myomatous formation and the development of complications. The patient develops a high temperature, severe abdominal pain, weakness, and as her condition worsens, the patient loses consciousness. The situation becomes dangerous for the health and life of the woman.

Diagnostics

If symptoms of fibroids appear, you should immediately undergo a diagnosis of the disease by a gynecologist. Subserous fibroids often cause pain while walking, pain and discomfort during sexual intercourse, the ability of the myometrium to contract is impaired, and menstruation becomes heavy and painful. Early diagnosis will preserve reproductive function and reduce the risk of complications. Small fibroids respond better to treatment than large fibroids.

Diagnosis of the disease begins with an examination by a gynecologist. During the examination, the doctor determines the condition of the uterus, the presence of deformation of the organ, and its size. Changes in contours, size, and pain during examination become the reason for prescribing diagnostic studies. To diagnose the disease, they are referred for ultrasound, MRI or CT, and various tests. Additionally, laparoscopy or hysteroscopy may be prescribed to examine the tissues of the formation.

Histological examination will determine the type of fibroid. Due to malnutrition, the subserous node has areas of necrosis, mucoid and myxomatous degeneration, hyalinosis, hemorrhages, and calcification. An ultrasound will help determine the location of the fibroid, its size, tissue structure, the condition of the organs and tissues located next to the fibroid. Magnetic resonance imaging serves to clarify the nature of the formation and helps determine the benign or malignant nature of the formation.

Subserous myomatous node of the uterus: complications

The growth of subserous formation can lead to various complications. One of the complications is torsion of the pedicle of the subserous node, causing tissue necrosis and the development of an inflammatory process. A growing subserous node can compress neighboring organs and disrupt the blood circulation of tissues - this leads to the development of congestion in the bladder and intestines. A large formation can deform the uterus, cause the organ to bend, and the position of the uterus will prevent conception. The fusion of myomatous formation with the peritoneum causes severe pain during movement and physical activity. When the capsule of the subserous node ruptures, the contents enter the abdominal cavity and peritonitis develops, which can be fatal if assistance is not provided in a timely manner.

Subserous node in the uterus: to operate or not

There are certain indications for surgical treatment - large size of fibroids, torsion of the node, peritonitis, various complications requiring immediate surgical intervention. Whether to operate or not to operate on fibroids can only be answered by a doctor who will be guided by the individual characteristics of the patient’s body, her state of health, and the size of the fibroids.

Subserous node of the uterus and pregnancy

This type of formation rarely affects conception and pregnancy; the course of pregnancy depends on the size and location of the node. If there is a large node, it is recommended to remove it before planning a pregnancy.

Uterine fibroids, subserous node: treatment

When prescribing treatment, the doctor is guided by the patient’s age, the size of the formation, its location, the general condition of the patient, and the presence of concomitant diseases. The woman is undergoing tests for endometriosis, tumors of the uterine appendages, cancer of the mucous layer of the uterus - the endometrium. Drug therapy is not prescribed: in the presence of large nodules, prolonged and heavy bleeding, or rapid growth of the nodule. Young women with small nodules are prescribed oral contraceptives, the Mirena spiral with hormonal content is recommended, and hormonal therapy is carried out.

Treatment of fibroids is carried out using organ-preserving methods and radical surgery (removal of the reproductive organ), when the uterus is significantly deformed, the fibroid nodes are huge, and the course of the disease is complicated.

Organ-preserving techniques include uterine artery embolization (UAE). Embolization of the uterine arteries allows the treatment of all myomatous nodes during one procedure, does not require the use of general anesthesia, and the procedure is bloodless and painless. The doctor performs UAE through a puncture of the femoral artery, observing the passage of special microbeads - emboli - into the vessels of the fibroids. Together with emboli, a contrast agent is used, which helps to observe the entire process of movement of polymer particles through the vessels, blocking of the vessels of the nodular formation. Complete destruction of the nodes occurs within several months. After the procedure performed by an experienced specialist, a woman can plan a pregnancy.

Treatment of fibroids should be carried out in modern, specializing in the treatment of the disease, using a variety of treatment methods, including the most modern techniques.

