Ovarian fibroma: symptoms, causes, treatment. Ovarian fibroids What size ovarian fibroids are best to operate on?

Or ovaries.

Ovarian fibroma, like fibrous tumors in other organs, usually develops asymptomatically, however, upon reaching a significant size, characteristic symptoms of the pathological process appear.

Concept and statistics

Per share fibrous formations in gynecology it accounts for approximately 10% of the total.

Women of premenopausal and menopausal age (40-60 years old) are most susceptible to such neoplasms. Ovarian fibroma is a tumor formation that does not have hormonal activity.

In appearance, such tumors are rounded compactions with a nodular or smooth surface. Such ovarian formations can grow up to 12 centimeters or more and are predominantly unilateral in nature. Such tumors, as a rule, have a stalk, so they are mobile.

On a section, the fibrous formation has a whitish-gray or White color, the tumor is poor in vascular network.

If the fibroma formed quite a long time ago, then in its middle there are dead areas with ischemia, hemorrhages, and degenerative lesions. From a morphological point of view, the tumor is formed from connective tissue cells.

Forms

Experts identify several fibrous varieties:

1. Diffuse fibroma - affects the entire ovary;
2. Limited tumor form - is a capsule with contents, which separates it from the rest of the ovarian tissue.

Fibrous formations often swell and have cystic cavities with liquid content inside, then they are called cystadenofibromas.

Typically, fibrous formations grow slowly, however, under the influence of degenerative changes they begin to grow very quickly. Often such tumors are accompanied by cystic processes in the ovarian tissues, which are formed for similar reasons.

The small size of fibrous formations usually does not affect ovarian functionality and does not interfere with conception, pregnancy and successful delivery.

Reasons for development

As in the case of uterine fibroma, an ovarian tumor has an uncertain etiology, however, the risk of pathology increases in the presence of an unfavorable health condition of the patient, which contributes to the development of various diseases (premorbid background).

This may include pathologies endocrine system, including disorders of reproductive and menstrual functions, pathologically low immune status, inflammatory processes in the ovaries or appendages (adnexitis, oophoritis, etc.).

Overall among probable causes fibrous tumors in the ovaries can be distinguished:

• Decreased immune status;
• Pathological processes in the genitourinary system and genitals;
• Inflammatory lesions of the appendages or ovaries of chronic origin;
• The presence of endocrine pathologies;
• Genetic predisposition;
• Age characteristics;
• Menstrual irregularities, etc.

Often, ovarian fibroma is accompanied by pathologies such as ovarian cystosis or. Therefore, many experts believe that these diseases have common etiological factors.

Symptoms of ovarian fibroma

Typically, ovarian fibroma develops hidden. With sizes less than 3 cm, ovarian functions are usually not impaired, and therefore there are no symptoms.

When the formation begins to grow, the patient experiences the appearance of symptoms such as Meigs syndrome, which includes the presence of pleurisy (inflammatory damage to the pulmonary lining), anemia and (fluid accumulation in the peritoneum).

Similar conditions appear:

1. General weakening of the body;
2. Tachycardic manifestations;
3. Bloating of the abdominal area;
4. Soreness;
5. Excessive fatigue;
6. Shortness of breath.

If the tumor secretes transudate into the retroperitoneal space, ascites occurs. In exceptional clinical situations, ovarian fibroma is accompanied (extremely severe depletion) or polyserositis (inflammatory lesions of the serous membranes), but this picture is usually observed with malignancy of the tumor process.

Typically, there are no menstrual changes or cycle disorders with ovarian fibroma. If the pathology is combined with other genital diseases, then the clinical picture is a complex of their symptoms.

Diagnostics

Fibrous ovarian masses are usually discovered during random examinations by a gynecologist, since the tumor for a long time develops latently.

After a gynecological examination, the patient is sent for laboratory tests, instrumental procedures such as ultrasound diagnostics, magnetic resonance or pelvic organs, etc.

If necessary, additional histological examination biomaterial obtained from the tumor through laparoscopic diagnostics.

Treatment

Treatment of fibrous formations in the ovary is carried out using operational methods. Since such neoplasms are not capable of resorption, then conservative therapy meaningless.

In accordance with the size of the fibroma, the presence of complications, the age and organic characteristics of the patient, the type is selected surgical intervention.

To get rid of small formations, it is usually used when the fibroma is enucleated, and the ovary is completely preserved, as well as its functionality.

If the fibroma has reached a large size, then it is removed along with the ovary. If the patient’s age has approached the premenopausal period, then it is recommended to also remove the appendages.

If the fibroma is bilateral in nature, that is, the tumor process affects both ovaries, then a part of the one that was less affected by the formation must be left.

