Gynecology

Features of the development of uterine fibroids in combination with endometriosis: signs, treatment and prognosis

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Situations in which the patient is diagnosed not one but several associated pathologies are not uncommon. Today, a uterus uterus myoma in combination with adenomyosis is found in every third woman aged 35 years. Hearing such a difficult diagnosis, do not panic. It is necessary to understand what these two diseases are and what modern methods of therapy are used to treat them.

Characteristics of both diseases

Endometrial adenomyosis in combination with uterine myoma in the early stages of development does not show any symptoms or discomfort. In most cases, they are diagnosed during examination, which are solved in cases of suspected infertility. To determine the risk of the simultaneous development of these diseases, it is necessary to understand what they are.

By myoma means benign formations formed from the muscle fibers of the uterus. The primary cause of tumor formation is hormonal imbalance. The most frequently diagnosed nodular myoma is a formation consisting of several cones of different sizes. Locations of tumors can be different - in the uterine cavity or on its neck, falling into the abdominal cavity. Gynecologists distinguish several types of myomas that are not dangerous to the fetus during pregnancy. They may not show pronounced symptoms for a long time.

Endometriosis

This pathology consists in the growth of pathogenic endometrial cells, both inside and outside the uterus. As a result of the formation of an additional layer, the functionality of the ovaries is disrupted, the process of follicular maturation and ovulation of the egg is disrupted. One of the most common consequences of this pathology is the impossibility of fertilizing and carrying a child (infertility). In addition, on the background of endometriosis, development of an endocervical cyst is observed - a vesicular body, provoking abundant uterine bleeding and other complications.

Causes of uterine fibroids in combination with endometriosis

Both pathologies are often diagnosed in patients. After all, the root causes of their development are the same:

  1. Hormonal failure observed during pregnancy, menopause or endocrinological diseases. It is against the background of impaired production of biologically active substances by the body by various gynecological diseases (including uterine fibroids and endometriosis).
  2. Inflammatory processes, most often observed due to the violation of the integrity of the epithelium of the walls of the uterus (postpartum period, abortion).
  3. Immunodeficiency. This is one of the reasons for the rapid spread of internal endometriosis. Pathogenic cells penetrate the tissue of the uterus, forming nodes in them and continuing to grow as myomatics.
  4. Genetic predisposition of the patient. If a woman has been diagnosed with fibroids in the family, there is a high probability that she will confirm the same diagnosis. The development of endometriosis is less dependent on genetic predisposition.
  5. Constant stress and fatigue provoke a decrease in immunity. Therefore, in women with irregular work schedules, the likelihood that uterine fibroids and endometriosis are diagnosed together increases.

The formation, growth and spread of pathogenic cells are influenced by the degree of environmental pollution. A high concentration of toxic substances in the air, water, causes a violation of reproductive function and the emergence of various neoplasms.

These pathologies can develop asymptomatically in the body. The main signs of uterine fibroids in combination with endometriosis are:

  1. Violation of menstruation.
  2. Long and abundant menstrual cycle.
  3. Pain in the lower abdomen of the aching nature, which increases before menstruation.
  4. Abdominal pain increases during sexual intercourse with a partner, becomes like a contraction.
  5. Pain increases with constipation - attempts in an attempt to empty the intestines.
  6. Sometimes there are disorders of the urinary system - frequent urge to the toilet, the process of emptying the bladder is accompanied by painful, uncomfortable sensations.
  7. Reproductive dysfunction.
  8. If uterine fibroids have reached a large size, uterine bleeding occurs.

These symptoms may not appear at the same time. But signs of uterine fibroids in combination with endometriosis are the reason to undergo a comprehensive examination by a doctor.

Diagnostic measures

In most cases, both pathologies are diagnosed during a routine gynecological examination. To confirm the preliminary diagnosis, the patient is prescribed an additional examination:

  1. Ultrasound diagnosis.
  2. Hysteroscopy.
  3. Hysterosalpingography diagnostics.
  4. Laparoscopic study.

Some of these procedures are performed using a contrast agent injected through the patient’s abdominal cavity. These diagnostic measures can detect pathogenic cells of both pathologies.