Bibliography

Lipsky A. A.,. Gynecology // Encyclopedic Dictionary of Brockhaus and Efron: in 86 volumes (82 volumes and 4 additional). - St. Petersburg. 1890-1907.
Bodyazhina, V.I. Textbook of gynecology / V.I. Bodyazhina, K.N. Zhmakin. - M.: State Publishing House of Medical Literature, 2010. - 368 p.
Braude, I. L. Operative gynecology / I. L. Braude. - M.: State Publishing House of Medical Literature, 2008. - 728 p.

Most women are frightened by the “terrible” diagnosis – subserous uterine fibroids. Surgery to remove the uterus seems inevitable to them, and therefore infertility is inevitable. Is this really so and is it worth panicking? In order to understand this issue, it is necessary to have an understanding of what fibroids are, why they occur, and what treatment methods currently exist.

Please note that this text was prepared without the support of our website.

General information about uterine fibroids

The development of uterine fibroids is caused by impaired regulation of myometrial cell growth. The formation of myomatous nodes is most often associated with hormonal imbalances in a woman’s body and damage to uterine tissue.

Hormonal disorders that provoke the development of a tumor can affect both the reproductive system and the endocrine sphere. Thus, decreased thyroid function (hypothyroidism) and obesity lead to increased estrogen levels, which, in turn, is a predisposing factor in the occurrence of fibroids.

The regulation of cell growth can be disrupted due to damage to smooth muscle cells, which often happens during curettage of the uterine cavity, abortion, inflammatory processes in the uterus and long-term use of intrauterine contraceptives. In addition, the development of a tumor may be due to hereditary predisposition, unfavorable environmental situation, frequent stress and decreased immunity, which increases the body's susceptibility to damaging agents.

Myoma nodes can be single or multiple, their sizes can be several millimeters and tens of centimeters. Myomatous formations are localized mainly in the body of the uterus; in some cases, the disease affects the cervix of the organ and its ligamentous apparatus.

Prevalence of the disease

Uterine fibroids are the most common benign tumor of the female genital area. Most often, the disease is diagnosed in women aged 30 to 48 years.

There are also cases where myomatous nodes were found in younger women, under the age of 20 years.

Localization of uterine fibroids

Fibroids can affect different parts of the uterus. The following localizations are considered the most common:

subserous - begins development from the outer part of the uterus and continues to grow outward into the pelvic cavity. This type of pathology, as a rule, does not lead to disruption of the menstrual cycle, but can cause some discomfort associated with its size and compression of surrounding tissues by the knot.
intramural - grows in the middle muscular layer of the uterus and leads to a significant increase in its size, the appearance of pain and a feeling of pressure in the pelvis, and also disrupts the menstrual cycle. This type of tumor is the most common;
submucous (submucosal) uterine fibroids - occurs deep in the uterus, under the thin layer of endometrium lining its cavity. This type of disease manifests itself with severe symptoms and is less common than others.

Symptoms of uterine fibroids

More than a third of cases of uterine fibroids occur without characteristic symptoms and the disease is detected only during a routine visit to the gynecologist. This is especially true for small intramural and subserous nodes.

The intensity of fibroid manifestations depends on factors such as the size and number of nodes, their location and morphological features.

Women may complain of the following symptoms:

heavy, prolonged menstruation with severe pain;
intermenstrual spotting and bleeding;
clots in menstrual flow;
pain in the abdomen, lower back and above the pubis;
sensations of pressure and heaviness in the lower abdomen.

The most pronounced manifestations are observed in women with multiple or large uterine fibroids.

In addition, with fibroids, the functions of nearby organs are disrupted, problems with pregnancy arise, and infertility develops.

The pain syndrome accompanying the pathology has a different origin.

Interstitial uterine fibroids of small size are manifested by long, heavy and painful menstruation.

With the active growth of nodes, a woman experiences constant aching pain. Necrosis of the node is accompanied by severe pain, increased body temperature, and symptoms of intoxication of the body. A similar emergency situation occurs with subserous uterine fibroids with pedunculated nodes. If the leg is thin, torsion of the node may occur, as a result of which its nutrition is disrupted. In such situations, an acute condition occurs - severe pain syndrome. In some cases, a woman may develop peritonitis, requiring urgent surgical treatment.

