Can intramural nodes be malignant? What do you need to know about the intramural node? Treatment of intramural and subserous-intramural fibroids

Uterine fibroids are a benign neoplasm that develops against the background of disturbances in the level of female sex hormones. Depending on the location of the tumor, several types of fibroids are classified. The most common of them are intramural - located in the middle muscular layer of the uterus and subserous - originating from the outer muscular layer and growing into the abdominal cavity.

Symptoms of fibroids

Intramural uterine fibroids are manifested by the following clinical symptoms:

menstrual irregularities - a woman experiences delays in menstruation or menstruation occurs 2 times per cycle;
severe pain in the lower abdomen of a pulling nature;
sensation of a foreign body in the abdominal cavity as the node increases in size;
heavy, prolonged menstruation, which quickly leads to the development of iron deficiency anemia in a woman and a number of other health problems.

Subserous uterine fibroids are manifested by the following clinical symptoms:

impaired emptying of the bladder and intestines with the progressive growth of fibroids - this is due to the fact that the node grows into the abdominal cavity and can put pressure on nearby organs;
feeling of discomfort and pain in the abdomen;
disruption of the internal organs, next to which the fibroid node is located

As a rule, subserous uterine fibroids do not affect a woman’s ability to conceive and bear a child, however, pregnancy itself can trigger the progressive growth of the tumor due to changes in hormonal levels.

Subserous fibroids with a thin stalk are considered especially dangerous. With any load or sudden change in the position of a woman’s body, torsion of this leg can occur, which is clinically accompanied by signs of an “acute” abdomen and requires immediate surgical intervention.

Subserous-intramural fibroids combine the presence of tumors in the muscular layer of the uterus and outside the organ, which is clinically accompanied by the following symptoms:

menstrual irregularities - delays, intermenstrual breakthrough bleeding, prolonged and excessively heavy menstruation;
pain in the lower abdomen of a pulling nature, radiating to the perineum, tailbone, lower back;
disturbance of urination and defecation - a feeling of incomplete emptying of the bladder and intestines;
difficulties with conceiving and carrying a pregnancy;
deformation of the uterus and tumor growth into adjacent pelvic organs.

Diagnostics

If symptoms of fibroids appear, a woman should consult a gynecologist. Diagnosis of benign neoplasms of the uterus is made by examining a woman on a gynecological chair with palpation of the uterus and appendages. During the examination, the doctor notes that the uterus is enlarged in size, but there is no pregnancy; there may be deformation of the organ and uneven contours of the uterus. In order to accurately determine the type of fibroid and its location, additional studies must be carried out:

Ultrasound of the pelvic organs;
MRI or CT of the lumbar region and pelvis;
diagnostic laparoscopy - in this case, if possible, the doctor can immediately remove the fibroid surgically.

Treatment of intramural and subserous-intramural fibroids

Treatment of intramural fibroids

Treatment of a myomatous node located in the muscular layer of the uterus involves the use of complex therapy, which is selected by the doctor individually for each woman, depending on the size of the nodes, their location, the growth rate of tumors and the patient’s future plans for future pregnancies and childbirth. Currently, treatment of intramural uterine fibroids is carried out in the following ways:

Conservative therapy - the woman is given hormonal drugs, under the influence of which the myomatous node will stop growing and will gradually decrease in size. The treatment is long-term and does not lead to the complete disappearance of the myomatous node. Sometimes conservative therapy is carried out to prepare the patient for surgery.
Uterine artery embolization is a surgical intervention during which the blood supply to the myomatous node is artificially stopped, which leads to its death, reduction in size and disappearance of the symptoms of the disease in the woman. This method is very popular and widely used for women who are planning to have a child in the future.
Surgical removal of the myomatous node itself is carried out using several methods:
- during hysteroscopy – a hysteroscope (a device with an optical system and surgical instruments) is inserted into the uterine cavity and, under control on a monitor screen, the doctor removes the tumor;
- laparoscopy – 2 punctures are made in the abdominal wall to insert instruments and pump air into the abdominal cavity;
- laparotomy is an abdominal operation performed through an incision in the abdominal wall.
Radical surgery - during the operation the uterus is removed. Most often, such radical treatment is resorted to in cases of severe deformation of the uterus by multiple myomatous nodes, with a high risk of degeneration of the pathology into a cancerous tumor, as well as in women of menopausal age who no longer intend to give birth to children.

Treatment of subserous-intramural fibroids

Treatment of subserous-intramural fibroids is carried out surgically, but first the woman is prescribed a course of hormone therapy to suppress tumor growth. Hormonal therapy is effective only if the size of the fibroids does not exceed 12 weeks of pregnancy; large fibroids should be operated on as soon as possible, as they progress in growth and disrupt the functioning of internal organs.

To remove fibroids from the outer and inner muscular lining of the uterus, the following surgical methods are used:

embolization of the uterine arteries - this method can only be used for fibroids that do not have a stalk, since in the process of death of the tumor neoplasm, torsion of the stalk and development of an acute abdomen are possible, which will require repeated surgical intervention;
surgical removal of myomatous neoplasms - a combination of subserous and intramural fibroids requires laparotomy, that is, abdominal surgery, during which myomatous nodes are excised without affecting healthy tissue areas. After myomectomy, the patient is prescribed a course of hormone therapy to eliminate the risk of tumor recurrence;
hysterectomy is a radical operation with complete removal of the uterus, which is performed for women during menopause, as well as for patients with a high risk of pathology turning into a malignant process.

Indications for abdominal surgery to remove myomatous nodes are:

progressive growth of myomatous neoplasms;
compression of nearby organs by fibroids, which disrupts their functioning;
diagnosing myomatous nodes larger than 12-13 weeks of pregnancy;
massive intermenstrual bleeding, which leads to anemia and other complications of the general condition;
acute disturbance of the blood supply and nutrition of the myomatous node - torsion of the leg;
degeneration of a tumor neoplasm into a cancerous tumor;
softening and disintegration of the tumor.

Forecast

Modern surgical methods for treating myomatous nodes make it possible to relieve the patient of the disease and at the same time preserve her reproductive function, which is especially important for young women planning to give birth in the future. Despite the high effectiveness of surgical treatment, the risk of relapse of the disease is very high, therefore, in addition to removing nodular changes in the uterus, it is necessary to establish the cause of the appearance of fibroids and direct treatment to eliminate it. In the postoperative period, the woman is prescribed hormonal therapy, physiotherapeutic treatment, therapeutic exercises and treatment of underlying diseases that could provoke the growth of myomatous nodes.

In addition, it is very important to adjust your diet in favor of healthy foods, since hormonal imbalances can primarily be associated with an unhealthy unhealthy diet and obesity.

Hormonal changes in women of childbearing age lead to the development of hyperplastic processes in the genital organs. They can be benign or malignant.

According to statistics, 30% of women over 35 years of age experience uterine fibroids, and the percentage of asymptomatic development of the disease is even higher. Its development cannot always be prevented, but it is possible to reduce the likelihood of its occurrence.

Intramural fibroids are a benign growth of smooth muscle cells of the uterus, the name is determined by the location of the nodes - in the thickness of the myometrium. In contrast, submucous nodes grow under the mucous membrane, the endometrium, and subserous nodes are located closer to the outer surface of the uterus.

