Every day, there are friends who consult the uterine cavity on the Internet. Every day, hysteroscopy is diagnosed with uterine cavity adhesion.Among these friends, some of them were unexpectedly pregnant when they were young, and the uterine cavity adhesion caused by abortion. They often regretted young ignorance and unfortunately injured; some were caused by repeated embryos.pain.Because everyone knows that the uterus is the palace of bred baby, the environment of the palace is destroyed, and the baby will have nowhere to settle.
They are all worried:
"Can’t the uterine cavity stick to pregnancy?"
"If I want to surgery, is it completely cured by adhesion of the uterine cavity?"
"Will the uterine cavity adhesion still recur?"
In fact, these problems are very professional clinical issues.Then, let’s take a look at the uterine adhesion.
1. What is the uterine cavity adhesion?
The uterine cavity adhesion is due to the trauma of pregnancy or non -pregnancy uterus, which causes damage to the endometrium base layer, causing the uterine cavity part or all occlusion to cause abnormal menstruation, infertility or repeated miscarriage. The essence is endometrial fibrosis.Any factors that cause endometrial destruction can cause adhesion of the uterine cavity, of which about 91%of the factors related to pregnancy are.
2. How is the uterine adhesion formed?
I often tell my friends that the uterine cavity is protected by endometrium in normal state. In addition, the menstrual tide of once a month brings the endometrium to remove the uterine cavity, so that the intrauterine cavity has been kept smooth for a long time.In the usual state of the uterine cavity, even if the front and rear walls are close, it will not stick.
The endometrium of normal uterine cavity is smooth
When various incentives of the external cavity are damaged, the damage of the uterine cavity is damaged. This damage makes some functional layers cannot regenerate the long endometrium. There is no endometrium in the uterine cavity.Together, it is easy to form scars and adhesion.
Just as our fingers and fingers are isolated from the fingers, it will make it won’t stick between the fingers.When the fingers are burned, the skin will be destroyed. At this time, the smooth skin no longer exists, and the wound between the fingers and the fingers will appear adhesive and contracture.
In fact, scars caused by the wound and fibrous tissue hyperplasia in the uterine cavity form the same situation of adhesive contracture and the fingers described above, but it is difficult for us to observe its changes in the naked eye and cannot imagine its existence.
3. The cause of the uterine cavity adhesion
The formation of uterine cavity must be induced.
(1) History of uterine cavity operation
Pregnancy factors: This factor accounts for 91%of the cause of uterine cavity adhesion.Condition -related uterine surgery such as early pregnancy negative pressure suction, medium pregnancy claw scraping, postpartum hemorrhage curettage, and natural abortion curetto surgery.This may be that the endometrium function layer of the pregnancy uterus is more likely to be damaged, which leads to sticking to each other’s walls to form permanent adhesion.
Non -pregnancy factors: uterine fibroids removal (entering the uterine cavity), underclavic mirrooscopic mucosal uterine fibroid resection, uterine hypertrophy and other destruction of the base layer of the endometrium, which exposes the uterine muscle layer to the uterine cavity, Resulting in the palace wall adhesion.
(2) Infement in infection of uterine disease
Tuberculosis infected infection, postmenopausal uterine endometritis, subsequent secondary infections, puerperium infections, and secondary infections after placing in -paladin -saving infection may cause uterine cavity adhesion.
(3) Medical derivative factors
Artificially destroy the endometrium base layer, so that the uterine cavity adhesion occurs.Such as: after uterine endometrial electromotive treatment, intrauterine microwave, freezing, chemical treatment and local radiation therapy.These methods are mainly used for the treatment of more menstruation and tumors, which can artificially cause uterine cavity adhesion.
4. What clinical manifestations of uterine adhesion
If the parts and degrees of uterine adhesion are different, the clinical manifestations will be different.The main symptoms are the amenorrhea, less menstruation, periodic abdominal pain, secondary infertility and repeated abortion after artificial abortion or curettage.
Those with severe or completely adhesion of uterine cavity may occur with amenorrhea, with different menstrual periods, and no retreat bleeding can be caused by estrogen hormone treatment.The adhesive part of the uterine cavity is manifested as less menstrual passage, but the menstrual cycle can be normal.If it is a cervical adhesion or adhesion of the lower uterine segment, periodic abdominal pain may occur because the menstrual blood accumulated in the upper paragraph can not be discharged through the lower paragraph or cervix.
