fibromatosis of the uterus
fibromatosis of the uterus - is the process of replacement of sections of the muscle tissue of the uterus connective tissue, prior to the formation of fibroids uterine body.Fibromatosis of the uterus, contrary to popular opinion wrong patients, not a diagnosis, but merely states the fact of atypical changes in the muscular wall of the uterus, that is considered to be diagnosed contingent.Its outcome is not always predictable: with the progression of the process to complete the formation of benign tumors gormonalnozavisimyh (fibroids), and in the absence thereof fibromatosis may be present in the uterus for years without symptoms or disappear altogether symmetrically menopause.
prevalence of fibromatosis of the uterus is difficult to determine.Often, it can be present in asymptomatic women 25 - 40 years, many years, and is detected by chance.Much more often (30%) diagnosed in the final stage of fibromatosis - fibroids, manifested clinically and causes patients to
ubiquity and availability of ultrasound scanning in gynecology has increased the number of cases of diagnosed fibromatosis of the uterus, and thus allowed it to prevent potential negative consequences.
uterine wall consists of three layers:
1. perimeter.The dense outer serosa.
2. myometrium.The most voluminous and powerful muscular layer having the unique ability to hold the uterus in the developing fetus and the "push" of his birth.Increased strength and good elasticity (stretchability) myometrium cross linked stratified arrangement of muscle fibers, between an outer, podseroznym and internal submucous, layer of longitudinal muscle fibers is an average, circular layer in which the muscle structure spirals.For the elasticity and strength of the myometrium it contains elastic fibers and connective elements.
3. endometrium.Lining the uterine cavity, the outer layer of mucous.
fibromatosis of the uterus is formed exclusively in the myometrium from existing connective tissue structures.By not well studied causes in the muscle layer of an excess of connective tissue, which differs from the normal myometrium greater density and ability to contract.
diffuse fibromatosis uterine myometrium different common seal without clear localization areas proliferation of connective tissue.Sometimes sites fibromatosis have clear boundaries and with a further increase to form nodes.
Hub fibromatosis uterine fibroid is considered to be emerging.
fibromatosis of the uterus Clinical signs are minimal and available only in a large number of lesions.Diagnosis of uterine fibromatosis states ultrasound.Most ehopriznaki fibromatosis of the uterus are the only evidence of his presence.
diagnosis of fibromatosis of the uterus should not scare the patient, since it is conditional.That is, under certain conditions against the backdrop of fibromatosis may (but not necessarily grow) fibroids grow.Therapy fibromatosis of the uterus is designed to eliminate these negative predisposing conditions.
Causes uterine fibromatosis
No significant causes of the uterus sections fibromatosis is not established.However, since a significant proportion of patients fibromatosis of the uterus combined with hormonal dysfunction, one of the reasons why it considered the likely change in the normal balance of sex steroids (FSH, LH and progesterone).According to the most popular theory of the origin of hormonal fibromatosis of the uterus, increase in estrogen and progesterone concentrations decrease provoke structural changes in the tissues of the myometrium.
There are three most popular variant form fibromatosis:
1. The stock option.It is not related to ovarian dysfunction.In the normal ratio of hormone receptors of the uterus properly perceive progesterone, so estrogenic effect on the myometrium increases.This can happen after mechanical damage to the structure of the uterine wall during abortion, dilatation and curettage, diagnostic tools and therapeutic manipulation (hysteroscopy, biopsy, and the like).Inflammatory processes (endometritis, endomyometritis) in the uterus also play a negative role in the origin of fibromatosis.
2. Ovarian option.Any pathological processes in the epididymis, resulting in failure of the proper ratio of estrogen and progesterone.
3. The central option.All hormonal ovarian function depends on proper operation of the regulatory centers in the hypothalamus and the pituitary gland, so changing the controlling influence of the brain can lead to hormonal dysfunction and provoke fibromatosis.Examples of these situations include severe psycho-emotional state, vegetative - vascular disorders, tumors and the like.
on estrogen levels affect chronic liver disease.The liver is responsible for the disposal of estrogens, if it can not cope with this feature, they accumulate in the body.
Some extragenital diseases, especially endocrine, accompanied by lipid disorders.Adipose tissue is able to synthesize a small amount of estrogen, but in obesity when her much estrogen becomes greater.
reliably established a close relationship with fibromatosis risk of the presence of a genetic predisposition.As a rule, in the family of patients have relatives who have symptoms of fibromatosis, uterine fibroids, endometriosis.
None of the above reasons is not absolute, since their presence does not necessarily imply the appearance of structural defects in the uterus.For the development of fibromatosis of the uterus, a combination of causes and conditions for their implementation.
between fibromatosis of the uterus and uterine fibroid there is a close etiological relationship.However fibromatosis not always transformed into fibroids often it exists for years independently.
