Uterine fibroids are formed by the proliferation of uterine smooth muscle cells and are pathologically characterized by substantial spherical nodules of varying sizes. The tumor is surrounded by a pseudo-envelope composed of compressed muscle fibers, and there is loose connective tissue between the pseudo-envelope and the fibroid. It is common to see edema, vitreous degeneration, cystic degeneration, calcification, and rarely, red degeneration and sarcoma degeneration, and secondary infection.
Classification
According to the location of the fibroids, they can be classified as cervical fibroids and uterine body fibroids, with uterine body fibroids being the most common.
According to the relationship between the fibroid and the uterine wall, they can be divided into 3 categories.
a. Interstitial fibroids, which are located in the myometrium and surrounded by the myometrium, accounting for 60% to 70% of the fibroids.
b. subplasmalemmal leiomyomas, which protrude from the plasma surface of the uterine body and cover only the plasma membrane on the surface, accounting for 20%.
c. Submucosal leiomyoma, which is a leiomyoma growing into the uterine cavity with the surface covered by the endometrium, accounting for 10%-15%.
Clinical features
The clinical symptoms of uterine fibroids are related to the growth site of fibroids.
1.Submucosal myoma: persistent vaginal bleeding or irregular vaginal bleeding.
2.Interstitial myoma: prolonged menstrual period and increased menstrual flow.
3. Subplasmalemmal leiomyosarcoma presents symptoms later, with abdominal masses being found more often or without any clinical symptoms.
Clinical treatment methods
1.Drug treatment
2.Surgical excision
3.Radiotherapy
4.Interventional treatment
Choice of treatment method
1.Will it recur?
2.Can fertility be preserved?
3.Is there any effect on sexual life?
4.Will it leave a scar and affect the beauty?
Interventional treatment principle
After embolization of the myoma artery, the myoma becomes ischemic, atrophies, absorbs and disappears. In contrast, normal uterine tissues have many sources of blood supply and are rich in blood supply, so they do not suffer from ischemia, necrosis and atrophy.
Interventional method
It is a method to block the blood supply to the uterine fibroids by injecting particulate material into the uterine artery to cause embolization, so that the fibroids will shrink and even disappear due to ischemia. Also known as uterine artery embolization
Clinical efficacy evaluation
B ultrasound showed that the tumor was reduced, and MRI showed that the tumor was not enhanced after intravenous contrast injection.
Improvement of patient’s symptoms
In comparison, interventional treatment is the best choice for patients with uterine fibroids because it is non-medicated, non-invasive, less invasive, more effective, faster recovery, and can preserve uterine function intact.