About the organ

The uterus is an unpaired muscular organ, it is intended for bearing and giving birth to children. The inner epithelial layer creates the conditions for the attachment of a fertilized egg and the development of the embryo.

The muscle wall is formed by three layers of cells, which are located in three directions - outside and inside longitudinally, and between them in a circular manner. Their contraction during childbirth pushes the baby out.

Causes

Adverse factors affect smooth muscle cells, damaging them. This leads to the appearance of nodes consisting of myocytes and connective tissue cells.

The most likely causes of the formation of intramural fibroids:

Hormonal changes with a predominance of high levels of estrogen. This hormone causes increased division of uterine cells, its effect can manifest itself in the form of an increase in the mucous layer, then they speak of endometrial hyperplasia.

If the myometrium is affected to a greater extent, then nodes are formed. A decrease in estrogen levels during menopause leads to the reversal of fibroids.

Traumatic manipulation of the uterus– abortions, curettage, difficult childbirth, surgical interventions. There are proliferating (young) cells in the muscle layer; their damage during rough manipulation causes a gradual accumulation of such myocytes. Hormonal changes that necessarily accompany abortion and childbirth intensify the process of formation of nodes.
Inflammatory and infectious diseases of the uterus– endometritis, sexually transmitted infections. Inflammation is accompanied by swelling of the tissue, the release of the liquid part of the blood from the bloodstream, which leads to compression of microvessels and ischemia. The damaging factor in this case is infection itself and oxygen starvation of tissues.

Diseases of the endocrine organs– diabetes mellitus, damage to the thyroid gland, affect the overall level of hormones. Obesity always leads to an imbalance of sex hormones. This is explained by the hormonal activity of adipose tissue and its ability to increase the synthesis of estrogen.

Diabetes and hypothyroidism are in most cases accompanied by weight gain.

Irregular sex life after 30 years, a sedentary lifestyle leads to stagnation of blood in the pelvis, which contributes to myometrial hyperplasia.
Stress and bad habits in women can cause hormone fluctuations and increase the risk of developing fibroids.
The occurrence of fibroids in relatives speaks in favor of a possible hereditary predisposition to the disease.

Symptoms

In half of the cases, fibroids are asymptomatic. Symptoms become noticeable when neighboring organs are compressed, when the uterus increases in size due to large nodes. Some signs appear due to deformation of the organ. Symptoms:

Heavy and prolonged menstruation associated with changes in the shape of the inner surface of the uterus, worsening endometrial rejection and possible hyperplasia.
Bleeding between periods are also associated with high levels of estrogen and hyperplastic processes in the mucous membrane.
Painful menstrual bleeding due to difficulty in separating the endometrium.
Lower abdominal pain occurs when blood flow in the nodes is disrupted due to compression of the feeding vessels.
Excessive blood loss causes anemia, which is accompanied by dizziness and increased heart rate.
Large fibroids compress neighboring organs– bladder and rectum, which leads to urination and defecation disorders.
Malnutrition of large fibroids causes its necrosis. This is accompanied by severe pain, fever, intoxication, and discharge of blood clots from the genital tract.
Infertility, miscarriages, bleeding during pregnancy and after childbirth a consequence of changes in the shape of the uterus, disruption of hormonal regulation.

Clinical picture

The formation of myomatous nodes occurs under the influence of a cyclic increase in hormone levels. Presumably, with each menstrual cycle there is an accumulation of damaged myocytes, in which the mechanism of apoptosis, programmed death when damaged, is disrupted.

Exposure to damaging factors aggravates the process. But in the first stages, for the growth of fibroids, exposure to the usual concentration of estrogen, which fluctuates throughout the cycle, is sufficient.

Gradually, mechanisms for self-sustaining growth are formed in the pathological focus - the connective tissue begins to synthesize estrogen from androgens, and the level of hormones in the blood ceases to matter. The rate of development of self-regulation determines the nature of growth - the pathological focus will increase quickly or slowly, or at a certain stage it will stop increasing.

Small nodes may not manifest themselves for a long time and are discovered by chance during a pelvic ultrasound. Larger and more numerous formations are accompanied by severe symptoms and are forced to consult a doctor with complaints. A woman’s refusal of necessary treatment leads to further growth of fibroids.

The surrounding organs are compressed and the size of the abdomen increases. Frequent heavy bleeding leads to bleeding and sometimes severe anemia. Sometimes such conditions require emergency measures to remove the uterus and blood transfusion.

Deprivation of the uterus of hormonal stimuli leads to regression of the nodes. This can be achieved by taking hormonal drugs or over time with the onset of menopause.

Diagnostics

The following diagnostic methods are used:

Fibroids can be detected during an examination by a gynecologist. The doctor will note hardening of the uterus, changes in its shape, size, and the appearance of tuberosity. Intramural fibroids cannot be seen using gynecological mirrors. But the displacement of the cervix can suggest its presence.
Hysteroscopy– examination of the uterine cavity with a special sensor from the inside allows you to visually assess the condition of the node.
MRI and CT– X-ray methods, produce a series of layer-by-layer images. MRI is more sensitive to soft tissues, displays nodes of minimal size, clarifies their location and location relative to neighboring organs.
Informative ultrasound of the pelvis, with its help even small nodes are detected that require further regular monitoring.

In this video you can see what a node looks like on an ultrasound:

Therapy

Treatment aims to eliminate the symptoms of fibroids associated with bleeding and pressure on neighboring organs, while preserving the organ and reproductive function. Indications for conservative therapy:

small fibroids (up to 12 weeks of pregnancy);
single nodes (no more than 1-2);
slow growth of the lesion;
intramural localization of fibroids;
there is no pain or heavy bleeding.

Hormone therapy

The selection of a drug for treatment is always individual. The following groups are used:

Gestagens. A natural hormone in the second phase of the menstrual cycle, it lowers estrogen levels. For treatment, progesterone or Duphaston is used, which can be used even during pregnancy. The Mirena intrauterine device is also effective against fibroids.
Antigestagen drug Mefipristone Apply twice per cycle for small knots.
Gonadotropin-releasing hormone agonists reduce the concentration of estrogen, which leads to a reduction in the node.
Tamoxifen– a selective modulator of estrogen receptors has an antiestrogenic effect.
Antiandrogen drugs (Danazol) by reducing androgens, they influence gonadotropins, which inhibits the growth of the node.
Combined oral contraceptives will help in the treatment of small nodes up to 2 cm in diameter.

Other medicines

Other medications are used to relieve the symptoms and effects of fibroids:

Nonsteroidal anti-inflammatory drugs needed to eliminate pain. Analgin, Nimesulide, Meloxicam, Ketorolac are effective.
Iron supplements necessary for the treatment of anemia. Sorbifer, Maltofer, Totema are used.
Hemostatic agents needed for heavy bleeding, Etamzilat in injections or tablets is effective.

Folk remedies

Traditional medicine cannot be used as an independent method of treatment. It is used after consultation with the doctor as additional supportive therapy:

4 teaspoons flax seeds Brew 0.5 liters of boiling water, boil for 10 minutes. Take half a glass three times a day before meals for 2 weeks.
Freshly squeezed potato juice 100 g is taken on an empty stomach for 3 months.
Motherwort tincture Drink 30 drops twice a day for a month.
A decoction of a mixture of nettle, burdock, barberry, yarrow, cloves, shepherd's purse has a hemostatic effect.

