Tactics of managing patients with uterine myoma

Abstract

Uterine myoma is the most common benign neoplasm in the pelvic area, characterized by the formation of one or more nodes in the thickness of the myometrium. As a rule, there is a pronounced dependence of this pathology on the hormonal background. According to literature sources, the incidence of uterine fibroids is from 20 to 40%, this pathology is diagnosed mainly in women aged 35-55 years, while in the age groups up to 20 and over 70 it is extremely rare. Recently, there has been an increase in the detection of uterine fibroids; experts associate this fact with a later onset of the first pregnancy and childbirth. Most often, fibroids have a monoclonal origin - they grow from one cell or one cell pool. This problem is not only medical, but also socio-economic, as well as psychosomatic in nature, since the most radical method of treatment is surgery, which is based on the removal of the affected organ. Despite the fact that surgical treatment of fibroids is the main one, in some cases, conservative treatment with the use of selective progesterone receptor modulators is indicated for women of reproductive age. In addition, in some cases, the so-called complex conservative management of patients with minimal surgical intervention followed by chemical myomectomy is used. This approach allows ensuring the preservation of women’s reproductive function. According to the data of clinical observations, such approach allows one to count on the onset of pregnancy in every second or third woman; the prognosis among patients after the removal of a single myomatous node is especially optimistic.