Prognosis and prevention

In general, the prognosis for fibrous ovarian tumors is positive, the likelihood of malignancy is minimal - only 1%. Only pregnancy will have to be postponed until complete recovery and completion of post-operative rehabilitation.

There is no specific prevention of ovarian fibromas, so the main measure is an annual visit to the antenatal clinic with an ultrasound examination of the pelvic organs. This is the only way to promptly detect the development of a pathological fibrotic process in the ovaries.

The video shows an operation to remove ovarian fibroids using the laparoscopic method:

Ovarian fibroma is a tumor connective tissue. In this case, the disease does not exhibit hormonal activity. The tumor is benign. Experts diagnose this disease in 10% of all calls related to such neoplasms. Fibroids usually occur in women over the age of 40. However, the disease can also develop in younger individuals.

What does it look like

Ovarian fibroma has an oval or round shape. The surface of such a neoplasm is usually smooth or nodular. The size of fibroids can reach more than 10 centimeters. The neoplasm, which is completely hollow, acquires a dense elastic consistency. Swelling of the tissue makes it softer. If calcium deposits are present, the tumor becomes hard.

It is worth noting that in some cases, fibroids may have a stalk. Because of this, the neoplasm becomes mobile. Such fibroids grow much more slowly. However, some dystrophic changes can only accelerate its growth.

Why does ovarian fibroma occur?

The reasons for the occurrence of such neoplasms have not yet been precisely determined. Experts believe that the tumor forms and gradually grows from the stroma of the organ. In certain cases, the neoplasm arises from fibrous tissue. The risk group includes those women who have an unfavorable premorbid background. Often, representatives of the fairer sex begin to develop pathologies of the endocrine system, a chronic inflammatory process in the ovary and appendage, and there is also a decrease in immunity.

Types of tumors

Ovarian fibroma can be of two types, if you classify it by structure. The first form is a limited tumor, which has a capsule with clear outlines that separates the fibroma from the tissue. Such neoplasms are usually oval. The second form is diffuse, as it completely affects the ovarian tissue. In this case, the capsule may be missing. This type neoplasms are diagnosed more often. However, the histology of both forms of fibroma is almost the same. They are formed from fibrous substances, as well as cellular elements. However, the quantitative relationship is completely different.

It should be noted that ovarian fibroma, the treatment of which will be described below, may contain cysts. Tumors are usually edematous. With tissue degeneration, the growth of neoplasms is significantly accelerated. This disease often causes more serious complications. This could be twisting of the leg, hemorrhage, degeneration into a malignant tumor, suppuration of the tumor, and so on. Ovarian fibroid is very often accompanied by uterine fibroids and ovarian cysts. These diseases have a similar etiological development.

Does it greatly affect reproductive health ovarian fibroma? Pregnancy may occur. If the tumor is small in size, then it is not capable of causing disturbances in the functioning of organs. A woman in such a situation has a chance to conceive a child and carry it to term.

Ovarian fibroma: symptoms

If the tumor is small in size, for example, no more than 30 millimeters, then the organs continue to perform their functions properly. The main symptoms of the disease may not appear for a long time. If the fibroma begins to increase in size, then signs of Mace's syndrome appear: ascites, anemia, pleurisy, and so on. Often a woman experiences bloating and discomfort. This may cause tachycardia, shortness of breath and general weakness. A woman with ovarian fibroma gets tired much faster. Ascites is the main one, which is often formed when transudate is released directly into the abdominal cavity.

Signs of ovarian fibroids can be completely different. Cachexia and polyserositis are often observed with this disease. These signs indicate the presence of neoplasms that are malignant in nature. It is worth noting that the symptoms, as well as the severity of the disease, depend for the most part on the degree of compression of neighboring organs by the fluid. With necrosis and hemorrhages into the neoplasm, more pronounced signs of peritoneal irritation occur. Ovarian fibroids do not cause menstrual irregularities.

Who to contact?

At the first symptoms of the disease, a woman should undergo a thorough examination. First of all, you should visit a gynecologist. In such cases, the doctor conducts an examination using a two-handed method. In this case, a specialist can determine not only the location of the neoplasm, but also determine its surface structure, rocky consistency, density, pain and mobility.

Basic diagnostic methods

After a thorough examination, the woman must undergo additional laboratory test. For ovarian fibroids, it is necessary to take not only general analysis blood, but also analysis for tumor markers. The diagnosis is confirmed only after an ultrasound examination, which allows one to determine the main parameters of fibroids.

In some cases, a test is required. After this, the cytological material is carefully studied in the laboratory. To complete the diagnosis, specialists must examine the removed tissue.