Treatment methods

Doctors after diagnosing these two pathologies prescribe therapy. Treatment methods may vary. Two methods of therapy are most often used:

  1. Conservative treatment. It is used to treat fibroids of small sizes. Sometimes traditional medicines are combined with traditional medicine recipes. Also often used hormonal drugs for the treatment of uterine fibroids and endometriosis. Medicines based on biologically active substances contribute to the reduction of tissue lesions.
  2. Surgical intervention. This method of treatment is used in cases where the results of drug therapy were unsatisfactory. Another operation is assigned to patients in whom the size of pathogenic formations is too large and cannot be cured by alternative methods.

Today, the treatment of uterine fibroids and endometriosis is carried out using minimally invasive methods. For example, laparoscopy, a procedure for diagnosing pathologies, is often used to remove nodes.

Do I need surgery, what and when?

Surgery is the most effective method of treating these pathologies. It is used if the drugs for the treatment of uterine fibroids and endometriosis have been ineffective. There are several ways to remove pathogenic tissue and formations. The most popular today are laparoscopy and hysteroresectoscopy. These methods of surgical intervention allow you to remove education without performing punctures or incisions of soft tissues. There are a number of clinical indications for which surgery is necessary:

  1. When diagnosing formations of large sizes.
  2. If uterine fibroids cause heavy and frequent bleeding.
  3. If there is a rapid tissue hyperplasia.
  4. Myoma tissue begins to die off.
  5. With a strong pain syndrome.
  6. If myomatic or endometrial formations have passed into malignant tumors.

In extreme cases, doctors recommend a full-scale operation, during which the uterus is completely removed. Such intervention is used for particularly advanced forms of pathologies.

Home ways

Uterine fibroids and endometriosis are not diseases of the new generation. These pathologies have been known for a long time. Traditional medicine offers many effective recipes for the treatment of these diseases. But they can not be used independently. Treatment of folk remedies should be agreed with your doctor. And sometimes gynecologists themselves recommend taking decoctions of medicinal plants in the early stages of pathologies. In addition to herbal medicine, the following are used for treatment:

  1. Therapeutic clay.
  2. Leeches.
  3. Bee products.

Before you start applying the recipes of traditional medicine, you must pass the test for the body's sensitivity to biologically active components. This is done to exclude the possibility of the development of allergic reactions to alternative treatments.

Contraindications

If the gynecologist decides to monitor the progression of growth of the formations or use medical methods of treatment, the patient must adjust their lifestyle. After all, conservative treatment of fibroids and endometriosis has contraindications:

  1. Self-medication. Arbitrary ingestion of decoctions or medicines not prescribed by a doctor can lead to a worsening of the clinical picture of pathologies and other unforeseen consequences.
  2. Receiving progesterone medication. They often cause tumors to grow.
  3. A woman should avoid conception - pregnancy in the presence of uterine fibroids and (or) endometriosis is one of the main contraindications to drug treatment.
  4. It is impossible to be in direct sunlight for a long time, to minimize exposure to ultraviolet radiation (to refuse to visit the solarium).
  5. Bad habits (from fatty foods, alcohol, cigarettes will have to be abandoned).
  6. Physical exercise. To avoid the possibility of uterine bleeding from visiting the gym, running will have to be abandoned.

If you diagnose the disease in time and prescribe treatment, the chances of complete recovery are high. Patients after therapy become pregnant and give birth to healthy children.

Judging by the opinions of women who have been diagnosed with uterine myoma and endometriosis, the disease is effectively treated with the help of conservative methods of treatment and herbal medicine.

For quite a long time I treated myoma with hormones, the therapy gave a good result. The tumor has decreased in size, but endometriosis has also been added to it. The doctor advised me to take a course of herbal treatment. Personally, it helped me and my physical condition improved.

Kristina, 29 years old

I was diagnosed with myoma and endometriosis during an examination at the gynecologist. At first I was very scared, and the doctors insisted on the operation, the node was quite large. But I did not operate on it and went to see another doctor, he advised me to drink hormones for a start and see what would happen. Now, halfway through the course, the tumor has decreased a little. While continuing treatment.

