What is the cause of the enlarged uterus? Pay attention to uterine hypertrophy

Patients with uterine hypertrophy will experience varying degrees of bleeding, increased menstrual volume and prolonged duration, and some will have shortened menstrual cycles. This is common in women who have given birth to more than three children and should be promptly diagnosed and distinguished from other uterine diseases.

1. Gross appearance: The uterus is uniformly enlarged, with myometrial hypertrophy of 2.5 to 3.2 cm, grayish white or pink cross-section, increased hardness, woven fiber bundles, vascular protrusions in the outer 1/3 of the myometrium, normal or thickened endometrium, and sometimes small leiomyoma (less than 1 cm in diameter) or endometrial polyps can be seen.

2. Microscopic examination : The images are inconsistent and have the following forms: ① Simple smooth muscle cell hypertrophy, which is the same as the normal uterine myometrium under microscopic observation, without collagen fiber proliferation and no obvious changes in the blood vessel wall; ② Collagen fiber proliferation in the uterine myometrium, forming uterine fibrosis; ③ Changes in the blood vessel wall in the myometrium: arteries and veins are obviously dilated, and there are clusters of elastic fibers proliferating around the new blood vessels.

3. Diagnosis

Multiparous women with heavy menstruation and uniformly enlarged uterus, normal or thickened endometrium, and some polyp-like endometrium, but most of them are normal in pathological examination, and a few show hyperplasia, can be diagnosed with uterine hypertrophy. Care should be taken to differentiate it from uterine fibroids, especially those with a single intramural or submucosal myonucleus. When the uterine body is uniformly enlarged, it is often difficult to differentiate it from uterine hypertrophy. Diagnostic curettage and exploration of the uterine cavity and B-ultrasound examination can assist in the diagnosis, but in a few cases the diagnosis can only be confirmed during laparotomy. In addition, attention should be paid to the differentiation from diseases such as adenomyosis and endometrial cancer.