What are the symptoms of uterine hypertrophy? Increased menstruation is the most typical

The most typical symptom of uterine hypertrophy is increased menstrual volume, and the menstrual period will last for a long time. Women with multiple births have a high chance of developing uterine hypertrophy. Patients can be diagnosed through curettage and B-ultrasound examination, and timely treatment is required to avoid uterine cancer.

1. Common symptoms

The main symptoms are excessive menstrual flow and prolonged duration. There may also be a shortening of the cycle to about 20 days with no significant change in the menstrual flow and duration. Or there may be a prolonged menstrual period but not much menstrual flow.

Most of the patients are multiparous women, and most of them have given birth to three or more children. They have been ill for a long time, and those with heavy bleeding appear anemic. Gynecological examination shows that the uterus is uniformly enlarged, generally the size of 6 weeks gestation, and a few are larger than 8 weeks gestation. The texture is tough, and the bilateral ovaries may be slightly enlarged, with multiple follicular cysts.

2. The basic pathological changes of this disease are changes in the smooth muscle cells and blood vessel walls in the myometrium.

(I) Gross findings: The uterus is uniformly enlarged, with myometrial hypertrophy of 2.5 to 3.2 cm, grayish white or pink in 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.

(B) 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: The arteries and veins are obviously dilated, and there are clusters of elastic fibers proliferating around the new blood vessels.

3. Common inspection items

Diagnostic curettage and exploration of the uterine cavity and B-ultrasound examination can assist in the diagnosis, but in a few cases, laparotomy is still required for a definitive diagnosis. Diagnostic curettage is abbreviated as DCT. Its purpose is to scrape the contents of the uterine cavity for pathological examination to assist in diagnosis. If cervical lesions are suspected, the cervical canal and uterine cavity need to be examined in steps, which is called segmented DCT. Diagnostic curettage is divided into general diagnostic curettage and segmented diagnostic curettage. General diagnostic curettage is suitable for endocrine abnormalities, which require understanding of endometrial changes and responses to sex hormones, the presence or absence of ovulation, the presence or absence of tuberculosis, etc. Segmented diagnostic curettage refers to the operation of first scraping the cervical canal and then the uterine cavity. The scrapings are sent for pathological examination separately. It is suitable for diagnosing cervical cancer, endometrial cancer and other uterine malignancies, and can understand the range of the cancer.