With large fibroids, the function of nearby organs is impaired, which leads to constipation and increased urination. Sometimes the myomatous node compresses the ureter, as a result of which the outflow of urine from the kidney is disrupted.

Submucosal fibroids with submucosal localization of the node are manifested by heavy menstruation. With large sizes of the submucosal node, which occupies a large area of the uterine cavity, there is a disturbance in the cyclicity of menstrual flow, and sometimes its complete cessation.

The clinical manifestation of subserous (subperitoneal) fibroids is pain. Pain is felt in the lower abdomen or lower back. They arise due to the tension of the ligamentous apparatus of the uterus and the pressure of the growing myomatous node on the nerve plexuses of the pelvis. If blood circulation in the tumor is impaired, the pain increases and becomes acute.

Uterine fibroids can cause infertility and miscarriage, which is explained by a change in the size of the uterine cavity by a growing node, mechanical compression of the tubal angle and deterioration of local blood flow in the endometrium.

Thus, uterine fibroids can have a varied clinical picture, but most often it manifests itself as a triad: bleeding, pain and dysfunction of adjacent organs.

What is subserous uterine fibroid

Subserous uterine fibroids are a benign tumor that affects the outer side of the uterus, its growth is directed into the pelvic cavity.

Subserous fibroids usually look like a node with a wide base or a thin stalk through which the tumor is fed. Nodes can be single or multiple. A single node in subserous uterine fibroids is covered by a capsule that separates it from the surrounding tissues. Myomatous node can be small or large, but usually no more than 10 cm.

Due to its localization on the outside of the uterus and growth into the abdominal cavity, subserous uterine fibroids are considered one of the most harmless tumors. In women with this type of fibroid, the size of the uterus does not increase and menstrual function is not impaired. There are no problems with pregnancy. Difficulties with conception can arise only in cases where the subserous node is located near one of the fallopian tubes and compresses it. However, the presence of this tumor can cause miscarriage.

Types of subserous uterine fibroids

In modern gynecology, there is the following classification of subserous fibroids:

zero type - a subserous node on a stalk that does not contain an intramural component;
first type – the size of the intramural component is less than 50% of the volume of the myomatous formation, most of it is subserous;
the second type is a myomatous node with an intramural component of more than 50%, with a mild subserous component.

Causes of development of subserous uterine fibroids

The development of this benign formation may be due to the following predisposing factors:

endocrine disorders: according to statistics, subserous fibroids most often develop in women before or during menopause, when the usual ratio of female hormones - progesterone and estrogen - is disrupted;
hereditary predisposition: if close relatives of the woman suffered from this disease;
trauma to the muscular layer of the uterine wall during childbirth, pregnancy or heavy uterine bleeding.

Symptoms of subserous uterine fibroids

Patients with subserous nodes usually complain of pain. Most often, the pain has a pulling, aching character, is localized above the pubis and can radiate to the lumbar region.

The pain syndrome intensifies in case of hypothermia, overwork, being in an uncomfortable position for a long time and after intense physical activity.

Diagnosis of subserous fibroids

After collecting an anamnesis: clarifying the patient’s complaints, genetic predisposition, life history and illness, the gynecologist prescribes a series of laboratory and instrumental studies:

blood test (at least three times): general - to exclude inflammatory processes, biochemical and hormonal;
gynecological examination;
Ultrasound: considered the main diagnostic method;
computed and magnetic resonance imaging: to determine the size and location of the tumor in the uterine cavity and in relation to adjacent organs.

Treatment of subserous uterine fibroids

Treatment tactics for subserous fibroids are selected according to the size of the tumor. For example, the most effective method of treating large fibroids is surgery to remove the nodes. For small myomatous nodes, it may be sufficient to use conservative therapy, embolization of the uterine arteries, or regular monitoring of tumor growth using ultrasound (at least four times a year). Thus, surgery is not the only method of treating this pathology.

Conservative therapy.

Conservative treatment of subserous uterine fibroids involves taking medications such as:

combined oral contraceptives (progesterone-containing and estrogen-containing);
gestagens;
antiestrogens (not used for the treatment of fibroids in patients under 45 years of age);
antigonadotropins and gonadoliberins.

