Necrosis of uterine fibroids and cervix
Uterine fibroid necrosis
Myoma of the uterus refers to a benign tumor that develops in the muscular layer of the uterus. This disease is one of the most common in gynecology. Formed in women aged 30-40 years. There are several types of fibroids, depending on the location of the nodes:
- intramural (interstitial)
- subperitoneal (subserous)
- submucous (submucous)
- interconnective (intraligamentary)
Fibroids are multiple, when several nodes of various sizes grow. The reasons for the development of uterine fibroids can be hormonal disorders, metabolism, changes in the structure of the myometrium. Risk factors include hereditary predisposition, impaired reproductive function, menstrual and metabolic disorders, frequent abortions and diagnostic curettage.
Very often, as a result of complications in the course of uterine fibroids, irreversible changes occur in the tumor tissue - necrosis. This is due to the cessation of nutrition and vascularization of the neoplasm. The death of tumor tissue is a consequence of a violation of the formation of new blood vessels or torsion of the leg of the myomatous node. What is the necrosis process?
It manifests itself in the form of hemorrhage, edema, aseptic inflammation and degeneration. Timely treatment of necrosis prevents peritonitis, which can lead to the death of a woman. The onset of necrosis is preceded by a violation of the blood supply to the tumor tissues. This occurs as a result of torsion of the leg of the myomatous node, multiple thrombosis in the intramural nodes, ischemia, stagnation of venous blood.
During the growth of uterine fibroids, pressure is exerted on the vessels feeding it, they are compressed or deformed. Necrosis can develop after taking drugs that contract the muscles of the uterus or after childbirth. During pregnancy, necrosis of myomatous nodes can develop due to an increase in vascular tone, a decrease in the blood supply to the myometrium, and impaired blood outflow through the veins.
According to morphological manifestations, red, dry and wet necrosis are distinguished. Red necrosis is defined by soft consistency and varicose veins with thrombosis. With dry necrosis, shrinking of tumor areas occurs, the appearance of cavernous formations with dead tissues. Wet necrosis is characterized by the formation of cystic cavities, softening and moist tissue necrosis. Aseptic necrosis can lead to the development of sepsis and peritonitis.
A signal for the development of this disease can be a sharp manifestation of an acute abdomen, nausea, vomiting, cramping pains, fever and chills. Pain attacks are usually accompanied by tachycardia, bowel dysfunction, and bladder dysfunction. If necrosis is caused by torsion of the myoma pedicle, conservative surgery to remove myoma nodes is used to treat women of childbearing age and pregnant women.
Women of menopause are prescribed a procedure for the complete removal of the uterus without appendages, supravaginal amputation of the uterus. After that, long-term recovery is required, the normalization of the water-electrolyte balance and the elimination of intoxication. As a preventive measure in the development of necrosis of the myoma node, rather conservative treatment of uterine fibroids, timely diagnosis of deviations. It is possible to exclude the development of complications of uterine fibroids by preventive medical examination, which implies a gynecological examination and ultrasound examination of the pelvic organs.
Cervical necrosis
Cervical necrosis develops after an injury that can occur during childbirth or erosion. The smallest ruptures of the cervix should be sutured, since they are the most compelling reason for the appearance of changes in the tissues lining the cervical cavity of the epithelium. Getting into foci of tissue damage, microorganisms and infection contribute to the development of severe pathology.
The formation of a zone of superficial coagulation necrosis is also possible after laser vaporization with a beam in the treatment of cervical erosion. But since the focus of necrosis is formed within healthy tissues, the rejection of the coagulation film and rapid regeneration occurs. Traumatic necrosis of the cervix is also associated with compression of the cervix by the head of the fetus and the walls of the pelvis of the pregnant woman. Compression necrosis occurs if a woman has a narrow pelvis, with weak labor, the presence of cicatricial changes in the cervix.
Necrosis forms on the anterior wall of the cervix and is usually localized at the site of the infringement of the cervix. After childbirth, the necrotic area is rejected and a fistula is formed, which is eliminated only by surgery. The zone of necrosis can be determined visually by sludge using special temperature sensors.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
