Uterine fibroids and their complications remain one of the main reasons for surgical interventions in gynecological practice in all developed countries. The frequency of this pathology in the structure of gynecological diseases is high and comprise by different authors data, from 10 to 27%, the results of autopsies of about 50%, according to U.S. researchers more than 70%.
Approximately 30–45 % of cases of uterine fibroids are diagnosed in women of reproductive age: 15–17 % in women older than 30 years, and 30–35% at the premenopausal age. Recently there was determined a trend towards the rejuvenation of the disease. After 30 years the risk of uterine fibroids increases to 70–80 %, and the incidence continues to be very common pathology in women in the perimenopause period. However, it is impossible to determine the true incidence due to asymptomatic course in more than 70 % of uterine fibroids.
The study was aimed to evaluate risk factors for uterine fibroids in women of reproductive age.
The research was conducted at the SI “Road Hospital” of SE “Odessa Railway” during 2008–2013. There was conducted a retrospective analysis of medical records of women of reproductive age suffering from uterine fibroids (code ICD-10 D25). Statistical analysis performed using the software Statistica 7.0 (USA).
Results of research. Retrospective analysis showed that during 5 years in the hospital there were observed 1982 women with uterine fibroids. Overall, uterine fibroids rank third position after inflammation of the uterus and endometriosis in the structure of gynecological diseases registered in the Odessa Railway Hospital.
Clinical signs of uterine fibroids varied and depend on the location and size of the tumor, presence of degenerative processes in the nodes, the duration of the disease. The most common cases (80.8%) are associated with menstrual dysfunction (menorrhagia, metrorrhagia), which led to anemia. In 23.3% of cases there was pain, which was due to rapid growth or large uterine fibroid, distortion of junction, thrombosis of blood vessels that nourish capsule of myoma node, as well as delivering submucosal node or its necrosis .
The important role in clinical uterine fibroids played reproductive disorders (infertility, miscarriage, complications during childbirth and the postpartum period), which occurred in 50.4 % of women. Impaired function of adjacent organs (increased frequency of urination, urinary retention, pyelonephritis, hydronephrosis, constipation) occurred in 5.9% of patients. The relatively infrequent occurrence had manifestations of myelopatic and radiculopatic syndrome that developed with increasing tumor size greater than 14-week gestation (1.5% of cases). Mielopatic syndrome manifested with weakness and heaviness in the legs, paresthesia. Radiculopatic syndrome developed as a result of compression of the uterus, pelvic nerve plexus or certain nerves that lead to the occurrence of pain in the lumbosacral region and lower limbs, disturbance of sensitivity as paresthesias or hyperpatias.
It is shown that in a gynecological hospital of Odessa railway the leiomyoma takes the third place after uterine inflammation and endometriosis in the structure of gynecological pathology. The most frequent localization is an interstitial fibroid, while in 49.8 % of cases the tumor is localized in the corpus uteri. The main risk factors for fibroids are hormonal imbalance, age of 45 years and genetic predisposition.