The duration of conservative therapy is three months. During this period, a woman must follow a special diet. After finishing taking the medications, the woman must remain under regular supervision of a specialist to monitor the condition of the myomatous node.

Unfortunately, hormonal therapy rarely leads to lasting results; relapses often occur: growth and enlargement of nodes. In this situation, surgical intervention is necessary.

Subserous uterine fibroids: dimensions for surgery

Surgery for subserous uterine fibroids can be a treatment method for large node sizes and in cases where the node grows on a thin stalk. The operation can also be performed in case of infertility and the presence of severe pain, uterine bleeding that cannot be treated with conservative methods.

Abdominal surgery. One type of surgical treatment is abdominal surgery aimed at removing the myomatous node. Indications for its implementation are the large size of the node, as well as malignancy of the process - the degeneration of a benign form into a malignant one. The incision is made in the area above the pubis. Then all layers (skin, subcutaneous fat, peritoneum, etc.) are dissected layer by layer, after which the fibroid is excised.

Hysterectomy. If the fibroids are very large, compressing adjacent organs and it is impossible for one reason or another to remove the myomatous node, the woman is prescribed a hysterectomy. During such operations, the uterus is removed along with the node. Hysterectomy is a radical treatment for fibroids. This operation is used only in cases where the disease threatens the woman’s life.

Laparoscopy. Currently, removal of uterine fibroids is most often performed using the laparoscopic method. A laparoscope is inserted through an incision on the anterior abdominal wall, after which the fibroid is excised and removed. This is a minimally invasive method, after which there are no cosmetic defects - postoperative scars.

Uterine artery embolization (UAE). An effective and safe organ-preserving alternative to surgery is the innovative method of uterine artery embolization. This technology is based on stopping the nutrition of the myomatous node by introducing special balls - emboli, which block the blood flow in the uterine arteries. With the help of UAE, a lasting lifelong effect is achieved, relapses of the disease are excluded. This is the most preferred method of treating fibroids and avoids surgery.

FUS ablation. A method involving exposure of uterine fibroids to ultrasonic waves. The effectiveness of the procedure is high only when treating fibroids with small single nodes.

Diet for subserous uterine fibroids

During treatment, a woman must follow the following nutritional rules:

give preference to plant foods high in fiber, which help normalize metabolism;
reduce the amount of meat consumed;
give up fatty, fried and spicy foods;
eat vegetables and fruits daily;
introduce soy products and bran into the diet, which cleanse the body of toxins;
to normalize hormone levels, regularly consume nuts and dairy products;
eat dishes made from fatty varieties of sea fish, which have an antitumor effect.

Improper nutrition can cause serious disruptions in the functioning of the endocrine system and the active growth of myomatous formations.

Traditional medicine

Traditional medicine has a large number of recipes for herbal infusions and decoctions, with which you can significantly reduce the severity of the symptoms of subserous fibroids, as well as stop the growth of myomatous nodes. However, these drugs should be taken only as an additional method in complex therapy and only after consultation with the attending physician.

Flax seeds. Due to the content of antiestrogens, flax seeds have a positive effect in the treatment of this hormone-dependent tumor. Preparations made from flax seeds help restore hormonal balance, help suppress inflammatory processes and counteract carcinogens that provoke the development of tumors.

Potato juice. This remedy has wound-healing, anti-inflammatory, antispasmodic, analgesic, diuretic, restorative, immunostimulating effects, and also normalizes metabolism and the body’s water-salt balance. In addition, a decoction of potato flowers also has similar healing properties. However, taking potato juice is contraindicated for patients suffering from diabetes, intestinal dysfunction, and gastritis with low acidity.

Borovaya uterus. This plant is rightly called “female grass”. With the help of boron uterus infusion, many gynecological problems are solved, including uterine fibroids.

Poisonous plants. Due to their antitumor properties, tinctures of hemlock, aconite, hellebore and celandine are successfully used in the treatment of subserous uterine fibroids. It is important to understand that these plants should only be purchased in pharmaceutical packages that contain instructions for use, because Preparations from poisonous herbs must be taken strictly in the indicated doses.

Hemostatic herbs. If uterine fibroids are complicated by heavy uterine bleeding, you can take infusions and decoctions from plants that have a hemostatic effect. The following help reduce the volume of blood secreted: barberry, nettle, shepherd's purse, yarrow, burnet, burdock, cloves.