I did not drink hormonal medications, I decided to have an operation and have no regrets. Recovered in 4 months. I feel good now. For the prevention, I once every 6 months drink special herbal preparations for women's health, which the doctor advised me ..

What is a disease?

Internal endometriosis is the pathology in which endometrial cell structures grow beyond the boundaries of a given layer.

As a result, functional connections between the ovaries and the uterus are destroyed, follicular maturation and ovulatory processes are disturbed.

Such violations provoke a violation of the hormonal status, weakening of the immune system and leads to the appearance of tumor formations.

Causes of development

The etiology of endometriosis has not been fully elucidated, however, experts have managed to determine the range of factors that can affect its occurrence:

  1. Mud therapy in the form of mud baths,
  2. Frequent stressful overload
  3. Pathological childbirth or the presence of abortions in history, accompanied by inflammatory complications, uterine perforation, etc.,
  4. Abrupt change of climatic conditions of residence,
  5. A large number of diagnostic scraping and other intrauterine manipulations, such as an IUD installation or surgery,
  6. Irradiation with ultraviolet rays (insolation).

Uterine fibroids on the background of internal endometriosis

The simultaneous formation of myomas and endometriosis usually occurs on the background of sharp hormonal jumps or failures, in the postpartum period, on the background of abortions or inflammations, traumatic injuries or miscarriages, etc.

An equally important factor provoking the development of such a combination of pathologies is harmfulness at work, unhealthy habits, aggressive ecology, hereditary predisposition, mental stress and so on.

The endometriosis combination may initially remain unnoticed by the patient, and is only detected during the examination, most often associated with infertility.

It happens that pathology is manifested only by a single sign or several:

  • Menstrual disorders,
  • Long and abundant periods,
  • The aching pain of a persistent nature in the uterus, which is prone to aggravation when menstruation occurs,
  • Increased pain during sexual intercourse, pain becomes cramping,
  • Often, exacerbation of painful symptoms occurs due to constipation,
  • There are urinary disorders such as frequent urge, painful urination, etc.

Ways of making a diagnosis

Typically, such diseases are detected during gynecological examinations, some patients have any of the listed symptoms, which causes them to consult a gynecologist.

To confirm the diagnosis, it is necessary to undergo an ultrasound examination, hysteroscopy, etc. These diagnostic procedures allow to detect the characteristic signs of both diseases.

In addition, the patient is sent for hysterosalpingographic diagnosis and laparoscopic examination. These procedures involve the use of a special drug, administered through abdominal punctures.

Usually, treatment of uterine fibroids with endometriosis is based on operative measures. The specific method is selected in accordance with the form of myoma tumors, the patient's condition, age characteristics and degree of neglect of pathological processes.

Surgical intervention

The main indications for surgical debridement are:

  1. Large myoma nodes
  2. Bleeding endometrial localization,
  3. Noticeable decrease in performance
  4. The rapid growth of formations
  5. The death of nodular tissues
  6. The presence of malignant processes
  7. Unbearable pain,
  8. The spread of endometriosis on adjacent tissues.

In most cases, specialists conduct organ-sparing operational measures such as laparoscopy, hysteroresectoscopy, etc. Modern operations are performed even without punctures in the abdomen, all manipulations are carried out in a transvaginal way.

Treatment after surgery

After undergoing surgical treatment, the patient is usually prescribed long-term hormone therapy with drugs like ARGG (hypotalamic Rizlin hormone agonists).

With the help of these drugs, the patient artificially causes menopause. When the body is gradually restored, and the hormones are canceled, the menstrual functions resume again.

If the case is pathologically serious and there is a real danger for the patient's life, then the uterine body is removed.

Fortunately, such an operation is used quite rarely and in particularly neglected cases of pathology.

After uterine ectomy, complications such as:

  • Sexual impairment,
  • Memory impairment
  • Sharp drops of emotional and mental state,
  • Completeness
  • Painful sex
  • Frigidity
  • Anorgasmia,
  • Cancer pathologies, etc.

