Indications and contraindications for surgery for fibroids
For women over 30 years old, the most frequent indications for surgery on the uterus are fibroids, which is diagnosed in 15-17% of patients in this age group. At the same time, single nodes do not make the operation mandatory. Conservative treatment may be quite sufficient in the absence of malignant tumor growth and precancerous diseases in the cervical region and in the endometrial layer. The operation is also not required in case of detection of submucous nodes, if they do not exceed the size of the uterus at the 12th week of pregnancy in women under 45 years of age and if the formation in patients over 45 years of age is less than 15-16 weeks of pregnancy.
In some cases, the effect of therapeutic methods may be low, which requires the introduction of restrictions on the conservative treatment of the patient, regardless of the size of the fibroid. In 25% of women who seek help, the disease develops asymptomatically and requires constant monitoring at least three to four times a year. Such patients need to take a blood test for hormones and, if necessary, correct the hormonal background. It should be remembered that dyshormonal disruptions are more common in women after 40 years, therefore, the latent course of the disease in such patients requires more careful attention from doctors.
Indications for surgery for uterine fibroids
Surgery to remove fibroids is necessary in the presence of obvious symptoms such as menorrhagia and metrorrhagia, accompanied by secondary anemia. Indications for surgery include pain caused by node necrosis, twisting of the subserous fibroids stem, as well as pain syndrome accompanying the compression of nerve fibers and stretching of the ligamentous apparatus when the formation is localized in the pelvic region between the ligaments.
Removal of fibroids is also required if subserous and submucous tumors have a thin stem that can twist and necrotize. In some cases, the formation can disrupt the act of urination or defecation, putting pressure on the bladder or rectum.
If the fibroid is of considerable size and is rapidly developing, especially during the menopause and during menopause, then surgery can also be recommended as the only effective treatment. Subject to removal of education, the size of which exceeds the size of the pregnant uterus for a period of 12 weeks in women under 45 years old and 15-16 weeks in size in patients over 45 years old.
If you suspect a malignant tumor growth or the development of cervical fibroids of the uterus, surgery is also necessary.
In addition, the indication for surgery is infertility or repeated miscarriages, if it is established that the cause of the pathology is precisely fibroids. As part of this operation, the uterus is not removed.
Contraindications to surgery for uterine fibroids
Surgery for uterine fibroids is not performed if there is a history of diseases of the cardiovascular system, upper respiratory tract, kidneys. Removal of the formation is also contraindicated in violation of metabolic processes, the presence of an acute or subacute infectious process in the peritoneal region and the pelvic organs.
Acute infectious diseases cause the transfer of surgery until the patient is fully recovered.
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".