Leeches. The saliva of leeches contains enzymes and other biologically active substances that help restore the level of hormones in the female body, due to which treatment with leeches has a positive effect on such a hormone-dependent tumor as uterine fibroids. In addition, hirudotherapy helps thin the blood, eliminate congestion in the blood vessels of the pelvis, strengthen the immune system, and reduce inflammatory processes.

There is no need to be afraid to get treatment, you need to be afraid to get sick! In order to prevent fibroids, a woman needs to adhere to a healthy lifestyle, avoid heavy physical activity, abortions, treat her body with care, and if any warning symptoms are detected, do not hesitate to consult a doctor. Any disease can be treated more easily and effectively in the early stages, and uterine fibroids are no exception.

We will help you select the best specialists who use organ-preserving methods of treating fibroids in their practice, incl. and embolization of the uterine arteries, as the most preferable way to get rid of fibroids without surgery. Our partners are leading clinics in Moscow and other Russian cities. Contact us to any doctor at the clinic with which we cooperate. . We will provide ongoing support. To all your questions.

Bibliography

Sidorova I.S. Uterine fibroids (modern aspects of etiology, pathogenesis, classification and prevention). In the book: Uterine fibroids. Ed. I.S. Sidorova. M: MIA 2003; 5-66.
Androutopoulos G., Dekavalas G. Recent advances in the treatment of uterine fibroids. Translation from English N. D. Firsova (2018).
Savitsky G. A., Ivanova R. D., Svechnikova F. A. The role of local hyperhormonemia in the pathogenesis of the growth rate of tumor nodes in uterine fibroids // Obstetrics and Gynecology. – 1983. – T. 4. – P. 13-16.

02 November 2017 16301 1

An interstitial myomatous node is a benign neoplasm, the occurrence of which is caused by a violation of the sensitivity of uterine muscle cells to male sex hormones. The development of this tumor may be accompanied by nonspecific symptoms: impaired urination, pain in the lower abdomen, infertility and various complications.

Please note that this text was prepared without the support of our website.

Interstitial node: what is it?

Interstitial uterine fibroids are a tumor of the myometrium, the development of which is associated with an imbalance of androgenic hormones and estrogens in the female body. The disease can often occur without visible symptoms; the nodes gradually reach a fairly impressive size. In other words, uterine fibroids are called leiomyoma and fibromyoma.

According to statistics, uterine fibroids are diagnosed in more than 30% of women over 30 years of age. Most often, the tumor is localized in the body of the uterus. In women in the age range from 30 to 45 years, interstitial myomatous nodes account for about a third of all gynecological diseases.

Interstitial uterine fibroids can be single or multiple - with several myomatous nodes with different growth rates, which is due to the histological features of the structure.

The location of the tumor may also vary. Some women may have an interstitial uterine node along the anterior wall of the uterus, while others may have an interstitial node along the posterior wall of the uterus.

Interstitial myomatous node: causes of development

Interstitial uterine fibroids most often occur when the normal structure of the muscular layer of the uterus changes, which, in turn, is associated with hormonal disorders at different periods of the menstrual cycle. This aggravates the hormonal imbalance and complicates the course.

Such hormonal imbalances can be provoked by chronic heavy metal poisoning, late pregnancy, early onset of the first menstruation, frequent abortions and diagnostic curettages, and other reasons:

infectious and inflammatory diseases of the pelvic organs;
frequent stress, increased neuropsychological stress;
congenital sexual infantilism;
irregular sex life;
genetic predisposition;
chronic diseases of the genitourinary system;
endocrine disorders: obesity and diabetes;
unbalanced diet and bad habits.

Interstitial uterine fibroids: symptoms

The appearance of clinical symptoms of interstitial uterine fibroids is usually noted in the later stages of development.