Classification

All fibroids are divided into diffuse and nodular. The former are quite rare, so when diagnosing uterine fibroids, doctors most often have in mind precisely the nodular form. Very often, the nodal form of the disease is combined with such pathologies of the reproductive system as endometriosis and adenomyosis, therefore, several diseases are usually treated at once. These diseases are dangerous because if they are not started in a timely manner, they can cause infertility.

Depending on the location of the tumor, the uterus myoma is divided into the following main forms.

  • Subserous form is located under the serous membrane of the uterus, often on the leg and looks on ultrasound like a small mushroom. It is dangerous that when torsion of this leg necrosis of tissues appears, and this condition is very dangerous for the body. If the subserous nodular myoma reaches a large size, it has a squeezing effect on the organs adjacent to the uterus. This leads to disruption of the functioning of these same organs. For example, difficulty urinating.
  • Submucous nodular myoma is located under the mucous membrane, therefore, it is almost always the cause of uterine bleeding. Most blood loss, if not treated, leads to anemia and the accompanying symptoms. In this case, the woman looks tired and faded.
  • The intramural nodular form of uterine fibroids is located in the muscle layer and occurs most frequently. A tumor can grow both inside the body, and out and on an ultrasound looks like a thickening in the wall of the uterus. The main symptoms of this form of the disease - disruptions in the menstrual cycle, pain, increased blood loss.

The uterus myoma can be multiple. At the same time, several tumors of different size and location are detected. The most common treatment for multiple nodal myomas is more difficult, but easier to detect.

Causes of

The exact cause of the appearance of nodular uterine fibroids in combination with adenomyosis or endometriosis was not found. Однако однозначно известно, что появлению этой формы заболевания способствуют несколько факторов.The main are 2 theories of the appearance of the disease

The first theory says that even during intrauterine development, a so-called defective cell appears in the woman's body.

When a combination of several concomitant factors, this cell begins to divide and thus the growth and development of the tumor occurs.

Imbalances of sex hormones, stress, some diseases of the female reproductive system, such as adenomyosis or endometriosis, as well as a combination of some other factors can be provoking factors.

The second theory also says that there is such a defective cell in the body, but it does not appear in the prenatal period of development, but at the onset of the menstrual cycle. Part of the muscle cells of the uterus, which were supposed to prepare the organ for the attachment of a fertilized egg, do not die after the pregnancy has not occurred, and leave the body along with menstruation.

They remain for the next cycle, but they are already pathological. Some of them may later die, and some - turn into the nodular form of uterine fibroids. If there are several, then multiple nodes may appear.

Also factors contributing individually or in combination to provoke the appearance of fibroids together with adenomyosis and endometriosis are:

  • inflammatory processes in the reproductive system,
  • abortion and other interventions in the integrity of the uterus,
  • uterine injury,
  • overweight and related diseases
  • endocrine disruption.

The nodular form of uterine fibroids in combination with endometriosis and adenomyosis or without them can develop asymptomatically for a long time. And to begin to manifest itself only reaching large sizes or in a multiple form. Symptoms may vary depending on the type of site, but the following are considered major.

  • Various violations of the menstrual cycle, most often an increase in the duration of discharge and their abundance.
  • Bleeding in the middle of the cycle.
  • Pains that intensify during the premenstrual period.
  • When the nodes of large sizes are possible violations in the work of neighboring organs with the uterus. For example, problems with urination or defecation.
  • If the node grows in the uterus, then there are problems with the conception of a child.
  • There may be pain during sex.

With multiple nodes of different shapes, the symptoms may be slightly blurred.

Not long ago, the diagnosis of uterine myoma was a verdict, because it was thought to be dangerous because it was a precancerous condition. Therefore, almost all tumors, and especially large sizes were treated either by removing the node or by removing the uterus. The latter was common if nodular myoma was diagnosed in combination with diseases such as endometriosis and adenomyosis. Modern medicine offers several treatments that preserve the reproductive function of women.