Fibroma therapy

How is ovarian fibroma treated? With this disease, conservative therapy does not produce results, since such neoplasms cannot be resolved. In this case, surgery is recommended to remove the ovarian fibroid. The operation is carried out only after a thorough examination. In this case, the doctor takes into account the presence of any pathologies, the condition of the uterus and second ovary, the patient’s age, as well as the size of the tumor.

In addition, the specialist must determine the completeness of the surgical intervention and the type of access. If the ovarian fibroma is small in size, then it is removed using the most gentle method - laparoscopy. In such a situation, the tumor is removed. The functions of the organs are completely preserved.

If the tumor is large

Elimination of large neoplasms is carried out with In such situations, the organ is compressed, stretched and gradually transformed into a cyst capsule. In this case, the follicles may undergo complete atrophy. For women who are postmenopausal, not only the ovary, but also the appendages are large. If both organs are affected, then the part that is less affected by the disease is left.

Prevention of the disease

Ovarian fibroma is serious disease, which can occur for a long time without any symptoms. There are no preventive measures in this case. It is simply impossible to prevent the development of the disease. As for the postoperative prognosis, it is always favorable. Degeneration of ovarian fibroma into malignancy occurs in only 1% of all women undergoing surgery. The rehabilitation process after surgery is easy, and patients recover quickly. During this period, the doctor may prescribe a course of antibiotics.

In conclusion

Now you know what ovarian fibrosis is, how it manifests itself and what consequences it leads to. Therapy for this disease is carried out only through surgery. Alternative medicine is simply useless in such a situation. Since there are no preventive measures for the disease, a woman must undergo a thorough examination every year and also undergo an ultrasound examination. This is the only way to diagnose ovarian fibroma and prevent its further development.

Thus, ovarian fibroma is a hard, non-spread benign formation consisting of fibrous or connective tissue. It accounts for only 1% to 4% of all organ tumors. Such tumors grow slowly and are small in size (about 7 cm in diameter).

It should be borne in mind that, despite the non-invasive nature of the growths, sometimes a cancerous tumor can arise within the fibroid structure, which complicates diagnosis and therapy.

Reasons for development

Possible conditions affecting the appearance of the formation include:

• earlier menarche and subsequent puberty, as well as irregular menstruation;
• infertility and related problems with the patient’s hormonal system;
• therapy using Tamoxifen;
• older age (over 50 years) and, accordingly, pre- or postmenopause;
• genetic inheritance;
• increased level of male hubbub.

However, it is almost impossible to determine exactly what causes ovarian fibroma.

Symptoms

If the formation is small (up to 6 cm), then symptoms appear very rarely. If the size is more than 10 cm, it may be accompanied by the following symptoms:

• Meigs syndrome, associated with ascites (accumulation of fluid in the uterine cavity or abdomen) and pleurisy (excess fluid around the lungs).
• Abdominal and pelvic discomfort in a very advanced state. About 45% of women talk about this circumstance.
• Sometimes tumors produce androgens, which are indicated by facial hair growth, acne, and scalp hair loss.
• Unusual heavy bleeding. Women may experience irregular, heavy periods, or no periods at all.
• Increased belly size and weight. This sign may be accompanied by ascites.
• Pressure on the bladder.
• Possible constipation and pain due to the physiological needs of human life.

What is included in the diagnosis?

Benign fibroids of the right ovary, like those of the left, are often difficult to identify preoperatively and are misdiagnosed as ovarian fibroids due to their solid nature. Upon examination, it looks like a whitish-yellow lump.

Sometimes there is an increased serum level of the hormone CA125, which can be mistakenly interpreted as a malignant tumor.

To clarify the features of the seal, important role careful diagnosis plays a role:

1. Gynecological examination. Regular visits to the doctor help identify all unclear formations. Anamnesis is also established using the patient’s individual complaints.
2. A pregnancy test also helps rule out the possibility of an ectopic fetus.
3. Ultrasound using an internal examination device to confirm suspicions.
4. If the diagnosis remains unclear, magnetic resonance or computed tomography is used.
5. In some cases, histological analysis may be recommended.
6. A blood test is taken to check the presence tumor markers(tumor markers for women).

Treatment of ovarian fibroma

When diagnosing a small lump, it is advisable to wait a while and watch the situation develop. It may not be necessary to take any therapeutic measures. Application oral contraceptives in this case it is not recommended. However, pregnancy should be avoided for a certain time.

If education causes discomfort or interferes with childbearing, then recommended different ways surgical excision. Most of them are very effective. And, as a rule, they provide maximum results with minimal impact on reproductive ability.