FUS ablation

Focused ultrasound - destruction of fibroids in a non-invasive way using ultrasound under MRI control is carried out as follows:

Before the procedure, an examination is carried out to determine the location and size of the nodes. It is impossible to use the method for submucosal and subserous nodes on a stalk or sizes greater than 500 cm3.
The distance to the nodes is calculated.
The appropriate hardware settings are made.
Under the control of MTP, ultrasound is applied to the node. Anesthesia and pain relief are not needed at this stage.
After the procedure, analgesics are prescribed.

Operation

Surgical treatment is possible radical - removal of the organ, conservative-plastic - myomectomy.

Indications

Removal of the uterus is resorted to in the following cases:

There is no need to preserve fertility.
The size of fibroids is more than 15-16 weeks of pregnancy.
Rapid node growth.
Tumor enlargement in postmenopause.
Suspicion of sarcoma.
Dysfunction of neighboring organs.
Bleeding leading to the development of anemia.

Operation process

General anesthesia.
Access to the abdominal cavity laparoscopically for small fibroids. If the size of the uterus is more than 16-18 weeks, a laparotomy is performed.
The vessels feeding the uterus are ligated.
The appendages are cut off, the neck is preserved.
The uterus is freed from ligaments and removed. The ovaries are inspected for tumors.
Checking the reliability of hemostasis.
Layer-by-layer suturing of the abdominal cavity.
Apply an aseptic bandage to the wound.

Rehabilitation

After surgery, thrombosis prevention is continued for a month (compression garments, low doses of aspirin). After removal of the uterus, hormone replacement therapy is prescribed to prevent castration syndrome. After removal of the nodes, a control ultrasound is performed after 1, 3 and 6 months.

Forecast

With timely treatment, the prognosis is favorable. During childbearing age, reproductive function can be maintained and pregnancy can be achieved.

Relapse is possible if not all nodes were removed during treatment (for example, with FUS ablation).

Prevention

To avoid getting sick, you need to adhere to the following principles:

Protect yourself from infections, treat inflammatory diseases in a timely manner.
Refuse abortion.
Have a full sex life.
Have at least 2 children.
Control your weight, eat right, and avoid physical inactivity.
Treat other endocrine diseases.

To prevent relapse:

Adhere to a healthy lifestyle, and if you are obese, get rid of extra pounds.
Avoid stress.
If you need to take hormonal medications, strictly follow the instructions.
Use the Mirena intrauterine hormonal system.

Muscular tumors from the body of the uterus are almost always hormone-dependent, so special medications are used for treatment. Surgical intervention is performed according to indications: if a woman wants to give birth to a child, the doctor will perform a conservative myomectomy to preserve the future fetal sac.

Types of intramural leiomyoma

Intramural fibroids can occur anywhere in the reproductive organ, but most often benign formations appear in the following areas:

Intramural localization of the node is a form of tumor located deep in the muscle tissue. This location of leiomyoma is most often completely asymptomatic. Therefore, in the first stages of the development of the disease and when the size of the node is small, it is possible to detect a tumor only with the help of ultrasound scanning. However, as the tumor grows, the following types of leiomyoma are possible:

single or multiple small fibroids, when the nodes do not deform the uterine cavity;
intramural fibroids with centripetal growth of the node (the node changes the internal surface of the reproductive organ, creating conditions for infertility);
formation of a subserous node on a broad base (the node grows outward);
isthmus intramural fibroids, in which the cervix is deformed.

Asymptomatic small intramural fibroids are usually discovered incidentally during a preventive ultrasound. If, against the background of heavy menstruation, a doctor finds an enlarged, tuberous uterus during a gynecological examination, then the doctor’s first assumption will be the presence of a benign tumor of muscle tissue.

Causes of tumor

The main factors for the occurrence of intramural myomatous nodes include the following reasons:

genetic predisposition, which is confirmed by the family nature of the disease (if the mother has it, then there is a high risk of leiomyoma formation in her daughter);
hormonal imbalance (predominance of estrogens over gestagens).

It is imperative to take into account risk factors that predispose to the appearance and growth of leiomyoma. In this case, the combination of several factors that create maximum conditions for the occurrence of the disease will be important.

Symptoms of the disease

A small interstitial node very rarely causes any symptoms. A woman has regular, light menstruation, and nothing prevents the desired pregnancy from occurring. However, when the node grows or multiple uterine fibroids form, the following symptoms occur:

heavy critical days, when during menstruation the amount of blood lost sharply increases;
nagging or pressing pain (if there is a node on the back wall - pain in the sacrum and in the lower back, if the fibroid is on the front wall, then the problem arises in the lower abdomen);
Various types of menstrual disorders occur;
A common complaint will be the lack of desired conception.

Typically, a woman consults a doctor when uterine bleeding and infertility occur. In addition to a routine medical examination, you will need to undergo an examination to identify the variant of leiomyoma.

Diagnostics

Any form of benign tumor growing from the uterus is clearly identified by transvaginal ultrasound scanning. Such a study should be done for all women with infertility and suspected presence of a tumor in the pelvic cavity. An ultrasound diagnostic specialist will be able to identify the number of nodes, the size of the uterus and tumor, the condition of the endometrium and ovaries. If conservative therapy is possible, the doctor will use medications. If there are indications for surgery, the doctor will recommend surgery.

Treatment

Small intramural leiomyoma is treated conservatively, especially if there is no uterine bleeding. For young women, the main goal of therapy is to conceive the desired baby. In older women who have completed their childbearing function, hormonal treatment is carried out to prevent the growth of nodes. The main indication for surgery for intramural tumor localization is centripetal growth of the node, which causes uterine bleeding. Surgical treatment methods include:

conservative myomectomy;
embolization of uterine arteries;
FUS ablation of the interstitial node;
supravaginal amputation of the uterus (partial removal of the uterus while preserving the cervix);
hysterectomy (complete removal of an organ).

The choice of treatment method depends on many factors, therefore, in each specific case, treatment tactics are selected individually for each woman.

Uterine fibroids are one of the main gynecological diseases. Most often, examination reveals an intramural node. Regardless of the form of the tumor, with the right approach to treatment, you can achieve the desired goal - conceiving a child or preventing the growth of leiomyoma.

The information on the site is provided for informational purposes only and cannot replace the advice of your attending physician.

How to treat an intramural node in the uterus during childbearing years, is it possible to avoid surgery

Intramural fibroids are a benign tumor. Myoma can affect all layers, or it can be nodular, which is more common.

Types and causes of the disease

There are several types of nodes. A node that has formed in the mucous layer of the uterus is called submucosal; if the node grows towards the abdominal region, it is called subserous; interstitial is a node that has formed in the interstitial apparatus.

The intramural (transmural) node is localized in the muscle layer. With this pathology, a diagnosis may be made: myoma, fibromyoma, leiomyoma.

Intramural miasmatic node can be caused by various factors:

hormonal imbalance (predominance of estrogen)
genetic predisposition
mechanical procedures in the uterine area (curettage, operations, caesarean section)
hormone-dependent diseases (adenomatosis, endometriosis)
chronic diseases of the genital organs
high blood pressure, diabetes, excess weight

Since hormonal levels have a great influence, with the onset of menopause and a decrease in estrogen levels, the nodule may resolve. But if you refuse hormonal therapy, fibroids can begin to grow. Women's health is also affected by lifestyle: physical activity, nutrition, bad habits.

