Lecture uterine fibroids

2021-03-21 12:00 AM

Immediately at the tumour, the uterine lining and fallopian tubes, especially for polyps protruding from the cervix are infected or necrotic: abdominal pain, fever, leukocytes increase, the whole-body collapses.

Outline

Uterine fibroids are benign tumors in the uterus, common in women of sexually active age.

There may be a relationship with endocrine: due to hyper Estrogen.

Location of uterine fibroids

It depends on the part of the uterus

In the body of the uterus: Accounted for 96%.

In the uterus: Account for 1%.

In the cervix: Account for 3%.

Compared with the uterine wall

Subrentals fibroids: May have stalks.

Interstitial fibroids are located in the muscle layer thickness.

Submucosal fibroids: Raised in the uterine cavity. Sometimes there are stalks called fibrous polyps.

Symptom

Depends on the location of the tumor.

Function

Bleeding from the uterus: In the form of hypermenorrhea gradually becomes menstrual disorders, blood clots mixed with dilute blood, lasting 7 -10 days or more.

Damaged gas: Weak like water due to complications of infection coordination.

Hypotension or pelvic pain: Severe abdominal pressure, pain that increases before menstruation or menstruation.

Urinary disorders: urination, urinary retention, urinary incontinence.

The patient may be examined for infertility.

Physical symptoms

Manipulation: The bladder is empty. Manipulating the abdomen shows the hypotonic bulging, determining the base of the uterus of the tumor in the middle, knocking cloudy, firm, mobile, unable to manipulate the lower pole of the tumor.

Platypus: The stalked polyps may appear on the outside of the cervix.

Vaginal examination combined with abdominal manipulation: The whole uterus is large, firm, smooth, even, sometimes there are tumors floating on the face of the uterus, painless, mobile with the uterus.

Measure the uterus longer than usual.

Additional testing

Ultrasound: The size of the uterus increases. The number, size and location of the fibroids, the density of the fibroids.

Contrast-pumped uterine imaging: There is a uniform, homogeneous defect image that occupies the uterus or on one edge of the uterus.

Endometrial biopsy detects overproduction damage, uterine mucosal dystrophy, uterine lining polyps.

Cytology of the cervix to detect cervical cancer early.

Hysteroscopy: beneficial for small fibroids under the mucosa.

Differential diagnosis

Pregnancy, miscarriage, stillbirth.

Ovarian tumor.

Cancer of the uterus.

Progression and complications

Bleed

Often seen in fibroids under the mucosa. Heavy bleeding leads to chronic hypochromia.

Mechanical complications

Compression to the ureter when the tumor is in the wide ligament, leading to renal pelvis stagnation, compression of the bladder, causing urinary retention, difficult urination.

Squeezing into the rectum causes constipation.

Insertion into the vein causes swelling of the lower extremities.

Tumor twisting under the peritoneum with stalk causes pain in the pelvic fossa, peritoneal irritation: vomiting, mediastinal squash, abdominal distention, rapid pulse, dizziness.

U got stuck in Douglas.

Complications of infection

Immediately at the tumor, the uterine lining and fallopian tubes, especially for polyps protruding from the cervix are infected or necrotic: abdominal pain, fever, leukocytes increase, the whole-body collapses. Platypus placement shows a soft, dark brown mass, necrosis.

Degenerative changes of uterine fibroids

Fat degeneration, menstruation, calcification, necrosis ...

Oncology (Sarcoma)

Low ratio

Obstetric complications

Late pregnancy, infertility, miscarriage, premature birth, premature rupture of amniotic fluid, underdeveloped fetus, abnormal throne, placenta, forward tumor, postpartum bleeding, vegetable defect, uterus, mucositis uterus after childbirth.

Treatment

Medical

For small fibroids, there are no complications other than blood, waiting for surgery, or for premenopausal patients taking Progestatif: from day 16 to 25 of the menstrual cycle.

Use drugs to contract the uterus: Oxytocin.

Use a hemostatic drug such as hemocaprol.

Surgery

Conservation: The core of the fiber is removed for a young person who wishes to have a baby, and the core can be removed.

Radical: Partial hysterectomy, complete with appendectomy or leaving appendages depending on the age of the patient.