Can uterine serosa fibroids cause uterine bleeding?

Nowadays, more and more women do not know much about various parts of the body. Many people think that as long as they pay attention to hygiene in daily life, they will not get sick. However, even if many women clean their vagina regularly every day to ensure their health, they are still prone to uterine serosa fibroids, which is an early type of uterine fibroids on the serous surface of the uterus. After the onset of the disease, patients will initially have mild uterine bleeding. The symptoms of uterine bleeding are that the duration of heavy menstruation begins to prolong, there are spots of blood, there is frequent secretion, the menstrual cycle is irregular, the abdominal mass is relatively large, and you will feel a hard mass in the abdomen by gently pressing it with your hand. A few people will often feel lower abdominal pain and pain from nerve compression, especially during bleeding. Pelvic pain will be more obvious, because going to the supermarket for a long time can easily cause inflammation.

Uterine bleeding

It is the main symptom of uterine fibroids, occurring in half or more of the patients. Among them, cyclical bleeding (excessive menstrual flow, prolonged menstruation or shortened menstrual cycle) accounts for most, about 2/3; while non-cyclical (continuous or irregular) bleeding accounts for 1/3. Bleeding is mainly caused by intramural fibroids and submucosal fibroids. Cyclic bleeding often occurs in intramural fibroids, while submucosal fibroids often present as irregular bleeding. Subserosal fibroids rarely cause uterine bleeding. In some cases, the amount of menstruation actually decreases. Reasons for heavy bleeding caused by fibroids: ① Patients with fibroids often have excessive estrogen levels combined with endometrial hyperplasia and polyps, which lead to heavy menstrual flow; ② Fibroids cause the uterus to increase in size and endometrial area, resulting in excessive bleeding and bleeding for too long. Especially in the case of submucosal fibroids, the mucosal bleeding area can reach more than 225cm2 (normal is about 15cm2); ③ Submucosal fibroids, the mucosal surface is often ulcerated and necrotic, leading to chronic endometritis and causing continuous bleeding; ④ Intramural fibroids, affecting uterine contraction and clamping blood vessels, or submucosal fibroids endometrium exfoliation and unable to contract, all lead to heavy bleeding and prolonged duration; ⑤ Larger fibroids may be combined with pelvic congestion, making the blood flow vigorous and large; ⑥ Menstrual irregularities during menopause. Excessive menstrual flow or prolonged menstruation may occur alone or in combination. If it occurs simultaneously with shortened (excessive) menstrual cycles, a large amount of blood may be lost in a short period of time, leading to severe anemia. Submucosal fibroids prolapse into the vagina and cause non-cyclical bleeding, which can be extremely heavy. Large polypoid fibroids also often cause persistent bleeding.

Abdominal mass

Lower abdominal mass is often the main complaint of patients with uterine fibroids, accounting for as high as 69.6%. Sometimes it may be the only symptom of fibroids. This situation often occurs with intramural fibroids that grow into the abdominal cavity and do not affect the endometrium, especially subserosal fibroids located at the fundus of the uterus or with pedicles. Abdominal masses are usually discovered after uterine fibroids grow out of the pelvic cavity and are often obvious in the early morning when the bladder is full and the stomach is empty. Because the uterus and fibroids are pushed upward, patients can easily touch them by themselves. If the uterus is larger than 4 to 5 months of pregnancy, it can be touched even when the bladder is not full. Uterine fibroids are generally located in the center of the lower abdomen, but in some cases they may be located on one side of the lower abdomen and may be hard or have an uneven feel. The larger ones tend to be degenerated, softer and smoother. Most do not grow quickly. According to data from the early days of liberation, some women did not seek medical treatment until they were 22 years old. This was mainly because working women were deeply oppressed in the old society and had no conditions for medical treatment. In rare cases, the tumor may grow rapidly or be accompanied by dull pain, and malignant transformation should be suspected.

pain

About 40% of patients suffer from abdominal pain, 25% suffer from back pain and 45% suffer from dysmenorrhea. Some also suffer from a feeling of heaviness in the lower abdomen or back pain, but the degree is usually not very serious. The pain is caused by the tumor compressing the pelvic blood vessels, causing congestion, or compressing the nerves, or the pedunculated submucosal fibroids can stimulate the uterus to contract and be discharged from the uterine cavity, causing the cervical canal to widen and cause pain; or the necrosis and infection of the fibroids can cause pelvic inflammatory disease, adhesion, traction, etc. If some patients have red degeneration of uterine fibroids, the abdominal pain will be more severe and accompanied by fever. Acute and severe abdominal pain can also occur when the pedicle of a subserosal uterine fibroid is twisted or the axial torsion of the uterus occurs. Large subserosal fibroids grow into the broad ligament, which can not only compress the nerves and blood vessels and cause pain, but also compress the ureters and cause hydroureteral or renal pelvis, resulting in low back pain. Severe and progressively worsening dysmenorrhea is often caused by uterine fibroids with complications such as adenomyosis or endometriosis.

Compression symptoms

It often occurs in uterine cervical fibroids, or is caused by the enlargement of fibroids in the lower part of the uterine body, which fills the pelvic cavity and compresses the surrounding organs. Compression of the bladder can cause frequent urination, difficulty urinating, urine retention, etc.; compression of the ureter can cause hydronephrosis and pyelonephritis. Fibroids growing on the posterior wall of the uterus can compress the rectum, causing constipation or even difficulty in defecation. Compression of the pelvic veins may cause lower limb edema. The compression symptoms are more obvious in the early stage of menstruation, which is due to the congestion and swelling of uterine fibroids. If the subserosal fibroids are incarcerated in the uterorectal fossa, bladder or rectal compression symptoms may also occur. About 30% of patients suffer from compression symptoms caused by myoma, including 20% ​​frequent urination, about 10% dysuria, 3.3% urinary retention, 5% urinary pain, 5% constipation, 6% lower limb edema.