The risk group includes women with irregular menstrual cycles: early puberty, early or, conversely, late menopause. When several factors are combined simultaneously, the likelihood of developing the disease increases.

How does the disease manifest itself?

During intramural fibroids, healthy muscle cells and blood vessels are replaced by connective or fibrous tissue. The nodes have a clear outline. If the fibroid grows into the muscle layer, then the clinical form is called submucosal-interstitial; if the periphery is affected, it is called the intramural-subserous form.

A small node in the uterus does not cause discomfort to a woman. As the formation increases, the following symptoms appear:

The latter symptoms are associated with an increase in the size of the node and its pressure on neighboring internal organs. Possible nerve pinching.

In severe cases of the disease, deformation of the uterine cavity is possible. Then bleeding begins and there is a risk of infertility.

If treatment is not started in time, blood circulation in the myomatous node is disrupted and it may become necrotic. In this case, immediate surgical intervention is required.

With a medium-sized myomatous node, patients complain of:

Each new node is characterized by pain at the location. The course is much more difficult if the fibroid has a leg.

Fibroids and pregnancy

Multiple small nodes do not affect the possibility of conception and the course of pregnancy. If the cause of the disease is a lack of hormones, then their levels normalize during pregnancy and the problem goes away.

Large nodes have a negative impact on the course of pregnancy. Possible complications: miscarriages, premature birth, bleeding, placental abruption, weak fetus.

Ultrasound alone does not give a reliable result if the node is located in the muscle layer. During pregnancy, the node stretches and its borders become stretched and invisible. This is the reason why the nodes come back after pregnancy.

The course of pregnancy is influenced by the size and location of the intramural node. The node located near the placenta has a negative effect. A tumor can lead to infection of the fetus, block the supply of nutrients and oxygen, and provoke a miscarriage.

Diagnostic methods

You should consult a doctor if typical symptoms appear. The gynecologist performs the following examination:

Using palpation, the gynecologist can immediately detect nodular formations. After this, an ultrasound is prescribed to confirm the diagnosis. Additional diagnostic method: transvaginal sensor. It allows you to determine the location of nodes, their sizes, and condition.

Ultrasound alone is not used to diagnose fibroids, since a node in the muscle layer may not be displayed on the screen. An ultrasound will show endometriosis, which simultaneously develops with fibroids.

The next research method is hysteroscopy. It is reliable even in the initial stages, allows you to determine the size and condition of the node, and prevent necrosis.

MRI and CT also give good results. A photo of all nodes, their sizes and location is taken. The method makes it possible to determine which layers are affected by fibroids and whether there is an impact on neighboring organs.

If there is a suspicion of an ovarian tumor, then it can be differentiated from fibroids using laparoscopy. This is necessary because fibroids and ovarian tumors have similar symptoms.

Complications and treatment

The most dangerous complication with an intramural node is infertility. Pregnancy is also difficult. It is possible to get pregnant with fibroids, but the fertilized egg has difficulty moving. If the node is localized in the posterior wall of the uterus, then the egg will not be able to gain a foothold for further development. If it becomes fixed in the cervical area, a miscarriage will occur.

The technology for treating small and moderately complex nodes depends on the patient’s age, location of the nodes, and size. During childbearing age, treatment is carried out with medication; doctors try to preserve the uterus to the last.

The first treatment method is embolization. The blood circulation to the node is cut off and it is anesthetized. After a few months, the node dies and the inner layers of the uterus are restored. Sometimes hormonal therapy continues.

Myomectomy involves removing the node laparotomically or through the cervix. The technology resembles curettage, but not the entire mucous layer is removed, but only the area where the node is located. Complete restoration of the uterine cavity occurs after six months to a year. After this period, you can plan to conceive a child.

Vaporization - the node is exposed to different temperature conditions. As a result, the node becomes necrotic. The procedure is effective only for small nodes, no more than 60 mm.

In adulthood and if there is no desire to have children in the future, they resort to removal of the uterus. The organ is removed using laparotomy or the cavity method. Indications for removal:

In difficult cases, the intramural node in the uterus can only be removed surgically. Surgical removal of the node is recommended if the formation grows rapidly, the patient cannot become pregnant, placental abruption, or fetal hypoxia are observed. The operation is not complicated and after removal the woman can continue to lead a normal life without any negative consequences

During pregnancy, small nodes are only observed (they may shrink or disappear) and if they do not have a negative effect on the fetus, they are removed after birth.

Conservative treatment method

Conservative treatment is not complete without taking hormonal drugs. The type of hormones and their quantity are chosen by the doctor individually, depending on laboratory tests.

Drug therapy is used for patients who are planning pregnancy. The nodes resolve on their own after the hormonal levels return to normal. A nodule with calcites does not resolve, which is why correct diagnosis is so important.

Hormonal treatment is also carried out after surgical removal to prevent recurrence of the disease. If the nodes do not resolve after several methods, the treatment regimen changes.

The main objectives of hormonal therapy:

decreased estrogen levels
decreased sensitivity of the myometrium to estrogen

progestogens
antigonadotropics
antiprogestogens
gonadotropin-releasing hormone agonists

Surgical removal is recommended if the leg of the node is torsed, the structure of the formation has changed, or softening of the tissue has occurred. During pregnancy, the node is removed if it is large. If the node begins to grow during the postmenopausal period, then surgical intervention is also prescribed.

Medicines that are aimed at normalizing the menstrual cycle:

antiandrogens
agonists
progestins
testosterone derivatives
hormone replacement drugs

Conservative treatment is used if the woman still plans to have children. If fibroids tend to grow and have a negative impact on overall health, then more radical methods are used.

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Interstitial and intramural myomatous nodes

A myomatous node is a benign formation formed along the anterior or posterior wall of the uterus, in the thickness of the cervix or outside the uterus. The disease is otherwise called leiomyoma, myoma or fibroma. Pathology is often diagnosed in women after thirty years of age. With the onset of menopause, the nodes on the anterior or posterior wall of the uterus usually regress.

The wall of the uterus consists of three layers.

Perimetry. This is the outer layer of the uterine wall, including the peritoneum and peri-uterine tissue.
Endometrium. This layer of the uterine wall is otherwise called internal.
The endometrium is represented by a basal and functional layer. The functional layer grows and is rejected every cycle under the influence of hormones. The basal layer provides functional growth.
Myometrium. It is the source of the described tumor. Myomatous nodes are localized in the muscle layer of the uterine wall.

Momatous nodes are presented in various types.

Interstitial node or intramural myomatous node. This type is formed in the muscular uterine wall, for example, anterior or posterior. If the tumor does not extend beyond the myometrium, such a node is called intramural.
The submucosal node is located inside the mucous membrane of the uterine wall.
The subserous node is located directly under the serous membrane on the outside of the organ.
The retroperitoneal node grows from the lower sections, for example, the cervical part.
The intraligamentous node is located between the leaves of the broad ligament.

Nodes can develop:

By number and size, myomatous nodes can be:

single and multiple;
large, medium and small.

Nodes can attach to the uterine wall:

on a leg;
on a wide base.

The interstitial myomatous node, located on the anterior or posterior wall of the uterus, is a hormone-dependent pathology. This type is detected in approximately 60% of cases of the total number of nodes. Only 5% of interstitial or intramural nodes are localized in the cervical region.

