Symptoms of uterine incisional diverticulum

Normal women have a menstrual cycle every month, but with the increasing number of people undergoing caesarean sections, more and more women are suffering from uterine diverticulum. This phenomenon always makes women's menstrual period longer and longer, seriously affecting their normal life. However, sometimes due to our lack of understanding of uterine diverticulum, we cannot treat it in time when it occurs. Let's take a look at the symptoms of uterine diverticulum.

Symptoms of uterine incisional diverticulum

A diverticulum is a sac-like image formed by the outward bulging of a weak area in the outer wall of a hollow organ, or by the adhesion and traction of adjacent tissue lesions outside the organ, causing the entire layer of the cavity wall to protrude outward. The mucosal folds inside and nearby are normal in shape.

Diverticula are divided into congenital and acquired types. Congenital diverticula are related to abnormal embryonic development and are often seen in the digestive tract and bladder. Acquired diverticula are also called pseudodiverticula. Diverticula at the uterine incision belong to acquired uterine diverticula, which are often seen in the lower part of the uterus, followed by the isthmus of the uterus and the upper part of the cervical canal.

Due to poor apposition during cesarean section, the endometrium is brought into the incision. After the incision diverticulum is formed, the endometrium inside the diverticulum also exfoliates and bleeds periodically. The diverticulum is connected to the normal uterine cavity, and the bleeding needs to be discharged through the uterine cavity. However, since the channels between the two are small, the withdrawal bleeding is not discharged smoothly, so it often manifests as vaginal spotting in the late menstrual period or a small amount of vaginal bleeding in the middle of the menstrual period.

Based on the size of the diverticula, the amount of bleeding, and previous examination experience, it is divided into three types: mild, moderate, and severe [1]:

① Mild type: A slit-like defect can be seen in the scar of the lower uterine segment. The serosal layer is continuous, with a thin layer of muscle wall and endometrium, and the fissure is connected to the uterine cavity. The diverticula may appear and disappear during examination, with a small amount of dribbling bleeding or no bleeding.

② Severe: The endometrium, myometrium and serosa protrude outward in a hernial shape to form a large diverticulum. When the uterus contracts, blood-like echoes can be seen spraying into the diverticulum. Retained blood clots are often seen in the diverticulum, and bleeding may occur for a long time.

③Medium: between light and heavy.

Prevention of uterine incision diverticulum

In addition to causing clinical abnormal vaginal bleeding and infertility, uterine incisional diverticulum is also a predisposing factor for many high-risk diseases:

① Uterine rupture during subsequent pregnancy;

② The embryo is retained in the diverticulum, resulting in pregnancy at the incision site;

③ Uterine perforation is prone to occur during intrauterine operation;

④ Intrauterine contraceptive device misplaced. Although there are many treatments for PCSD, there is still no unified and effective treatment method. Therefore, it is more important to prevent the occurrence of PCSD. Therefore, obstetricians and gynecologists should:

Strictly grasp the indications for cesarean section and reduce social factors leading to cesarean section;

Pay attention to the selection and treatment of the uterine incision to prevent the thickness of the upper and lower incision edges from being inconsistent, which increases the risk of poor incision healing;

If the previous incision did not heal well during the second cesarean section, surgery will be performed on the original incision and repaired; if the previous incision healed well, an incision will be made above the original incision;

During the operation, the decidua and placenta tissues should be fully removed to prevent the residual tissues from affecting the healing of the incision and reduce the risk of incisional endometriosis.

Pay attention to the technique of uterine suturing. The incision suture should be of appropriate tightness. Too tight will affect the blood circulation of the incision, and too loose will easily form hematoma.

During the operation, anatomical reduction of each layer of tissue was achieved.

The sutures at both ends of the incision should extend 0.5 cm beyond the incision to prevent missing blood vessels.

Use absorbable sutures to reduce abnormal uterine bleeding caused by suture residue.

Take adequate measures to prevent and treat infection after surgery. To reduce the incidence of PCSD and avoid unnecessary harm to patients. We should be vigilant about abnormal vaginal bleeding after cesarean section encountered in clinical work and rule out the possibility of uterine incision diverticulum.

The above is an introduction to the symptoms of uterine incisional diverticulum. After understanding it, we will be able to detect the disease in a timely manner and treat it in a timely manner. In order to better avoid the occurrence of such symptoms, female friends should try to choose natural childbirth when choosing the method of delivery. This will cause less harm to the body and is also more conducive to the recovery of the disease.