Clinical morphological peculiarities of uterine leiomyoma in women of reproductive age

Abstract

The aim of the research: to identify the clinical morphological peculiarities of uterine leiomyoma (UL) in women of reproductive age. Materials and methods. 90  women of reproductive age with uterine leiomyoma (the main group) operated by minimal invasive surgical methods were examined. The control group consisted of  45 apparently healthy women. All the women were examined using ultrasound dopplerometry. Hormone  homeostasis was analyzed by determining the content of  blood pituitary-ovarian hormones using radioimmunoassay before and after the surgery. Complex morphological examination consisted of histological,  mmunomorphological and morphometrical methods. Results and discussion. The increased levels of blood FSH and LH were almost two times higher in the women of  main group comparing to controls. The content of blood sex hormones was also higher in the patients of the main group comparing to controls (p<0,05). Significant  intranuclear blood flow was noted by the dopplerography in the grater part of intramural nodules while the nodules of subserous localization were characterized with  moderate blood flow regarding the peculiarities of nodular blood supply in women with UL. The endometrium of women with UL unlike the endomentrium of healthy  women had disparity according to the phases of the menstrual cycle between the stroma and the glands revealed by morphological examination. The presence of  glandularfibrous or fibrous endometrial polyps in 35 cases (38.8%) was typical when examining the endometrium scrapes of women in the main group. Conclusions.  Thus, the results of hormonal balance study in women with UL are indicative of the pituitary axis hyperfunction regulating the menstrual cycle.  Significant intranodular blood flow is characteristic for intramural nodules and moderate blood supply — for subserously located nodules. The deformation of uterine  cavity was revealed by the results of hysteroscopy in 51 (56.6%) cases, and hyperplasia of endometrium in 50 (55.5%) women. This fact testifies to the close relationship  of leukomyoma and pathological endometrial changes.