Interstitial nodes come in several forms.

Intramural nodes do not extend beyond the boundaries of the anterior or posterior wall of the uterus.
Interstitial-submucosal neoplasms grow inside the uterine cavity.
Interstitial submucosal tumors progress outward or toward the peritoneum.

Typically, interstitial myomatous nodes along the anterior wall of the uterus develop latently. Localization inside the uterine wall causes a disruption of contractile function, which causes a characteristic clinical picture.

Causes

The etiology and pathogenesis of a disease such as uterine fibroids have not been sufficiently studied. In modern gynecology, three hypotheses are actively being developed:

congenital structural features of the uterine wall caused by intrauterine developmental disorders;
a tumor of the muscular wall of the uterus is considered by some authors as hyperplasia rather than a tumor formation;
acquired pathology that develops as a result of repeated surgical interventions.

Interstitial or intramural uterine fibroids go through several stages of development:

the appearance of a zone of increased growth in the area of localization of small-caliber spiral arteries of the uterus;
progression of a microscopic nodule;
macroscopic appearance of the neoplasm.

The following factors can provoke the growth of interstitial or intramural fibroids along the anterior and posterior wall of the uterus:

endocrine disorders;
multiple surgical procedures;
excess weight;
lack of physical activity;
high blood pressure in women under 30 years of age;
family history aggravated by the disease;
onset of menstruation before age 11;
late first birth;
stress;
venous stagnation.

Interstitial and intramural myomatous tumors have different rates of progression. The volume of neoplasms is measured in weeks of pregnancy. Large uterine leiomyoma causes its deformation.

Symptoms

Signs of intramural or interstitial fibroma depend on the location along the anterior and posterior wall of the uterus, the number and size of tumors. In particular, an interstitial subserous tumor does not have pronounced symptoms when its volume is small.

Multiple uterine fibroids, as well as large tumors, have the following manifestations:

compression of the bladder and intestines;
discomfort or heaviness in the lower abdomen;
pelvic pain, intensifying during menstruation;
acyclic bleeding;
increase in the amount of menstrual flow;
shortness of breath and tachycardia;
anemia.

Often, an interstitial or intramural node on the anterior wall of the uterus causes a constant urge to urinate. Myoma located in the cervical region can cause defecation problems and discomfort during sexual intercourse.

Large uterine fibroids often cause organ deformation, infertility and miscarriage. It has been proven that interstitial leiomyoma can lead to various complications during childbirth.

Diagnosis and treatment

Often, pathology is detected during a routine examination. It is possible to identify a myomatous formation located, in particular, along the anterior wall of the uterus using:

gynecological ultrasound of the pelvic organs;
examination by a doctor on a chair using palpation;
computer and magnetic resonance imaging;
hysteroscopy;
laparoscopy.

During treatment, the following types of examination have diagnostic value:

analysis of hormone levels, which helps prescribe adequate drug therapy;

Dopplerography, which examines blood flow in the formation before embolization of the uterine arteries;
diagnosis of tumor markers to exclude malignancy.

Interstitial or intramural myomatous nodes have a favorable prognosis. These formations have a low oncological risk, progress relatively slowly, and at the initial stage of the disease they are not accompanied by pronounced manifestations.

Treatment of the intramural form of the disease includes several tactics:

Watchful waiting is used for small nodules that do not cause severe symptoms. The patient regularly visits the gynecologist and undergoes examination. As the disease progresses, conservative or surgical treatment is performed. Many doctors consider wait-and-see tactics to be wrong. In the absence of timely treatment, interstitial or intramural myomatous nodes can rapidly progress, leading to the need for surgical intervention.

Drug or conservative treatment is used for fibroids up to 12 weeks. A prerequisite for drug therapy is the absence of dysfunction of neighboring organs. The patient is prescribed hormonal medications to stop the progression of interstitial neoplasms and reduce the manifestations of the disease. Drug therapy is often prescribed before surgery to stabilize fibroid growth.

Surgical intervention is the main type of treatment for myomatous nodes, including interstitial or intramural types. The manipulation can be carried out:

organ-preserving method through laparoscopic and laparotomy myomectomy, uterine artery embolization and FUS ablation;
radical technique using hysterectomy and hysterectomy.

Organ-preserving tactics are recommended for patients of reproductive age. It is advisable to plan pregnancy no earlier than six months after removal of myomatous formations. Radical treatment methods are carried out with concomitant loss of a muscular organ and oncological suspicion.

Surgical treatment is necessarily combined with hormonal and antibacterial drug therapy, which helps prevent many complications and relapses of the pathology.

Treatment of intramural fibroids, causes of tumors of the muscular layer of the uterus during pregnancy

Uterine fibroids are a group of pathological processes during which formations in the form of tumors appear in the mucous membrane and muscles of this reproductive organ. In this case, there is a possibility of diffuse processes occurring; they can involve all uterine layers. The disease occurring in this form has certain courses, and the method of therapy is determined after a complete examination.

Intramural fibroids - what is an intramural myomatous node?

First of all, it should be noted that there are nodes of several shapes. If the nodes are located in the submucosal layer, this indicates the presence of a submucosal form of pathology. This type of fibroid begins to grow towards the peritoneum; if this disease exists, then the localization of the nodes is in the interligamentous apparatus of the organ. If the node is located deep in the muscle layer, then in this case the diagnosis sounds like a transmural or intramural node. In some cases, a diagnosis such as myoma, fibromyoma, or leulomyoma may be made, which is essentially the same disease.

This pathology can occur as a result of a number of reasons:

1 Hormonal levels are often disrupted as a result of high amounts of the hormone estrogen. The node may disappear during menopause. The growth of fibroids in this case can provoke refusal of hormonal pills and lack of pregnancy;

2 The absence or presence of a traumatic factor can play a significant role. First of all, this should include operations, caesarean section, curettage, as well as abortions;

3 The impetus for the development of fibroids can be hormone-dependent diseases, which primarily include adenomatosis and endometriosis. However, the worst thing is if these two pathologies are combined;

4 Myomas in muscle tissue can be caused by polyp, erosion and inflammation;

5 Factors that can provoke the disease include obesity, arterial hypertension, and diabetes mellitus;

6 Nutrition, activity and lifestyle play a significant role.

Doctors today believe that hereditary predisposition may also be a decisive factor in the development of fibroids. Ultimately, it should be said that a lot of effort will be required to eliminate the causes of formations. However, there are options by which you can reduce the likelihood that you will develop fibroids, for example, not having an abortion, choosing appropriate hormonal contraceptives. There should also be no inflammatory processes present.

Symptoms and signs of intramural fibroid development

First of all, it must be said that these processes can manifest themselves against the background of the size of the formation, as well as where it is located and in which direction it is growing. Often, against the background of intramural fibroids, a woman is bothered by bleeding from the uterus, and heavy periods occur, which are accompanied by pain. In some cases, discharge with blood is observed in the middle of the monthly cycle; in the future, if nothing is done, signs of anemia, dizziness, headache, weakness, excessive fatigue, and pale skin may occur.

If we talk about the likely complications of the disease, then necrosis of fibroid nodes can be considered among them. In this case, painful sensations occur in the area of the uterus, blood clots may come out, and the temperature rises, indicating intoxication of the body. In this case, treatment aimed at relieving inflammation can be used; if the condition occurs during pregnancy, surgery may be required.