Interstitial nodes are manifested by the following symptoms:

the occurrence of pain in the lower abdomen. Their appearance is associated with compression of blood vessels and nerve endings. The nature of the pain can be varied: from cramping to aching, mild;
uterine intermenstrual bleeding - metrorrhagia, as well as changes in the very nature of menstruation, which become longer and more abundant;
anemia, the development of which is associated with significant blood loss during metrorrhagia. A decrease in hemoglobin levels is accompanied by the appearance of general symptoms of malaise, which include increased fatigue, decreased performance, pale skin, lethargy, apathy;
disruption of the intestines and bladder, resulting in increased urge to urinate and constipation. This is due to compression of neighboring organs by fibroids. These conditions can be complicated by pyelonephritis, cystitis, and hemorrhoids.

Interstitial uterine fibroids: diagnosis

During the diagnosis of interstitial fibroids, the doctor listens to the patient’s complaints and collects an anamnesis of the disease, a life history, palpates the abdomen and conducts a gynecological examination.

Ultrasound examination (ultrasound) is used to detect myomatous nodes, determine their size, quantity and location, which is considered the most informative method for diagnosing uterine fibroids.

In some cases, if there are complications of fibroids or there is suspicion of tumor malignancy, additional examination methods are prescribed:

hysteroscopy – endoscopic examination of the uterine cavity using a thin long device (hysteroscope) followed by histological examination of the biomaterial (a piece of tissue from the myomatous node is examined under a microscope);
laparoscopy - an endoscopic examination that involves inserting a laparoscope into the abdominal cavity through a small incision. During the study, a piece of tissue may be removed for biopsy;
angiography - a study that allows you to evaluate the blood flow in the vessels of the fibroids into which a liquid contrast agent is injected;
magnetic resonance imaging (detailed examination of the abdominal organs with magnetic rays).

These diagnostic measures allow you to establish an accurate diagnosis and prescribe the necessary treatment regimen.

Interstitial uterine fibroids: treatment

Conservative and surgical therapy are used to treat interstitial uterine fibroids.

Conservative (drug) therapy is used for fibroids whose size does not exceed 3 cm. Hormonal medications are prescribed, the action of which is aimed at stopping the growth of myomatous nodes. With the help of drug treatment, it is impossible to completely cure uterine fibroids, but it is effective in stopping the growth of the tumor, reducing its size and reducing negative symptoms.

Among the methods of surgical treatment of interstitial uterine fibroids are the following:

radical - perform abdominal or laparoscopic surgery to remove the uterus. It is used for large fibroids, intensive growth of the node in the postmenopausal period and if there is a suspicion of tumor malignancy;
conservative-plastic – interstitial myomatous nodes are removed using electro- and laser surgery. Additionally, hormonal therapy is carried out;
stable-regressive – occlusion of the uterine arteries and uterine artery embolization (UAE).

The most effective and safe method of combating uterine fibroids today is.

This procedure is offered in the most modern clinics equipped with innovative equipment.

After UAE, women experience normalization of symptoms: menstrual bleeding returns to normal, its volume and duration decreases.

Over time, the symptoms of compression are eliminated, the size of the fibroids and the overall size of the uterus decrease (usually, this occurs six months after the UAE procedure). After a year, the size of interstitial myomatous nodes becomes at least 4 times smaller, and small tumors completely disappear.

One of the most important features of UAE is that after the procedure the risk of disease relapse is virtually eliminated. The woman does not require any additional treatment.

The advantages of EMA include the following:

safety and minimally invasive treatment method;
no need for general anesthesia;
high efficiency (more than in 98% of cases);
rapid relief of symptoms;
short recovery period;
low risk of complications;
preservation of reproductive function.

Successful results of treatment of uterine fibroids using the UAE method largely depend on the competence and experience of the endovascular surgeon who performs the procedure. Make an appointment with the best specialists in Moscow who are proficient in the technique of performing UAE - endovascular surgeon, Candidate of Medical Sciences Bobrov B.Yu., gynecologist, Candidate of Medical Sciences Lubnin D.M. Can .

Bibliography

Lipsky A. A.,. Gynecology // Encyclopedic Dictionary of Brockhaus and Efron: in 86 volumes (82 volumes and 4 additional). - St. Petersburg. 1890-1907.
Bodyazhina, V.I. Textbook of gynecology / V.I. Bodyazhina, K.N. Zhmakin. - M.: State Publishing House of Medical Literature, 2010. - 368 p.
Braude, I. L. Operative gynecology / I. L. Braude. - M.: State Publishing House of Medical Literature, 2008. - 728 p.