How to treat posterior uterine wall nodules

Nodules on the posterior uterine wall generally refer to adenomyosis, which is a common uterine disease. There are many causes of adenomyosis, the most common of which are sequelae of cesarean section, artificial abortion, etc. Since nodules on the posterior uterine wall cause considerable harm to patients, many patients are concerned about the treatment of this disease. So, how to treat nodules on the posterior wall of the uterus? Let’s take a closer look below.

1. Medication

(1) Symptomatic treatment For patients with mild symptoms who only require relief of dysmenorrhea, especially those near menopause, non-steroidal anti-inflammatory drugs can be used for symptomatic treatment during dysmenorrhea. Because the ectopic endometrium will gradually shrink after menopause, the pain of such patients will be relieved after menopause without the need for surgical treatment.

(2) Pseudomenopause therapy GnRHa injection can make the hormone level in the body reach the menopausal state, thereby causing the ectopic endometrium to gradually atrophy and play a therapeutic role. This method is also called "medical oophorectomy" or "medical hypophysectomy."

(3) Pseudo-pregnancy therapy: Some scholars believe that oral contraceptives or progestins can cause the ectopic endometrium to decidualize and atrophy, thereby playing a role in controlling the development of adenomyosis. However, some scholars believe that the ectopic endometrium of adenomyosis is mostly the basal layer of the endometrium, which is insensitive to progesterone. Therefore, the effect of progesterone in the treatment of adenomyosis remains controversial.

2. Surgery

Including radical surgery and conservative surgery. Radical surgery is hysterectomy, and conservative surgery includes adenomyosis lesion (adenomyoma) resection, endometrial and myometrial resection, myometrial electrocoagulation, uterine artery occlusion, presacral neurectomy and sacral neurectomy.

(1) Hysterectomy is used for patients who have no fertility requirements, whose lesions are extensive, whose symptoms are severe, and who have not responded to conservative treatment. Moreover, in order to avoid residual lesions, total hysterectomy is the first choice, and partial hysterectomy is generally not advocated.

(2) Lesion resection for adenomyosis is suitable for patients who want to have children or are young. Because adenomyosis often has diffuse lesions and unclear boundaries with normal uterine muscle tissue, how to choose the method of resection to reduce bleeding, residual tissue and facilitate postoperative pregnancy is a very confusing issue. Different scholars have different plans, and there is currently no unified procedure.

3. Interventional treatment

In recent years, with the continuous advancement of interventional treatment technology. Selective uterine artery embolization can also be used as one of the treatment options for adenomyosis. Its mechanisms of action are: ① necrosis of the ectopic endometrium, reduced secretion of prostaglandins, and relief of dysmenorrhea; ② After embolization, the uterine body becomes soft, the volume and area of ​​the endometrium in the uterine cavity are reduced, and the menstrual volume is reduced; ③ The continuous reduction in uterine volume and contraction of smooth muscles block the tiny channels that cause endometriosis and reduce the recurrence rate; ④ The local estrogen level and the number of receptors decrease; ⑤ The establishment of collateral circulation in the endometrium can gradually migrate from the basal layer to grow and restore function.

The above is an introduction to the treatment of posterior uterine wall nodules. I hope it will be helpful to patients. The situation of nodules on the posterior wall of the uterus is relatively complicated, and the conditions of different patients are different. Therefore, when this disease is discovered, it is best to go to a regular hospital for diagnosis and determine the best treatment measures to avoid greater harm.