Pregnancy with fibroids, how it goes, why uterine fibroids are dangerous during pregnancy, complications and possible consequences

Infertility in this case should be noted as a separate complication. During pregnancy, some pathologies may occur. First of all, problems with conception may appear; fibroid nodes may be located in the corners of the uterus, as a result of which the fertilized egg is not able to move normally. If there is a fibroid node on the back wall of the uterus, then difficulties arise with implantation, the embryo is fixed in the lower part of the cervix, which later becomes the cause of miscarriage.

The size of the education plays an important role in this case. If there are multiple small nodes, then there are no problems with pregnancy, and it proceeds without complications. Most often this happens if there is not enough hormone in the body, but during pregnancy this factor goes away. In some cases, the presence of fibroids can cause premature birth, there is also a possibility of bleeding after the birth of the baby, complications from the fetus may also occur, and placental abruption may begin.

It should be noted that in this case you should not rely on ultrasound. As mentioned earlier, such nodes are located in the muscle layer of this reproductive organ. During pregnancy, the uterus stretches. This leads to the tumor stretching to such an extent that it is simply invisible; at first glance it may seem that it has disappeared. This explains the reason why new nodes appear immediately after childbirth.

Diagnosis of intramural fibroids

If we take into account the presence of characteristic symptoms when a tumor of this type occurs, then identifying it can be very simple. First of all, it is recommended to conduct an examination using a mirror, as well as a two-handed examination, which leads to the identification of nodes in the uterus and its deformation. After which it is recommended to undergo an ultrasound examination.

The transvaginal sensor allows you to obtain the most detailed information. Thanks to such an examination, it is possible to understand the nature of the myomatous nodes, their location, size, as well as their general condition. By performing an ultrasound examination, you can also clearly examine the organ and determine the presence of endometriosis, which often accompanies fibroids. All the results obtained must subsequently be compared with a certain norm, namely the size of the organ, the thickness of the uterus and its cervix.

In addition, an effective remedy in this case is hysteroscopy, which allows you to see the intramural node and conduct a general assessment of its condition. This examination allows us to identify complications such as fibroid necrosis. Good performance is shown when performing CT and MRI. Thanks to this examination, it is possible to photograph the node, determine its exact location, and the involvement of neighboring organs and layers of the uterus. In some situations, it is necessary to do laparoscopy; it is especially recommended to do it if there is a possibility of an ovarian tumor, the clinical picture of which resembles the muscular location of the node.

Treatment of intramural uterine fibroids, whether it is necessary to treat, what to do?

As was said before, the principle of therapy is directly related to the location of the formation, the woman’s age and the size of the tumor. For dolet women, techniques are used that leave the uterus, after which the woman can still give birth to a child. In this case, there is the possibility of embolization of myomatous nodes. This method involves disrupting blood circulation in the node, which causes its anesthesia. After a few months, complete restoration of the inner layer of the uterus is observed; the woman needs to consult a doctor whether it is worth getting pregnant after such treatment or whether it is recommended to undergo hormonal therapy.

In addition, myomectomy is recommended. It is possible to remove fibroid nodes not only through the cervix, but also by laparotomy. In this case, the depth of the lesion, the area of the uterus, and the diameter of the formation play an important role. It must be said that the operation is completely different from curettage, since during cleaning it is necessary to remove the entire inner layer of the uterus, thereby obtaining material for histology, as well as eliminating bleeding, especially if a woman has endometriosis. In this case, a targeted procedure is performed, which is aimed exclusively at removing the node. After 6-12 months, complete restoration of the uterus is observed, after which the gynecologist allows planning a child.

Conservative methods of treating tumors of the muscular layer of the uterus

Despite the fact that in the modern world it is possible to remove formations through the use of surgery, modern women prefer to resort to conservative treatment. First of all, this includes treatment with hormones. Hormone therapy should be selected on an individual basis, depending on the tests obtained and the general condition. This treatment is often prescribed to young women who want to have more children. When pregnancy occurs, under the influence of hormones, spontaneous resorption of the nodes is often observed.

At the same time, in the presence of a nodule with calcites, such therapy will be practically ineffective, even with long-term treatment. At the same time, understanding what such a node actually is, it is necessary to understand that in this case it will not be possible to do without taking hormones. Also, such treatment is prescribed provided that nodes have previously been removed. In this case, such treatment is required in order to prevent the re-formation of nodes, because there is no guarantee that the fibroids will not grow back. The possibility of recurrence of nodes can be eliminated only if the woman’s uterus is completely removed.

What is intramural uterine fibroid?

Myoma is the formation of a tumor in the muscular uterine layer (myometrium). There are two types of lesions: nodular and diffuse (passes through all uterine layers).

Diffuse is extremely rare, so in most cases we are talking about myomatous nodes.

There are several types of fibroids:

Subserous - grows on the outer surface of the uterus;
Sumbucous is localized inside the uterus, in the submucosal layer, in contact with the endometrium;
Cervical fibroids grow in the cervix;
Intramural fibroids are a neoplasm in the uterine cavity that is localized in the middle, muscular layer of the myometrium.

Let's take a closer look at the last type of tumor.

Causes

Intramural uterine fibroids can appear for the following reasons:

Impaired estrogen levels (usually elevated when fibroids appear). After the onset of menopause, the concentration of estrogen naturally decreases, which is why many cases of disappearance and resorption of myomatous nodes are recorded during this period;
Late birth of the first child or complete refusal to give birth to children;
Various surgical manipulations on the uterus (abortion, operations, delivery by cesarean section);
The woman has diseases such as adenomatosis or endometriosis;
Chronic inflammation in the uterus;
The presence of polyps and erosion.

Risk factors

The likelihood of intramural node formation increases if:

The patient has diabetes;
Are overweight;
Diagnosed with arterial hypertension;
Close female relatives (mother, grandmothers) have or had fibroids. There are even cases of detection of intramural nodes in the initial stages in girls of age due to knowledge of the medical history of their closest relatives.

Symptoms

Intramural uterine fibroids manifest themselves with the following symptoms:

Periodic intermenstrual bleeding;
General state of weakness;
Anemia;
Pain in the lower abdomen (if the myomatous node is located on a leg, the pain is very severe);
Increased urination;
Constipation (chronic);
Pinched nerves, which are expressed by pain in the limbs, abdomen, heart, spine;
Painful, irregular menstruation.

The intensity of symptoms directly depends on where the myomatous node is attached (posterior or anterior wall of the uterus) and with what intensity it grows.

Complications

Possible complications of intramural nodes include the following:

Tumor necrosis - characterized by severe pain in the uterine area, fever, bleeding from the genital tract with blood clots. In this case, surgical intervention and anti-inflammatory therapy are indicated;
Fatty deformation of the neoplasm: the fibroid increases and begins to compress nearby organs in the patient’s abdominal cavity;
Infertility:

The nodes are localized in the corners of the uterus, which makes it difficult for a fertilized egg to pass through the genital tract;

The node is located on the back wall of the uterus, which prevents the attachment of the embryo; the egg attaches to the cervix and after a while a miscarriage occurs.

In severe cases, intramural uterine fibroids cause chronic iron deficiency anemia.