Ovarian fibroma – photo:

Surgery to remove ovarian fibroids

When the formation continues to grow, doctors still insist on resection. Depending on the stage of progression, the following methods are recommended for surgery:

The best way to get rid of ovarian fibroids. Three or four small incisions are made in the abdomen. Through them the camera and illumination are introduced. Using technical tools, the doctor has a detailed video image, which is relayed to a large monitor in the operating room. Thus, modern progress contributes to high-quality removal of unwanted growths. Removal of ovarian fibroids is done in the hospital under general anesthesia.

Recovery after surgery takes about two weeks. The incisions heal quickly, leaving tiny scars that unfortunately take a long time to fade.

Resection of the affected part of the ovary

Required if there is a large seal (exceeding 10 cm), which cannot be removed with less than invasive methods. The need to use such radical method is justified by the definition of a formation tightly fused with an organ. Sometimes a course of chemotherapy is given before and after excision. It is intended to reduce the solid tumor and smoothly remove the patient from the post-operative state.

The method is indicated for women around menopause, when the body's fertile activity is not an important condition.

IN general outline, ovarian fibroma is a non-cancerous lump that requires constant monitoring. Because the tumor occurs in one part paired organ, then the symptoms and therapeutic measures will be the same for the other.

It is important to know:

Add a comment Cancel reply

Categories:

The information on the site is presented for informational purposes only! Apply the described treatment methods and recipes cancer diseases It is not recommended to do it on your own and without consulting a doctor!

Ovarian fibroma

Ovarian fibroma is a connective tissue, hormonally inactive tumor of the ovary of a benign nature. Symptoms of ovarian fibroma develop when the tumor reaches a significant size and is manifested by ascites, anemia, and less commonly hydrothorax (Meigs syndrome). Diagnosis uses gynecological examination, ultrasound, CT; A clarifying diagnosis of ovarian fibroma is made based on the results of a histological examination of tumor tissue. Treatment of ovarian fibroma is surgical - removal of the tumor, sometimes along with the affected uterine appendage.

Ovarian fibroma

In gynecology, fibroma occurs in 10% of cases among benign ovarian tumors; can occur starting from puberty, but most often develops during premenopause and menopause (40–60 years). Ovarian fibroma is a round or ovoid formation with a smooth or nodular surface, the size of which can reach 10–12 cm. In the presence of pseudocavities, the consistency of ovarian fibroma can be densely elastic, with pronounced edema - soft, with the deposition of calcium salts - hard. Ovarian fibroma is usually one-sided and mobile, as it has a stalk.

Ovarian fibroma on a section - white or white-gray color, usually poor in blood vessels; if the tumor exists for a long time, foci of ischemia with necrosis, hemorrhages, and degenerative changes with a brown-red tint may be observed in its center. Histologically, the tumor consists of bundles of spindle-shaped connective tissue cells intertwined with each other in different directions; when swollen, the cells have a stellate shape.

There are two forms of ovarian fibroma: limited (the tumor has a clearly defined capsule separating it from the ovarian tissue) and diffuse (the ovary is completely affected). Ovarian fibroid tissue is most often swollen and may contain cysts. Ovarian fibroma is a slow-growing tumor, but when dystrophic changes in tissues its growth can be accelerated. Increased mitotic activity of the tumor is considered borderline state with low malignant potential.

Small fibroids usually do not affect ovarian function and do not interfere with pregnancy. Hypercellular (cellular) ovarian fibroma can recur, especially if its capsule is damaged during surgery. Complications of ovarian fibroma include pedicle torsion, necrosis, hemorrhage, tumor suppuration, and the likelihood of malignancy.

Causes of ovarian fibroma development

The causes of ovarian fibroma have not been precisely established, but the risk factor may be the patient’s unfavorable premorbid background, including endocrine pathology(menstrual irregularities and reproductive functions), decrease immune defense, inflammation of the appendages and ovaries (adnexitis, oophoritis). Ovarian fibroma can be combined with uterine fibroids, ovarian cysts and, most likely, has common etiological development factors with them.

Symptoms of ovarian fibroma

With small fibroids (up to 3 cm) and preservation of ovarian function, clinical manifestations may be absent long time. As the tumor grows, signs of Meigs syndrome develop (ascites, anemia, pleurisy), manifested by bloating, pain, shortness of breath, general weakness And fatigue, tachycardia.

Ascites – common symptom ovarian fibroids, occurs when transudate is released from the tumor into the abdominal cavity. Hydrothorax is caused by the entry of ascitic fluid through the slits of the diaphragm from the abdominal cavity into the pleural cavity. In some cases, ovarian fibroma may be accompanied by polyserositis and cachexia (usually with malignant degeneration of the tumor). The severity of the disease is largely determined by the compression of neighboring organs by fluid, especially with polyserositis.

