Myoma is a benign neoplasm localized in the uterus. The disease does not give symptoms for a long time, so it is found at a late stage, when the myoma itself has a large volume. For treatment, the value in which layer the uterine myoma is located is important, the dimensions - for the operation these are important parameters.
Diagnosis of uterine fibroids
Myoma is a neoplasm formed from smooth muscle cells. Its dimensions can be from a few millimeters to 30 cm or more. However, already a small myoma can be detected using ultrasound. Ultrasound diagnosis of uterine fibroids is the basis of all diagnostic measures. Using this technology it is possible to establish not only the size of the formations, their number, but also the exact localization of pathological structures.
Important in the diagnosis of fibroids is bimanual examination. With its help, a large uterine myoma can be detected, the size for the operation is determined with ultrasound. The doctor, feeling the formation through the anterior abdominal wall, can make an assumption about the shape, size and location of the tumor. For more accurate data on the volume of education, its structure, number of foci, additional studies are carried out:
- X-ray: X-ray of the pelvic organs;
- endoscopic: hysteroscopy , cervicoscopy, colposcopy .
Myoma of the uterus - dimensions
The dimensions of uterine fibroids are of important diagnostic value. This parameter is directly taken into account when choosing a method of therapy. With a small tumor size, conservative treatment can be performed. It involves the use of hormonal drugs that slow the growth of the tumor. An increase in the concentration of sex hormones causes an increased growth of myomatous nodes. As a result, the size of the genital organ also increases. In connection with this, the tumor volume is indicated in weeks of pregnancy (the size of the uterus is compared with that of the gestation).
Depending on the size of the neoplasm, the myomatous nodes can be subdivided into:
Dimensions of fibroids in millimeters
Dimensions of uterine fibroids in mm can be established during ultrasound. The doctor carefully examines the cavity of the small pelvis, especially the uterus. During the procedure, we study not only the size of education, but also evaluate its structure, the number of nodes available. It is necessary to determine the nature of the tumor. An important diagnostic value is the size of the myoma.
In conclusion, the doctor indicates the following information:
- small fibroids - the diagnosis is made if the tumor diameter does not exceed 20 mm;
- average - this conclusion is made if the diameter of the tumor is 20-60 mm;
- Large - in volume exceeds 60 mm.
The size of uterine fibroids in weeks
For the general characteristics of the tumor, doctors often estimate the size of fibroids in weeks when assessing the tumor. For example, if a woman is diagnosed with uterine myoma 11 weeks, this means that the volume of the uterus increased to the size of the genital organ at 11 weeks of pregnancy. Thus, with a myome measuring 3-4 cm in diameter, the conclusion is indicated in the conclusion: a neoplasm (myoma) is 6-7 weeks.
Doctors describe the size of uterine fibroids in weeks as follows:
- small myoma - the size of the genital organ does not exceed 4 obstetric weeks;
- average - is diagnosed when the uterus corresponds to 10-11 weeks;
- large - is equivalent to 12-16 weeks of gestation.
At what size do uterine fibroids do the operation?
When a uterine myoma is found, the dimensions for the operation are a parameter that doctors treat, in addition to the structure of the formation. It is important to monitor the tumor in dynamics. Women with a similar disease periodically undergo examinations, ultrasound. If there is a fast-growing tumor, surgical intervention is mandatory. If the operation is not carried out, the tumor takes up all of the free space in the small pelvis. There is a violation of excretory function.
At the diagnosis of a hysteromyoma the sizes for operation in millimeters doctors do not establish or install. Indication for mandatory surgical intervention is the growth of fibroids - the formation is increased by 20 mm and more during the year. In addition, those fibroids that do not have a large size operate, but there is a thin leg. Directly in this place there is a high risk of torsion, resulting in destructive tissue changes, necrosis. Other indications for the removal of fibroids may include:
- secondary infertility ;
- frequent miscarriages;
- severe pain syndrome (persistent pain in the abdomen, in the rectum, bladder).
Subserous myoma of the uterus - the dimensions for the operation
Subserous myoma refers to benign formations. It affects the outer part of the organ, grows in the direction of the cavity of the small pelvis. In form, it resembles a knot with a wide base or thin foot. Subserous hysteromyoma of large size is subject to mandatory removal. At the same time, the question of conducting surgical treatment rises when the formation in diameter reaches 80 mm.
Submucous uterine myoma - the dimensions for the operation
The sizes of a hysteromyoma for operation of this type of formation do not differ from the named above (8 sm and more). The peculiarity of submucous myoma is submucosal localization of the node itself. In this case, fibrosis fibers of the muscular layer of the uterus are present in the formation. The growth of the tumor is directed inside the genital organ. Surgical treatment of this type of neoplasm can be carried out using the following techniques:
- myoectomy - removal of nodes;
- Embolization of the uterine arteries is a violation of the nutrition of the tumor, as a result of which its reverse development takes place.
Multiple uterine myoma large
Having dealt with the size at which the uterine fibroids are removed, it should be noted that for multiple formations, doctors do not pay attention to the volumes of individual nodes. When choosing the method of the operation, the localization of the myomas and the patient's age are taken into account. If the woman still plans to have children, prescribe a myoectomy with the preservation of the genital organ. Surgery is performed by laparoscopy. Restoration of the body after surgery with this method is faster, so a year later in the absence of complications are allowed to plan pregnancy.
How is the uterine myoma removed?
Removal of uterine myoma by the classical method is a myoectomy. It is performed under general anesthesia or with the use of epidural anesthesia. Before the uterine myoma is removed, the dimensions for the assigned operation are checked before the surgery itself. It can be performed in one of the following ways:
- Open cavity operation - a horizontal incision is made 2-3 cm above the pubic articulation. Then gradually open access to the jumbo and excise it. Used for large sizes of formations.
- Laparoscopy - on the surface of the abdomen, several holes are made through which special instruments and video equipment are introduced.
- Hysteroscopic myomectomy - used for submucous myomas. Access is through the vagina, using a resectoscope. Using this instrument, which acts on the tumor with a high-frequency current, myoma is destroyed, and its fragments are then washed out of the uterine cavity.
Treatment of uterine fibroids of large size without surgery
When a small uterine myoma is found, doctors try to treat it medically. Therapy of large fibroids without the use of surgical intervention is unacceptable. The tumor will continue to grow, so the work of other organs and systems can quickly be disrupted. Drug treatment is possible when diagnosed with cervical myoma, the permissible size of which is set at 3 cm. In most cases, hormonal drugs have only a temporary effect, and complete disappearance of the tumor does not occur.