What Are Endometriomas?

Uterine bleeding due to obesity, diabetes, hypertension, etc., caused by compression of the ureter causes hydronephrosis or renal atrophy on the side of the pelvis and ureter; or systemic failure such as anemia, weight loss, fever, and cachexia occurs.

Endometrial tumor

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Uterine bleeding due to obesity, diabetes, hypertension, etc., caused by compression of the ureter causes hydronephrosis or renal atrophy on the side of the pelvis and ureter; or systemic failure such as anemia, weight loss, fever, and cachexia occurs.

TCM disease name

Endometrial tumor

Visiting department

Oncology, Gynecology

Multiple groups

Women of childbearing age

Common locations

uterus

Common symptoms

Uterine bleeding, pain, vaginal drainage

Contagious

no

1. Uterine bleeding: Irregular vaginal bleeding before and after menopause is the main symptom of endometrial tumors, usually small to moderate bleeding. Not only are younger or near-menopausal patients prone to misinterpreting irregular menstruation and not seeking medical attention in a timely manner. Individuals also have delayed menstrual cycles, but their performance is irregular. Postmenopausal patients often present with persistent or intermittent vaginal bleeding. Patients with endometrial tumors generally have no contact bleeding. Rotten flesh-like tissue may be mixed in advanced bleeding ^[1]

1. Obesity. Too much fat will increase estrogen storage.

2. Diabetes. Patients with diabetes or abnormal glucose tolerance have a 2.8-fold greater risk of endometrial tumors than ordinary people.

3. Hypertension. Endometrial tumors are associated with hypertension. Obesity, diabetes and hypertension coexist in patients with endometrial tumors, which is called "triad of endometrium" or "endometrial tumor syndrome". The three may be related to a high-fat diet, which is directly related to endometrial tumors.

4. Irregular menstruation. In patients with endometrial tumors, menstrual disorders and high volume are three times higher than in normal women.

5. Early menarche and late menopause. The prevalence of endometrial tumors is 60% higher than that of menarche before the age of 12.

6. Number of births. Endometrial tumors are more common in prolific, infertile and infertile patients.

7. Polycystic ovary syndrome. It is manifested by not ovulating, leaving the endometrium under the action of high levels of sustained estrogen, lacking the regulation of progesterone and periodic endometrial exfoliation, resulting in changes in proliferation.

8. Ovarian sarcoma. Granular cell tumors and follicular membrane cell tumors that secrete relatively high levels of estrogen can cause menstrual disorders, postmenopausal bleeding, endometrial hyperplasia and endometrial tumors.

9. Atypical hyperplasia of the endometrium.

10. Exogenous estrogen. Female friends who take estrogen have a high risk of endometrial tumors. The risk is closely related to the dose size, length of time taken, and whether progestin is used in combination, whether to stop medication in the middle, and the characteristics of the patient. At this stage, there is sufficient evidence for a causal link between estrogen and endometrial tumors.

1. Vaginal bleeding is irregular vaginal bleeding, usually in small amounts, and major bleeding is rare. Postmenopausal patients present with persistent or intermittent bleeding, and those who have not had menopause will have increased menstrual flow, prolonged menstrual periods, or bleeding between periods.

2. Some patients with vaginal drainage complained of increased leucorrhea, mostly serous or serous bloody leucorrhea in the early stage, and purulent or purulent drainage with foul odor at the end of the combined infection.

3. Pain usually does not cause pain. Tumors infiltrating the surrounding tissues or compressing nerves at the end of the disease can cause pain in the lower abdomen and lumbosacral region. When the tumor invades the cervix and the cervical canal is blocked causing pus in the uterine cavity, it can show abdominal pain and spastic pain.

4. No abnormality can be found in the early stage of the gynecological examination. As the disease progresses, the uterus will become larger, softer and normal, and the two appendages will be normal. In the late stage, when the cervix is affected and the cervical canal is blocked, the uterus will be significantly enlarged, and Soft, when the tumor tissue infiltrates to the periphery, the uterus does not move, and irregular nodules can be palpated in the uterus or pelvis.

Endometrial tumors can be suspected based on the above symptoms and signs. Diagnostic curettage for endometrium is the most diagnostic measure. In order to determine whether the cervical canal is affected, the curettage should be segmented. The cervical canal is scraped first, and then the uterine cavity is scraped.
It should be noted that it is different from menopausal functional uterine bleeding, submucosal fibroids, endometrial polyps, senile endometritis with pyogenic empyema.

Surgical treatment is the preferred method, and the scope of surgery is determined according to its clinical stage. If there are tumor cells in the ascites, lymph node metastasis is suspected, radiotherapy should be added after surgery. For patients with end-stage tumors or recurrence tumors that cannot be surgically removed or are young, and those who require fertility preservation at the initial stage can be treated with progestin. Various artificial progestins such as megestrol acetate, progesterone hexanoate, progesterone and so on can be used. The dosage should be large, such as medroxyprogesterone acetate 200-400mg / d, twice a week, at least 10-12 weeks to evaluate the effect.