Severe symptoms of peritoneal irritation appear with hemorrhages and necrosis in ovarian fibroma, as well as with torsion of the tumor stalk. The menstrual cycle is usually not disrupted. When ovarian fibroid is combined with other genital diseases, the clinical picture is characterized by the combination of their symptoms: for example, in the presence of uterine fibroid, menometrorrhagia may occur.

Diagnosis of ovarian fibroma

Ovarian fibroma is asymptomatic for a long period and can be discovered accidentally during examination or surgery for another disease. Making a diagnosis of ovarian fibroma is possible based on available clinical manifestations, examination by a gynecologist with mandatory two-manual examination; laboratory diagnostics(complete blood count, tumor markers CA-125, HE 4); instrumental methods(ultrasound, MRI, CT of the pelvic organs) and histological examination of the tissue of the removed tumor.

A gynecological examination can determine the presence of a formation on the side or behind the uterus, with a smooth or nodular surface, dense, sometimes stony in consistency, mobile and painless. Diagnostic ultrasound with Color Doppler reveals a round or oval formation with clear, even contours, predominantly with a homogeneous echo-positive structure, average (reduced) echogenicity, sometimes with echo-negative inclusions. With CDK, the vessels, as a rule, are not visualized, which determines the avascularity of the ovarian fibroma.

In the diagnosis of ovarian fibroma, MRI and CT are equivalent in sensitivity and specificity to ultrasound. It is possible to perform pleural puncture and puncture of the abdominal cavity with a cytological examination of the resulting transudate. The determining factor in the diagnosis of ovarian fibroma is histological examination of the tissue of the removed tumor after diagnostic laparoscopy. Differential diagnosis ovarian fibroids are carried out with subserous uterine myomatous node, ovarian cyst, metastatic ovarian cancer, follicular cyst ovary, corpus luteum cyst.

Treatment of ovarian fibroma

There is no conservative (drug) treatment for ovarian fibroids; surgical removal of the tumor is mandatory. The extent of surgical intervention and the nature of the approach are determined by the size of the tumor, the age of the patient, the condition of the other ovary and uterus, and existing concomitant pathology.

In young women with a small size, ovarian fibroids are limited laparoscopic removal(husking) the tumor itself while preserving menstrual and generative functions. In premenopausal women, oophorectomy or removal of the adnexa is advisable; with bilateral damage to the ovaries, they try to leave part of one of them.

Forecast and prevention of ovarian fibroma

The prognosis of ovarian fibroma is favorable, the probability of malignancy is 1%. Pregnancy can be planned only after completing a course of rehabilitation treatment.

There are no specific ways to prevent ovarian fibroids; It is necessary to visit a gynecologist at least once a year and conduct an ultrasound of the pelvic organs in order to timely detect this disease.

Ovarian fibroma - treatment in Moscow

Directory of diseases

Women's diseases

Last news

• © 2018 “Beauty and Medicine”

for informational purposes only

and does not replace qualified medical care.

Ovarian fibroma: is a benign tumor dangerous and how to remove it?

According to the classification of tumors of the genital organs, fibroma refers to neoplasms of the sex cord and ovarian stroma. This is a hormonally inactive formation that develops from the connective tissue of the organ, that is, from the cells that form its basis - the stroma. Under a microscope, abnormal cells appear as intertwined bundles of elongated cells, similar to spindles. They produce the main protein of connective tissue - collagen.

Causes of the disease

Ovarian fibroma is a benign neoplasm, that is, it does not metastasize to nearby and distant lymph nodes and other organs, does not cause cancer intoxication, and has no other signs of a malignant tumor. It is most often diagnosed during menopause in women aged 45 to 60 years. This pathology never occurs in girls who have not reached puberty. The diameter of the tumor can reach 15 cm.

Patients with diagnosed ovarian fibroma have an unfavorable gynecological history. In most cases, they experience menstrual irregularities, as well as infertility and miscarriage. This is likely due to a common factor that causes these diseases and fibroids. The exact reasons for its occurrence have not been established.

Quite often, ovarian fibroma occurs against the background of uterine fibroids or is combined with a cyst. In this case, the clinical picture of the disease is often caused by a concomitant disease.

Clinical picture

The growth of this formation is slow. In many cases, a small fibroid exists for many years without being noticed. Only if the nutrition of the tumor tissue is disrupted (dystrophy) can it begin to rapidly increase in size. Therefore, the symptoms of ovarian fibroma are erased or absent. In many cases, the tumor is discovered accidentally ultrasound examination(ultrasound) or during surgery for another reason.

The neoplasm does not secrete any hormones, therefore it does not affect menstrual cycle and pregnancy.

