Operation exactly is required if:
- The patient was concerned about heavy prolonged menstruation or acyclic bleeding leading to anemia.
- Dimensions fibroids are large, the tumor size greater than the size of the pregnant uterus 12 weeks in young women, and 14 weeks in women after 45 years.
- There are signs of compression of adjacent organs.
- The rapid growth of the tumor, especially during menopause or menopause.
- Subserous node on the stem (at risk of twisting).
- Availability of submucous fibroids. Even a small submucous nodule can cause bleeding, life-threatening.
- Necrosis myoma node.
- Fibroids placed in the cervix.
- Related gynecological pathology to be operative treatment (recurrent endometrial hyperplasia, some diseases of the cervix, ovarian tumor, prolapse of the vaginal walls and the uterus).
- Recurrent miscarriage (if no other set of reasons).
- Infertility is not explained by other causes.
What do the surgery?
The fundamental question, which determines the type of operation - to remove or retain the uterus. The younger the patient, the more reason to perform breast conserving surgery, especially if in the future it is planned the pregnancy.
The choice of access (abdominal, vaginal, laparoscopic or hysteroscopic) depends on several factors: tumor size, the need for examination of the abdominal cavity, the presence of obesity, the need for further intervention on the ovaries, fallopian tubes, and others.
Myomectomy - Surgical removal procedure only fibroids while preserving the uterus. This method is commonly used in young women who want to retain the ability to have children. Myomectomy successfully cured 80% of patients, but with a large number of nodes treatment effectiveness is considerably reduced.
Modern surgical practice allows for a minimally invasive myomectomy access. Laparoscopic myomectomy may be used if the host is on the outside of the uterus (subserous). The stomach is a few small incisions through which the doctor inserts into the abdominal cavity of a miniature video camera and special surgical instruments, and through which the tumor is removed.
Hysteroscopic myomectomy is performed using a hysteroscope. The skin incision is not made. Specialist enters the uterus special flexible instrument, equipped with a fiber optic (hysteroscope) and removes fibromatous nodes using special tools, conducted through the hysteroscope. The large nodes are removed completely or partially - hysteroscope removes some assembly projecting into the lumen of the uterus. Approximately 10-20 percent fibromatous nodes are in a position to remove them using a hysteroscope. This is usually an outpatient procedure performed in the first week after menstruation under local anesthesia. This method of treatment is only suitable for intrauterine (submucous) nodes.
They say you can not cut it?
Can. In some cases using modern minimally invasive intervention - uterine artery embolization and FUS ablation (evaporation) nodes.
UAE - uterine artery embolization blocks blood flow in the arteries that supply blood to the fibroids. The procedure is performed in a hospital by trained endovascular hirurgom.Spetsialist making skin puncture needle in the groin (hip place go to the stomach) and, once in the femoral artery, it carries a thin (1, 5-2 mm), specially curved tube - catheter. Since this procedure maloboleznenna used only local anesthesia, supplemented by drugs that cause drug-induced shallow sleep. Endovascular surgery carries a catheter through the arteries to the uterus under the control of X-ray equipment, which allows to monitor the movement of the catheter within the body. The catheter is fed into the uterine artery to the point where it divides into smaller branches that supply blood to fibroids. The uterine artery injected contrast agent that would ensure proper installation of the catheter.
Then the catheter is introduced a special substance that clogs all branches of the arteries feeding the myoma node. After the end of embolization is a control image, confirming the lack of blood supply to the fibroids. Skin puncture through which the catheter is inserted, processed, they are superimposed sterile compressive bandage for 12 hours.
The node is not suitable blood brings nutrients node begins to "wither."
Uterine artery embolization usually requires a hospital stay of one to three days. After the procedure requires bed rest for 6-8 hours. Postoperatively appointed painkillers. Pain of varying intensity occur in all patients. In addition, the temperature rise may occur. In this case, an additional anti-inflammatory agents are assigned. Complete recovery usually takes 2 weeks, but this period may be somewhat lengthened (depending on the size and number of nodes). In the usual course of postoperative monitoring and ultrasound examination is carried out in 2 weeks, 2 months, 6 months and 1 year after embolization.
EMA for the treatment of uterine fibroids It used in the world since 1995. Experience gained enough, but studies are still ongoing. 
The average duration of the procedure MRgFUS ablation of uterine fibroids is 3-4 hours.
The main advantage of FUS ablation is non-invasive (no punctures and cuts) and the possibility of out-patient procedure.
Clinically insignificant fibroids or myomas small size.
This group includes fibroids up to 15 mm. This asymptomatic pathology, such nodes detected only by ultrasound, which is a specific diagnostic success, since in the case of proper management, you can try to stop their further growth. We value the patient is not interested in pregnancy, long-term administration of low-dose oral contraceptives containing progestins third-generation, or intrauterine hormonal system "Mirena" can help stop the growth nodes, profilaktirovat complications and to provide reliable contraception.
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