Correlation between the Types of Myoma and the Pathological Process

Today myoma of the uterus is one of the most common pathologies of female reproductive system. According to one source, the rate of the disease varies in 20-25% of women of the reproductive age, according to other sources - from 40 to 60%. Separate researches represent that the rate of this disease may reach 70-80%. Previously it was considered that myoma is the diagnosis of females older than 35, nevertheless lately this pathology is found in women under 20-25, who have not realized their reproductive function yet, more and more often, including the ones without any sexual experience. In the case of myoma significant enlargement it leads to the disorder of functioning of the pelvis organs, pain syndrome and it is the reason of abnormal menstrual and intermenstrual hemorrhages. Severe symptoms may occur in 15-30% of cases, while the severity of symptoms depends on the localization, amount and sizes of the nodes. Myoma of the uterus may also give no symptoms. It is well-known that myoma of the uterus does not only lead to infertility (from 5 tj 10% of cases are related to the uterine myoma), but also it leads to miscarriages, complications during childbirth and postpartum period. One of less frequent, but still life-threatening for the patients, complications of the uterine myomas progressing is hemoperitoneum, which occurs as the result of hemodynamic instability and requires immediate surgical intervention. There is a big variety of different data about the factors of myoma of the uterus and its symptoms in literature, some of them are disunited and controversial. Materials and methods: A retrospective analysis of 80 case histories of patients with a confirmed diagnosis of myoma of the uterus (with submucosal, subserous and intramural uterine myoma according to ICD-10/ C00-D48 / D10-D36 / D25) admitted to the hospital for hysteroscopy, fractional-diagnostic curettage. The complex index of disease severity was calculated as follows. Each of the variables - the number of nodes, the size of the nodes (small nodes – up to 2 cm, medium – 2 to 6 cm, large – more than 6 cm (according to the classification of Tykhomirov), and the type of fibroids accordingly gradations of its unfavorability for a woman's condition and risk of malignancy (from subserous to submucous) – were given a scale of standard deviations – that is, they were standardized to lead to a single scale. Results. The greatest number of significant links of the status indicators of a woman with the objective parameters of the disease chosen by us (the number of nodes, the size of the node, the type of uterine fibroids, a complex index per listed in three parameters) turns out to be for the type of uterine fibroids (subserous, intramural and submucous). It is an important result that this kind of indicator does not carry new information, and to analyze the connection severity of the disease follows the correlation of the patient's status indicators with each of the objective parameters of the severity of the diagnosis of patients as a result of all sorts of these dependencies. Discussion: The largest positive connections received with complaints of infertility, as well as the localization of nodes on the uterine fundus with patients with submucous myoma of the uterus. The most common location of myomatous nodes is on the anterior and posterior walls. The associated abundant discharge and increasing blood loss during the menstrual period also depend on the number of nodes. Taking into account the above-said, we came to the conclusion that the complex indicator of the severity of the diagnosis does not carry new information. To analyze the connection of the disease severity we follow the correlation of the patient's status indicators with each of the objective parameters of the severity of the diagnosis due to various kinds of these dependencies.