If the tumor is large, a woman may be bothered by aching, nagging pain in the lower abdomen or lower back. They are not related to the menstrual cycle. The pain is caused by stretching of the fibroid capsule and compression of the pelvic nerve plexuses. Sometimes patients are bothered by a feeling of heaviness in the abdomen, constipation, and urinary problems. Such signs occur when the tumor presses on the intestines or bladder.

A tenth of patients have the so-called Meigs syndrome. It is manifested by the accumulation of fluid in the abdominal and pleural cavity and a decrease in the level of hemoglobin in the blood, that is, anemia. The origin of these symptoms is as follows: the fluid released from the fibroid tissue enters the abdominal cavity, and from there through the openings (hatches) of the diaphragm into the pleural cavity. As a result, ascites and hydrothorax develop. Clinically, Meigs syndrome is manifested by abdominal enlargement, shortness of breath, weakness, pale skin and other relevant signs. In this condition, it is necessary to especially carefully examine the woman to exclude ovarian cancer or metastases to the ovary of malignant tumors from other organs.

Ovarian fibroma has a round shape. Most often, only one organ of a pair is affected, but bilateral formations also occur. On section, the tumor tissue is dense and has a fibrous structure. There are areas of edema and degeneration with the formation of cysts. Calcium is often deposited in pathological tissues, causing them to calcify.

If cells begin to rapidly divide, and the formation grows rapidly, then the risk of its malignant degeneration increases. However, the probability of such a transformation is low (about 1%). Most often this happens if the tumor has a complex structure, that is, with adenofibroma and cystadenofibroma.

Complications of the disease are mainly associated with malnutrition of the tumor tissue or its infection. Quite often, tumor necrosis occurs with the development clinical picture acute abdomen(sudden severe abdominal pain, drop in blood pressure, cold sweat, severe weakness, nausea and vomiting, stool retention, increased body temperature, pain on palpation of the abdominal wall). This condition requires immediate surgical intervention.

This is what a removed tumor looks like

Diagnostics

Ovarian fibroma is diagnosed based on clinical signs and gynecological examination data. It needs to be differentiated from a large number formations of the uterus and ovaries.

With a two-hand examination, fibroma is determined on the side or behind the uterus in the form of a round or ovoid volumetric formation with a diameter of 5 to 15 cm. It has a very dense consistency, reaching rocky, smooth surface, painless and quite mobile. Often, patients have ascites as a manifestation of Meigs syndrome, so fibroma must be differentiated from a malignant neoplasm.

To clarify the diagnosis, ultrasound with color Doppler mapping is used. This study helps to establish not only the size and structure of the neoplasm, but also to clarify the features of its blood supply. Ultrasound can be replaced by magnetic resonance or computed tomography, but these methods do not have any advantages in diagnosing fibroids.

Fibroma is often part of complex tumors - cystadenofibromas, adenofibromas. In this case, the ultrasound and histological picture of the disease may change, which requires extensive experience and high qualifications from the diagnostician.

Histology of fibroma tissue

Treatment

Treatment of ovarian fibroma is carried out only by surgery. Access is determined mainly by the size of the tumor. If the diameter of the formation is small, laparoscopy is performed with preservation of ovarian tissue in women of childbearing age. After removal, pathological tissues are sent for histological examination to confirm the diagnosis.

For larger sizes, surgery for ovarian fibroma can be performed using laparotomy. In this case, the uterine appendages are most often removed from the affected side. This is the most common intervention option for postmenopausal women. If there are additional indications, the uterus is also removed. Of course, the scope of surgical intervention is previously agreed upon with the patient.

Conservative treatment is prescribed for postoperative rehabilitation. After the operation, the woman should get up as early as possible - this helps to avoid the formation of adhesions between the pelvic organs.

Longidase does not help against ovarian fibroma without surgical treatment, but this drug can prevent the formation of adhesions after removal of the tumor and appendages. It is used after surgery in the form intramuscular injections once every three days. The course consists of five injections. In addition, to prevent adhesions after surgery, physiotherapy is used, in particular, electrophoresis of zinc, magnesium and calcium preparations.

Pathology and pregnancy

Ovarian fibroid during pregnancy most often does not affect pregnancy. If the size is very large or complications develop, it is possible to perform surgery without waiting for birth, but in practice this is rarely required. If a tumor is discovered before a planned pregnancy, it is better to remove it in advance.

The prognosis of the disease is favorable. Education is growing slowly. After removal, the fibroma does not recur.

Prevention

Measures for the specific prevention of ovarian fibroma have not been developed. To reduce the likelihood of this disease, a woman should monitor her health: undergo an annual examination by a gynecologist, and treat identified diseases in a timely manner. Special attention should be given to patients with uterine fibroids. It is in them that ovarian fibroma is most often found.