Of course, because the uterine cavity adhesion and destroying the endometrium, the accumulation of uterine cavity is reduced, which affects the normal bed in the embryo, which can easily cause repeated abortion.Some uterine cavity adhesion can cause adhesion and blockage at the opening of the fallopian tube, leading to infertility.
The adhesion of the uterine cavity mainly depends on the above clinical manifestations and combined with the following auxiliary examination for diagnosis.
The method of diagnosis of the diagnosis of uterine cavity is given priority. It is the gold standard of diagnosis of uterine cavity adhesion. It can not only understand the uterine cavity adhesion, but also clearly clear the parts, scope, extent and extent of the uterine cavity adhesion under direct sight.state.For mild adhesion, it can also be processed directly.
(2) Gynecological B ultrasound
With the widespread application of B -ultrasound technology and the improvement of the diagnostic level, although ultrasound also has a certain diagnostic value, the sensitivity of the diagnosis of uterine cavity adhesion is about 52%, and its limitations aredegree.
(3) iodine oil angiography
It has a certain diagnostic value, but it is often discovered at the same time when the fallopian tubal angiography.It is not used as a routine recommendation of the diagnostic method of uterine cavity.
6. Treatment method
Surgery is the only effective way to treat uterine cavity adhesion.Simple drug treatment is invalid, but it also plays an important role in preventing postoperative adhesion recurrence.
Using hysteroscopic treatment of uterine cavity can not only intuitively judge the parts and range of the adhesive, but also perform accurate treatment.For membrane adhesion, fibrous muscle adhesion, can be separated under uterine laparoscopic or scissors with surgery; while connecting tissue -like dense adhesion is required, electrocoscinisions are required, and postoperative hysteria ball pockets are placedAnd give estrogen sequence sequencing medicine to promote endometrial growth.
The purpose of surgical treatment of uterine cavity adhesion is to remove adhesion, restore anatomical structure, prevent adhesion and formation, and ultimately achieve the three goals of restoring uterine anatomy and form, restoring menstruation, and creating concerted conditions. These are gradual.
Of course, the uterine cavity adhesion is very easy to relapse. However, if the purpose of the three surgical therapy can be followed, there is still hope to gradually achieve the three ideal goals.
The uterine cavity has a certain impact on fertility function.According to literature, the postoperative pregnancy rate of patients with uterine adhesion was 22-45%.
Are all the uterine adhesion need surgery?
In fact, for patients with no fertility requirements, even if there is amenorrhea or a reduction in menstrual flow, as long as there is no symptoms of periodic abdominal pain, there is no need to take risk surgery.Of course, this also needs to look at the understanding and acceptance of menstruation. If you need to improve menstruation, surgery can also be performed without understanding the risk of surgery.
7. How to prevent it?
We said that the occurrence of uterine cavity adhesion is incentives. Since there is a cause, we can prevent it. It is more important to prevent treatment than treatment.
For female friends, if you pay attention to contraception, you can reduce accidental pregnancy and pelvic inflammatory diseases, and avoid the occurrence of most uterine cavity adhesion.
For doctors, the operation of the abortion or the palace cavity needs to be as gentle and meticulous as much as possible, and try to protect the patient’s endometrium and reproductive function.For example: actively treat endometritis to prevent postoperative infection; smoothly expand the cervix, attract proper negative pressure, and avoid damage to the cervical canal and uterine cavity;The cavity adhesion occurs.
In short, the uterine cavity adhesion has a greater impact on women’s fertility functions and is easy to recur.Hysteroscopic examination is a diagnostic gold standard. The use of hysteroscopic surgical treatment is the best treatment method. Placing the balloon of the uterine cavity after surgery and supplemented by the artificial cycle can help reduce the postoperative adhesion.
Of course, for the adhesion of the uterine cavity, it is also more important to prevent treatment. Only when friends really do contraception and reduce artificial abortion and reproductive diseases caused by accidental pregnancy.Prevent uterine cavity adhesion.
Protecting the uterine cavity and protecting women’s reproductive functions requires me to work with you!
The uterine cavity adhesion is damaged, and the endometrium of the uterine is scarred.
Menstruation is reduced or amenorrhea will also affect pregnancy.
Hysteroscopic examination gold standard, surgery is the only way,
Postoperative balloon plus female pregnancy to reduce abortion prevention.(Medical cards have been added here, please go to today’s headline client to view)