Intramural (interstitial) uterine fibroids treated differently from younger women who want to preserve fertility, and women after forty years without planning procreation. Thus the main criterion for choosing a method of treatment is the choice of the woman.
Intramural uterine fibroids - Diagnostic
Intramural uterine fibroids can be detected even when examined by a doctor - the uterus increases in size as in pregnancy. To confirm the diagnosis carried ultrasound, which helps to clarify the size and location of the tumor. If necessary, a hysteroscopy
Hysteroscopy - examination of the uterus inside
(examination of the uterus using a special device - a hysteroscope, to illuminate and increase to the correct size test surface).
Sometimes, for further diagnosis is necessary to carry out X-ray examinations, magnetic resonance and computed tomography (MRI and CT).
Treatment of intramural uterine fibroids in women of childbearing age
If a fibroid uterus in women of childbearing age is small, located in the wall of the uterus, does not increase in size, it can not cure, but only monitor its growth. To do this, the woman must visit the doctor every six months. If the pregnancy occurs, then under the influence of hormones fibroids may decrease to a minimum.
If the tumor has a tendency to increase, it is better to remove. Women who are in the future want to have children, held organ operations - only the tumor is removed (conservative myomectomy). When small tumors (up to 12 weeks of pregnancy), situated closer to the outer surface of the uterine wall and the growing step can be carried out using a laparoscopic approach. This is done using a laparoscope apparatus, which allows you to make several mini-incisions in the skin, they enter through special tools and conduct an operation under the control of (the image is displayed on the screen).
If a tumor grows inside the uterus, the following operation is performed using the hysteroscope, which is inserted through the vagina and cervix in its cavity.
But large tumor was removed by laparoscopic or hysteroscopic impossible. Therefore, prior to the operation woman administered hormone therapy, with which it is possible not only to suppress tumor growth time, but also to reduce its size. After tumor size is reduced, operation is conducted sparing methods.
Very large fibroids, which can not be reduced to the desired size, are removed by conventional operations with large incision - that access to the site of surgery called laparotomy.
After conservative myomectomy woman can become pregnant and bear a child. Delivery with the most commonly performed by cesarean section.
Treatment of intramural uterine fibroids in women who are not supposed to have children
Women after forty years in the future if they are not intended to have children, it is recommended a radical (to get rid of the disease forever) operation - the removal of fibroids from the uterus together (hysterectomy).
Hysterectomy may also be different. Subtotal hysterectomy or uterine supravaginal imputation - the removal of the uterine body above her neck. Saving the cervix is very important because it is the basis of the perineum, supporting the pelvic organs. Therefore, in most cases with intramural uterine fibroids do just this operation. It can be done in different ways (using laparoscopy, laparotomy, hysterectomy) - in this case the choice of the physician.
Total hysterectomy (removal of the uterus and cervix) is carried out if the intramural myoma nodes have not only the body but also in the cervix. In addition, the indication for surgery is a suspicion of malignancy (degeneration of fibroids in a malignant tumor). This operation is called a hysterectomy
Hysterectomy - the uterus is sometimes necessary to remove
Hysterectomy always saves a woman from fibroids, allowing it to maintain in the future normal life and improves quality of life. Since in most cases the ovaries are removed, removal of the uterus
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women. Linked with uterine pains disappear immediately after surgery, and the gradual restoration of hemoglobin and disposal of iron-deficiency anemia women returnees activity, performance and ability to enjoy life.
Treatment intramural (interstitial) fibroids may be different. The choice in this case is a woman. But the physician should explain to the woman what method of treatment and why it will suit most.