The choice of treatment for a disease will depend on how large the node is, how dangerous the fibroid is, whether it is multiple, how old the patient is, whether adenomyosis or endometriosis is present in combination with myoma and other factors.

Drug treatment

This type of treatment of the uterus myoma nodular form is recommended for tumors of small size, possibly with multiple nodules. It is also possible to treat a tumor that has appeared in combination with adenomyosis or endometriosis. The main readings are two groups of drugs - hormonal contraceptives and gonadotropin-releasing hormone agonists. However, none of the groups of drugs eliminates the main cause of the nodular form of fibroids. They only reduce symptoms or suspend the growth of the tumor. However, after cessation of drug treatment, everything can return.

It should also be remembered that the treatment of this disease with hormonal drugs can provoke the appearance of various side effects, the most famous of which is weight gain.

Sometimes medication is prescribed to reduce the site of large size and prepare for further surgical treatment.

Uterine artery embolization

This method of treatment has proven itself with the uterine fibroids nodular form. It is effective even for multiple nodes and tumors of large sizes. Its essence lies in the fact that there is an obstruction of the arteries supplying the myoma node. To do this, use special microscopic particles - emboli. The method is considered safe for the reproductive system, since the tumor feeds through a separate artery, so there is no disturbance in the functioning of the uterus.

After the cessation of nutrition, the myoma node begins to decrease in size. Moreover, this process is irreversible, in contrast to drug treatment. As the size of the tumor decreases, symptoms begin to disappear. The menstrual cycle returns to normal, and the pain disappears.

Another advantage of this method of treatment is the simplicity and speed of the manipulations. The whole operation takes no more than an hour, and for rehabilitation it takes a day. In the future, you need only periodic visits to the gynecologist to monitor the condition of the body.

Surgical treatment

In case of uterus nodal myoma, treatment is often prescribed, in which the tumor is removed during surgery. Myomectomy is most commonly used - that is, the removal of the node while preserving the uterus itself. The most benign method of surgical treatment is laparoscopy, in which the node is removed without abdominal surgery. The doctor only makes punctures through which he gets access to the tumor. Often, this method is assigned if the tumor is located outside the uterus or has the shape of a node located on the pedicle.

Surgical treatment may also occur with the aid of a hysteroscope apparatus. Most often this is prescribed for intramural or submucous nodules that are located near the inner lining of the organ.

A hysteroscope is inserted into the cavity of the reproductive organ, and the surgeon controls all his actions with the help of a monitor.

The most radical surgical treatment is the removal of the uterus or hysterectomy. It is prescribed for very large nodes, with a combination of the disease with advanced forms of endometriosis and adenomyosis, with a sharp growth of the tumor, when it becomes dangerous for the body. However, now doctors try not to treat the pathology with this method and do everything to preserve reproductive function.

Folk methods

Many older women do not understand: uterine fibroids, the nodal form of the disease - what is it? How it looks and how dangerous it is for the body. And if already diagnosed: nodular myoma in combination with endometriosis or adenomyosis, then it becomes even worse. And therefore, after making such a diagnosis, they are very afraid of modern methods of treatment. But do the traditional methods of treatment help with the nodal form of pathology?

One of the popular herbs in traditional medicine that was used to treat tumors is calendula. It is soaked with a decoction swab and inserted into the vagina. Moreover, the disease should be treated with cooled liquid, three times a day for 2 hours. Also, decoction or infusion of calendula can be used for douching. To do this, it must be mixed with water in a ratio of 1 to 10.

You can treat the nodular form of fibroids with aloe juice in combination with honey and propolis. This combination of ingredients has many positive properties and has a good effect on a woman’s immune system.

Such treatment of fibroids may appoint a doctor who believes that if the node is not large, then you can apply such techniques. However, popular treatment can only reduce symptoms. It can be used only in combination with other techniques with which you will treat your disease.

The nodular form of fibroids, even in combination with endometriosis or adenomyosis, is not a sentence. Timely diagnosis and adequate treatment will help you to simply cope with this disease and live a full life in the future.

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