Ovarian fibroma - what is it and how dangerous is it?

IN Lately In the practice of every gynecologist, there are often cases of benign tumor formations of the female genital area. And about ten percent of the total number of such pathologies are ovarian fibroids.

What is ovarian fibroma

Ovarian fibroma is a benign neoplasm of ovarian tissue. A tumor is formed from the fibrous connective tissue of the sex cord and ovarian stroma. As a result of the proliferation of its cells producing collagen, it can increase up to 15 centimeters in diameter, but, as a rule, this applies to advanced cases. It grows quite slowly and may not “declare” itself for a long time.

This tumor in most cases does not malignize, that is, does not acquire a malignant course, and is formed mainly in women over forty-five years old who have a whole bunch of gynecological problems behind them.

Fibroids usually have a pronounced stalk (it gives the tumor mobility relative to nearby tissues), a rounded shape, their capsule is quite dense, and the surface can be nodular or smooth. The consistency of the formation depends on its “composition”, for example, when calcium salts are deposited in the structure of the tumor, it will be hard, if there is edema, it will be soft, if it is formed from pseudocavities, it will be hard-elastic.

Types of ovarian fibroma

Modern medicine distinguishes two main types of ovarian fibroma:

The diffuse type does not have membranes and affects the entire ovary completely (this variety is more common), and the delimited one is well separated from the ovarian tissues by a clearly defined capsule and is connected to them by a thin stalk.

In addition, fibroids are distinguished between left-sided, right-sided and bilateral. Typically, only one ovary is affected. Bilateral formations are extremely rare.

Causes and development factors

At present, the exact causes of ovarian fibroids have not been fully established. Most likely, the appearance of neoplasms provokes a whole complex unfavorable factors, which include:

• menopause;
• various hormonal imbalances;
• obesity;
• diabetes;
• reduced immunity;
• chronic and acute infectious diseases genitourinary system (including sexually transmitted diseases);
• chronic and acute inflammatory diseases genital tract;
• use of oral contraception;
• menstrual irregularities;
• pregnancy with complications;
• genetic predisposition to pathology;
• infertility;
• endometriosis;
• tumor diseases of the reproductive system.

Very often, the pathology is accompanied by uterine fibroids and ovarian cysts.

Symptoms of pathology of the left and right ovary

Small formations most often do not manifest themselves in any way, do not interfere with the work of the ovary, the menstrual cycle in their presence does not get disrupted, and pregnancy is not complicated. During such a period, a fibroma may turn out to be an accidental discovery at the next gynecologist’s appointment or during ultrasound examination pelvic organs.

As the tumor grows, it gradually begins to put pressure on neighboring organs, which can result in their destruction. normal operation, and also complicate the course of the pathology itself.

As the tumor grows, symptoms such as:

• urinary disorders;
• violations of defecation processes;
• fast fatiguability;
• feeling of heaviness on the affected side;
• accumulation of fluid (transudate from the tumor) in the abdominal cavity:
  • bloating and increase in its size;
  • weakness;
  • dyspnea;
  • deterioration in general health;
• feeling of fullness in the abdominal cavity;
• when the leg is torsion or hemorrhage, all the signs of an “acute abdomen” are observed:
  • sharp pain in the abdomen (especially on the affected side);
  • dyspnea;
  • increased heart rate;
  • drop in blood pressure;
  • dizziness (up to loss of consciousness);
  • pallor;
  • severe weakness;
• with malignancy (malignancy) the following occur:
  • general exhaustion of the body;
  • weakness;
  • pain on the affected side.

There is no significant difference in the symptoms of fibroids of the left and right ovaries. It should only be noted that hemorrhages on the right side of the lesion occur more often than on the left, due to physiological characteristics(the right ovary is more intensively supplied with blood).

General and differential diagnostics

As already mentioned, small fibroids are discovered by chance.

When examining a woman on a gynecological chair, the doctor palpates the enlarged ovary. With more detailed palpation on the side or behind the uterus, a painless, mobile formation with a dense and elastic consistency is determined. To study its nature in more detail, the gynecologist conducts a number of additional examinations to make an accurate diagnosis:

• taking a smear from the vagina allows you to identify inflammatory and infectious diseases of the genital tract;
• hormonal screening that evaluates hormonal background women;
• blood testing for tumor markers, excludes or confirms the malignant nature of the neoplasm;
• Ultrasound diagnostics (preferably with visualization of blood flow) allows you to study the structure, shape of the tumor and its blood supply;
• magnetic resonance or computed tomography clarifies the results of ultrasound diagnostics (if necessary);
• puncture of the abdominal cavity (for ascites) is necessary to remove the pathological transudate and its subsequent examination;
• laparoscopy is performed for diagnostic and therapeutic purposes and gives the most full information about the condition of the ovary and the structure of the formation.