Symptoms of uterine fibromatosis
fibromatosis of the uterus Clinical signs depend on the nature and prevalence of structural abnormalities in the uterine wall.
fibromatosis of the uterus can be of two types:
- diffuse fibromatosis of the uterus.It is characterized by widespread growth and the lack of clear boundaries.
- nodes or focal, fibromatosis of the uterus.The muscular wall of the uterus present delimited fibrosis areas, reminiscent of the nodes in the early stages of formation.Sometimes they start to grow and transform into uterine fibroids.If the nodes grow outward, they are detected by a serous layer (subserous nodes), nodes with an increase inward (toward the endometrium), they are located in a submucosal layer (submucous glands).
Often the presence of uterine fibromatosis has no clinical expression, therefore, are a surprise to patients.The first signs of fibromatosis may not draw attention to themselves.As a rule, it changes the nature of menstruation.The presence of foci of fibrosis in the muscle tissue interferes with the normal contraction, so menstruation becoming longer, a little painful, and increases blood loss.Such changes in the initial stage of development of fibromatosis expressed softly, and will become apparent only in the case of forming true fibroids.
During a pelvic exam with a small propagation fibromatosis it can not detect.Sometimes it is possible to determine the increase in the density of the uterus and / or a slight increase in its size.
reliable information on the structure of the uterine wall offers ultrasound scan.The presence of fibromatosis say increase (diffuse or focal) in the amount of myometrium locations overgrowth of connective tissue, changing its normal density, the presence of knots.Since fibroids are growing unevenly, both in the uterine wall, you can see the presence of small foci of fibromatosis and "adult" fibroids.
Ehopriznaki fibromatosis of the uterus and uterine fibroids have no clear distinctions.The most significant ultrasound criteria fibromatosis of the uterus are:
- changes in normal-sized uterus (increased 85%);
- deformation of the contours of the uterus (66.7%);
- presence in the walls of the uterus or pathological entities (100%): Seal knots.
When the diagnosis is not obvious uterine fibromatosis, additional diagnostic procedures: laparoscopy or hysteroscopy.
To understand the cause of the disease in a particular patient, conducted a study of hormonal status, established the presence of endocrine and metabolic diseases.
Patients aware of the presence of this disease, always ask the question of how to combine fibromatosis of the uterus and pregnancy.Problems with fertility in most cases do not arise because of fibromatosis, but because of the hormonal disturbances leading to the appearance like fibromatosis, and infertility.Only when in the myometrium are significant violations of the ability to reduce, fibromatosis of the uterus and the pregnancy ends in miscarriage or premature birth.
fibromatosis of the uterus refers to a reversible condition and not always transformed into fibroids.If the diagnosis of uterine fibromatosis delivered on time, it is possible to not only stop the progression of the process, but to eliminate it completely, eliminating the triggers.
treatment of uterine fibromatosis
to decide whether to treat fibromatosis, is taken into account the extent of the process and its severity, and the presence of clinical manifestations.If possible, it is necessary to establish the cause of fibromatous foci in the myometrium.
If a woman does not feel the negative manifestations of fibromatosis, and the process is not progressing, a specific treatment is not carried out, but set a regular (every six months) dynamic control.In between visits to the recommended control proper diet, adequate physical activity, vitamin and strengthens the immune system agents.
With the progression of fibromatosis and the appearance of clinical manifestations need to start therapy.As a rule, the correction of existing hormonal disorders.
To select the correct treatment policy should examine the data of hormonal research.If fibromatosis is formed in the uterus in the background incorrect ovarian function, hormone therapy is appointed.It is designed to restore the normal balance of hormones and eliminate the causes of fibromatosis.
Most used oral hormonal contraceptives with low estrogen (Jeanine, Yasmin, and the like), they mimic the correct menstrual cycle and inhibit the further growth of fibromatosis.
At small sizes fibromatous nodes in combination with endometrial hyperplasia possible appointment of progestogens (Utrozhestan, Duphaston and the like).
Good results showed the use of intrauterine hormonal spiral "Mirena", containing progestogen (levonorgestrel).It is injected into the uterus for five years, where every day, "throws" a portion of the hormone.
Symptomatic treatment includes painkillers, vitamin therapy, sedative and antianemic means.
If the treatment is effective, but the cause of fibromatosis is not eliminated, it can recur.
If fibromatosis of the uterus diagnosed at a late stage, when its transformation into an ambulance fibroids evident, the therapy is similar to treatment of uterine fibroids.Uterine fibroids also does not apply to an irreversible disease.Modern therapeutic techniques allow, if not get rid of it, then it stops its growth and eliminate the negative effects.
fibromatosis and uterine fibroids stop their progression at the time of menopause, and after its completion regress.