Intramural fibroids and pregnancy

The course of pregnancy directly depends on the size of the tumors:

If the myomatous node is small (even if there are several of them), pregnancy will occur without problems, complications are unlikely. There are known cases of resorption of intramural nodes during pregnancy, which occurred due to the regulation of the woman’s hormonal levels;
Large tumors can cause the following complications during pregnancy:

Premature placental abruption before birth;

Heavy postpartum bleeding;

Complications in the baby.

Diagnosis

To diagnose intramural fibroids, you must undergo the following tests:

Examination by a doctor of the uterus for an increase in its size using mirrors and the two-handed method;
Examination of the uterus using a transvaginal sensor: it will accurately show the overall picture: the number and size of tumors, the presence of associated complications in the form of endometriosis, adenomyosis;
Hysteroscopy to identify possible tissue necrosis of the myomatous node;
CT or MRI;
Laparoscopy.

Treatment

Treatment tactics depend on the size of the fibroid, where it is located, and whether it is single. One of the main factors speaking for or against surgical intervention is the age of the patient. They try to preserve the uterus for women up to 40 years of age.

Surgical methods

Embolization is a disruption of blood flow in the tumor cavity, leading to its complete death. After embolization, hormonal therapy is prescribed, after successful completion of which it is allowed to begin planning a pregnancy;
Myomectomy – removal of a myomatous node. It is performed by two methods: laparotomy and removal through the open cervix. Only the location of the node is excised. After a year it is allowed to plan a pregnancy;
Vaporization is a method of killing tumor tissue by exposing it to high and low temperatures;
Removal of the uterus by laparoscopy or abdominal (through an incision in the peritoneum) is indicated for:

Suspicion of degeneration of the node into a cancerous tumor;

The size of fibroids is more than 12 weeks of pregnancy, combined with bleeding and anemia.

Conservative treatment

Hormonal therapy is indicated if a woman is planning a pregnancy (after pregnancy, fibroids may disappear under the influence of hormones) or if fibroids have been removed surgically;
Sedatives, sedatives (stress causes intensive growth of nodes);
Immunomodulators.

Physiotherapy

Physiotherapeutic methods can also influence the intensity of fibroid growth and restrain it. The following methods of physiotherapy are applicable in the treatment of myomatous nodes:

Hirudotherapy (treatment with leeches);
Ozone therapy;
Irradiation of the patient's blood with ultraviolet rays (UFOB);
Laser blood treatment (ILBI);
Plasmapheresis.

Intramural uterine fibroids are much more treatable in the early stages, so at the first alarming symptoms you should contact a qualified specialist for examination and clarification of the diagnosis.

It can affect all layers, or it can be nodular, which is more common.

Types and causes of the disease

The intramural (transmural) node is localized in the muscle layer. With this pathology, a diagnosis may be made: myoma, fibromyoma, leiomyoma.

Intramural miasmatic node can be caused by various factors:

hormonal imbalance (predominance of estrogen)
genetic predisposition
mechanical procedures in the uterine area (curettage, operations, caesarean section)
hormone-dependent diseases (adenomatosis,)
chronic diseases of the genital organs
high blood pressure, diabetes, excess weight

Since hormonal levels have a great influence, with the onset of menopause and a decrease in estrogen levels, the nodule may resolve. But if you refuse hormonal therapy, fibroids can begin to grow. Women's health is also affected by lifestyle: physical activity, nutrition, bad habits.

How does the disease manifest itself?

A small node in the uterus does not cause discomfort to a woman. As the formation increases, the following symptoms appear:

pulling
intestinal motility disorder
dysuric disorders

The latter symptoms are associated with an increase in the size of the node and its pressure on neighboring internal organs. Possible nerve pinching.

Fibroids and pregnancy

Large nodes have a negative impact on the course of pregnancy. Possible complications: miscarriages, bleeding, placental abruption, weak fetus.

Diagnostic methods

You should consult a doctor if typical symptoms appear. The gynecologist performs the following examination:

inspection with mirrors
two-manual examination

Using palpation, the gynecologist can immediately detect nodular formations. After this, it is prescribed to confirm the diagnosis. Additional diagnostic method: transvaginal sensor. It allows you to determine the location of nodes, their sizes, and condition.

The next research method is hysteroscopy. It is reliable even in the initial stages, allows you to determine the size and condition of the node, and prevent necrosis.

Complications and treatment

The most dangerous complication with an intramural node is. Pregnancy is also difficult. It is possible to get pregnant with fibroids, but the fertilized egg has difficulty moving. If the node is localized in the posterior wall of the uterus, then the egg will not be able to gain a foothold for further development. If it becomes fixed in the cervical area, a miscarriage will occur.

The technology for treating small and moderately complex nodes depends on the patient’s age, location of the nodes, and size. During childbearing age, treatment is carried out with medication; doctors try to preserve the uterus to the last.

Myomectomy involves removing the node by laparotomy or through. The technology resembles curettage, but not the entire mucous layer is removed, but only the area where the node is located. Complete restoration of the uterine cavity occurs after six months to a year. After this period, you can plan to conceive a child.

Vaporization - the node is exposed to different temperature conditions. As a result, the node becomes necrotic. The procedure is effective only for small nodes, no more than 60 mm.

In adulthood and if there is no desire to have children in the future, they resort to removal of the uterus. The organ is removed using laparotomy or the cavity method. Indications for removal:

suspected cancer
presence of endometriosis
anemia

So, what are intramural uterine fibroids? This is a benign tumor that forms in the muscular part of the uterus. Because this is the largest area of the uterus, it is most vulnerable to tumor development.

Intramural myomatous node is the most common diagnosis among these pathologies and has its own characteristics of the development of the disease. And treatment tactics are selected individually, based on a preliminary examination.

There are several types of nodes in the body of the uterus:

Submucosal form– a nodular form of fibroids, which is located in the mucous layer of the uterus. The growth occurs predominantly in the abdominal side. Submucosal nodes cause severe pain with intense frequency. The uterus quickly increases in size.

Interstitial form– the formation of nodes is located in the interligamentous apparatus. As a rule, there is a multiple accumulation of nodes in the muscles, which causes heavy menstruation.

Intramural uterine fibroids– formations are found in the muscle layer.

Intramural-subserous fibroid– forms on the outside of the uterus, affecting the pelvic area. They are characterized by mild symptoms, which is the reason for late detection. In this case, a diagnosis of “subserosal fibroids of the uterus” is made.

Depending on the degree of disease, single and multiple appearances of tumor nodes can differ.

Reasons for appearance

The following reasons can lead to the development of this pathology:

Hormonal imbalance.
Any nervous system disorder.
Factor traumatic to the uterus: abortion, curettage, surgery.
Hormone-dependent diseases – endometriosis and adenomatosis.
A chronic inflammatory or infectious process in the uterus.
The presence of diseases such as diabetes, excess body weight.
Having irregular sex life.
Endocrine diseases.
Wrong lifestyle and nutrition, bad habits.
Menopause period.
Hereditary predisposition.

Symptoms

The most unpleasant and dangerous thing is that intramural fibroids can be asymptomatic, not making themselves felt until the fibroid nodes increase in size. In such cases, there will be pressure on neighboring organs and disruption of their functions, resulting in deformation of the uterus. In this case, the symptoms of the disease begin to clearly appear.