Ovarian fibroids must be differentiated primarily from functional cysts, ovarian cancer and uterine myomatous nodes. In contrast, fibroids are always mobile.

In addition, at the beginning of diagnosis, fibroma is often confused with ovarian thecoma. Their main difference is that fibroma is a painless, hormonally inactive tumor that does not in any way affect the menstrual cycle and work reproductive system women. Tekoma, on the contrary, is painful to the touch, causes discomfort, releasing estrogens, “breaks” the cyclicity of menstruation, causing their delay until their complete absence for several months, then replacing this with breakthrough bleeding.

Treatment

It should be noted that ovarian fibroids are not treated with medication, since they simply do not respond in any way to medicines. Therefore, when a tumor is detected, the doctor immediately refers it to surgical removal.

Drug therapy is used only in the postoperative period for rapid recovery after the intervention.

How to prepare for surgery + its implementation

For young women, the operation is performed with maximum preservation of healthy ovarian tissue. This is especially important for those who are planning to become pregnant and give birth to a baby in the future. The essence of such an operation is complete removal fibroids together with the capsule, without affecting the ovary (if the fibroma is limited). If the fibroma is diffuse, then the pathologically altered ovarian tissue is removed and, if possible, healthy tissue is preserved.

For pre- and postmenopausal women, the ovary is completely removed.

Depending on the size of the formation, two methods of surgical intervention can be used:

• laparotomy is used to remove small fibroids;
• Abdominal surgery is used to remove large fibroids.

Preparation for the operation is standard. In a day or two, the woman goes to the hospital and undergoes a series of examinations that are necessary before the operation. Most often this is:

• blood test for HIV and syphilis, hepatitis C and B;
• general blood analysis;
• general urine analysis;
• determination of blood group and Rh factor;
• biochemical blood test (glucose, bilirubin, total protein);
• vaginal smear;
• electrocardiogram (ECG);
• blood test for clotting factors;
• fluorography (FLG).

Maybe, medical institution, in which the operation is to be performed will require an additional series of examinations. It must be remembered that the slightest deviation from the norm is a contraindication to the operation. It is better to wait and put the indicators of the studies “in order”, and then proceed to remove the formation.

The day before surgery last appointment food must be taken no later than seven o'clock in the evening, and liquid intake (water, juices, fruit drinks, etc.) no later than ten o'clock in the evening. On the day of surgery, food and liquid intake is prohibited. In order for the intestines not to interfere with manipulations on the ovaries, it must be freed from contents as much as possible, for which the woman must take a laxative at night and empty it in the morning in a natural way. Immediately before the operation, a cleansing enema is given and pubic hair is shaved.

The duration of the operation depends on the “advanced” state of the disease and on average takes about forty minutes.

During the postoperative period, women are advised to move. To prevent the formation of adhesions, proteolytic enzymatic preparations are prescribed to reduce pain to relieve inflammation, non-steroidal anti-inflammatory drugs are prescribed, antibiotics may be prescribed wide range actions to prevent entry bacterial infection, to prevent thrombus formation, anticoagulant therapy is carried out.

Folk remedies

Folk remedies in the treatment of ovarian fibroma as well as drug therapy ineffective. Therefore, you should not entertain yourself with the illusion that everything will “resolve itself” with the help of improvised means. Unfortunately, in the practice of doctors there have been cases of worsening of the pathology when using various decoctions and tinctures.

Treatment prognosis and possible complications

Fibroma is a benign neoplasm that does not pose a threat to women's health. The prognosis is usually favorable (only in 1% of cases fibroids become malignant). As a rule, formations do not reappear after removal. Pregnancy after fibroid removal should be planned after full recovery body after surgery.

If the fibroma is not removed, complications such as:

• tumor necrosis;
• hemorrhages;
• suppuration;
• addition of infection;
• torsion of the legs.

To prevent all this, it is necessary to follow the rules of prevention.

Prevention

There are no strict measures to prevent the occurrence of ovarian fibroids. But everyone knows the rule: “Forewarned is forearmed.” To do this, you should regularly (at least twice a year) preventive examinations see a gynecologist and go once a year ultrasound diagnostics pelvic organs. This is the only way to early stages identify the problem and undergo treatment on time.

What ovarian tumors can women of pre- and menopausal age encounter - video

Fibroids are only scary by their name, and this diagnosis not a sentence. Many women live with such formations for many years, unaware of their presence. This once again proves that they are relatively harmless compared to other pathologies.