The most common symptoms of intramural uterine fibroids are:

Changes in the menstrual period of various types: an increase in the duration or amount of discharge, the presence of blood clots.
The presence of painful discomfort during menstruation: there is severe pain and a feeling of heaviness in the area of the uterus.
Heavy bleeding, which can subsequently cause increased fatigue, weakness, headache and dizziness, and pale skin. This usually indicates anemia.
Constant presence of pain in the lower abdomen.
There may be problems with the functioning of the bladder.
Presence of bleeding during the intermenstrual period.

The manifestation of signs of the disease depends on:

Node size;
Its location;
The degree of its growth.

5 myths about uterine fibroids video

Diagnosis of the disease

The presence of a neoplasm in the form of intramural fibroids anywhere in the uterus can be detected during a routine preventive examination by a gynecologist. With the help of mirrors on the gynecological chair, the doctor will notice the enlargement of the uterus. To make an accurate diagnosis, additional examinations and procedures will be needed:

Ultrasonography
Hysteroscopy.
Magnetic resonance imaging.

Treatment tactics

The course of treatment depends on the woman’s age, location and size of the tumor, as well as the presence of concomitant diseases and the causes of this pathology.

If the size of the intramural node is small - up to 2 cm - wait-and-see tactics with regular monitoring are acceptable.

A woman’s age is important in determining the preservation of reproductive function and the need for the patient to preserve internal organs to bear a child. Treatment can also be surgery.

During a medical course of treatment, patients are prescribed hormonal drugs to normalize the menstrual cycle and reduce the size and growth of nodes. As a rule, the hormonal course is 8-9 months. If intramural nodes are large, hormonal therapy may also be prescribed before surgery to reduce their size.

Treatment methods

Embolization– blocking with a medicinal method the access of blood to the neoplasm for its subsequent death. Within two months, the damaged layers are restored.

Myomectomy– removal of the node by surgical intervention. The affected area is cleaned and taken for histology. Restoration of the organ and pregnancy planning are possible a year after the operation.

Vaporization– exposure of the node to sudden changes in temperature, which leads to its death.

Hysterectomy– complete removal of the uterus. The operation is performed if a woman does not need to preserve her reproductive function. Also, large bleeding fibroids or suspected malignant tumors undergo this operation.

Modern methods of treating intramural nodes help protect a woman from having her uterus removed. After such operations, a long recovery period is not required, and the possibility of infection of the body from the external environment is reduced.

After any operation, a restorative course of treatment is required in compliance with all recommendations of the attending physician.

A woman who has been diagnosed with an intramural node must register with a dispensary and undergo regular medical examinations.

Consequences

If treatment is not started in a timely manner or if it is not treated independently, the following complications may develop:

Anemia;
Large blood loss;
Dizziness, attacks of nausea and vomiting;
Pressure of the tumor on nearby organs;
Development of bladder problems;
Renal dysfunction;
Development of frequent constipation:
Inability to bear a child;
Infertility.

Pregnancy and intramural node

Pregnancy may well occur and develop fully without any special features in the presence of intramural fibroids. But sometimes, miscarriage and other complications can occur.

During pregnancy, the location of the fibroid and the node is very important. Myomatous nodes can be located in such a way that they can provoke the development of complications during this important period.

In addition, the size of the node is important. Small nodes will not prevent conception; if its growth is not observed, then the pregnancy period will pass without complications.

If the formation is located near the placenta, it can provoke miscarriage caused by intrauterine infection of the fetus or insufficient supply of nutrients from mother to child.

If there are large nodes, pregnant women may face the following complications:

Untimely onset of labor;
Spontaneous miscarriage;
Rejection of the placenta;
Heavy bleeding.

For these reasons, ultrasound is performed quite often during pregnancy to monitor growth and prevent the development of complications.

When indicated, surgical removal of the node is prescribed, namely for:

Rapid increase in the size of the tumor node;
Impossibility of independent childbirth due to the location of the tumor;
Antepartum hemorrhage;
Acute fetal hypoxia.

As a rule, neoplasms during pregnancy, if they do not cause complications and do not cause inconvenience or pain to the expectant mother, are removed after childbirth.

If an intramural node has developed due to a hormonal imbalance, during pregnancy the disease can heal itself as the hormone levels are restored. However, this does not indicate that the fibroid has resolved without a trace. Because muscles stretch during pregnancy, nodes may not be noticed during examination. Also, ultrasound examination when the nodes are located in the muscle layer may not be reliable. After childbirth, fibroids may reappear.

It should be taken into account that this pathology significantly complicates the course of childbirth. As a rule, delivery in such cases is performed by caesarean section.

Prevention

Simple preventive measures will help reduce the risk of developing pathology:

Active lifestyle with regular rest and sleep;
Rejection of bad habits;
Refusal of abortion;
Correct selection of hormonal drugs;
Avoid chronic inflammatory processes.

In addition, the following are important in preventing the development of uterine fibroids:

Timely complete cure of diseases of the genital area, including STD infections;
Regular observation by a doctor during menopause;
Correction of hormonal levels;
Use of protective equipment to prevent abortions;
Regular sex life with a regular partner;
Do not expose the skin to direct sunlight, avoid skin burns.

Well, of course, it is necessary to lead a healthy lifestyle, maintain a normal weight, and eat properly and nutritiously.

Be attentive to your own health, regularly undergo preventive examinations with a doctor, then you will not be afraid of any health problems!

Can intramural nodes be malignant? What do you need to know about the intramural node? Treatment of intramural and subserous-intramural fibroids

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Diagnostics

Treatment of intramural and subserous-intramural fibroids

Treatment of intramural fibroids

Treatment of subserous-intramural fibroids

Forecast

About the organ

Causes

Symptoms

Clinical picture

Diagnostics

Therapy

Hormone therapy

Other medicines

Folk remedies

FUS ablation

Operation

Indications

Operation process

Rehabilitation

Forecast

Prevention

Types of intramural leiomyoma

Causes of tumor

Symptoms of the disease

Diagnostics

Treatment

How to treat an intramural node in the uterus during childbearing years, is it possible to avoid surgery

Types and causes of the disease

How does the disease manifest itself?

Fibroids and pregnancy

Diagnostic methods

Complications and treatment

Conservative treatment method

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Interstitial and intramural myomatous nodes

Causes

Symptoms

Diagnosis and treatment

Treatment of intramural fibroids, causes of tumors of the muscular layer of the uterus during pregnancy

Intramural fibroids - what is an intramural myomatous node?

Symptoms and signs of intramural fibroid development

Pregnancy with fibroids, how it goes, why uterine fibroids are dangerous during pregnancy, complications and possible consequences

Diagnosis of intramural fibroids

Treatment of intramural uterine fibroids, whether it is necessary to treat, what to do?

Conservative methods of treating tumors of the muscular layer of the uterus

What is intramural uterine fibroid?

Causes

Risk factors

Symptoms

Complications

Intramural fibroids and pregnancy

Diagnosis

Treatment

Surgical methods

Conservative treatment

Physiotherapy

Types and causes of the disease

How does the disease manifest itself?

Fibroids and pregnancy

Diagnostic methods

Complications and treatment

Reasons for appearance

Symptoms

5 myths about uterine fibroids video

Diagnosis of the disease

Treatment tactics

Treatment methods

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Pregnancy and intramural node

Prevention