What Is a Bulky Uterus?

Uterine hypertrophy refers to an even enlargement of the uterus. The basic pathological changes of the disease are changes in smooth muscle cells and blood vessel walls in the uterine muscle layer. The uterus was evenly enlarged, with muscular layer hypertrophy reaching 2.5 to 3.2 cm. The cut surface is off-white or pink, the hardness is increased, and the fiber bundles are arranged in a woven shape. The arteries and veins were significantly dilated, and there were clusters of elastic fibers hyperplasia around the new blood vessels. A disease with varying degrees of uterine bleeding. The main clinical symptom is increased vaginal discharge. In addition, due to the proliferation of connective tissue and inflammation along the cervix or transcervical ligament to the pelvic cavity, there is pain in the lumbosacral region or a feeling of perineal fall.

Basic Information

English name

uterine hypertrophy

Visiting department

Gynecology

Common causes

Hyperplasia of elastic fibrous tissue in myometrium, ovarian dysfunction, inflammation, etc.

Common symptoms

Excessive menstrual flow and prolonged days; Menstrual period prolonged, but not too much

Contagious

no

Causes of uterine hypertrophy

Uterine cause

(1) The elastic fibrous tissue in the uterine muscle layer of procreative women proliferates between smooth muscles and around blood vessels, causing uterine hypertrophy.

(2) Primary uterine vascular disease causes uterine hypertrophy.

2. Ovarian dysfunction

Continuous stimulation of estrogen can make myometrium hypertrophy. Clinically, patients with functional uterine bleeding, especially those with longer disease duration, have varying degrees of uterine enlargement.

3. Caused by inflammation

Chronic appendicitis, pelvic connective tissue inflammation, and chronic uterine myositis cause hyperplasia of collagen fibers in the myometrium and fibrosis of the uterus.

4. Pelvic congestion

Causes uterine connective tissue hyperplasia, can also cause uterine hypertrophy.

5. Pathogens

The pathogens that cause cervical hypertrophy are mycoplasma, chlamydia, bacteria, and viruses.

Clinical manifestations of uterine hypertrophy

1. Excessive menstrual flow and prolonged days;

2. The performance is shortened to about 20 days, and there is no significant change in menstrual flow and duration;

3. The menstrual period is prolonged, but the menstrual flow is small.

Most of the patients are menopausal, and most of them are more than 3 births. Those with a long illness and heavy bleeding showed anemia. Gynecological examination evenly enlarges the uterus, generally 6 weeks of pregnancy size, a few more than 8 weeks of pregnancy size, the texture is tough. The bilateral ovaries can be slightly enlarged with multiple follicular cysts.

Uterine hypertrophy examination

1. B-ultrasound.

2. Diagnostic curettage for uterine cavity.

Diagnosis of uterine hypertrophy

Multiple mothers, more menstruation and increased uterine consistency, endometrium normal or thickened, and some were polypoid, but most of the pathological examinations were normal, and a few showed hyperplasia.

Differential diagnosis of uterine hypertrophy

Attention should be paid to identifying diseases such as adenomyosis and endometrial cancer.

Adenomyosis

Endometriosis, also known as endometriosis, is an endometrial invasion of the uterine muscle wall, which is a special type of endometriosis. simultaneously exist. Most patients presented with secondary dysmenorrhea with progressive exacerbations. With the development of the disease, pain can start from about 1 week before menstruation, or can be extended to 1 to 2 weeks after menstruation. A few patients have pain that occurs before and after menstruation. Menstruation is another major symptom of adenomyosis, which often leads to anemia. A large number of patients have a large amount of bleeding, which is easily misdiagnosed as functional uterine bleeding.

Endometrial cancer

Irregular vaginal bleeding before and after menopause is the main symptom of endometrial cancer. Late-stage patients can touch the enlarged uterus of the lower abdomen or / and adjacent tissues and organs can cause swelling and pain in the lower limb of the side, or ureteral compression caused by the ureter in the side. Water accumulation or kidney atrophy; or systemic failure such as anemia, weight loss, fever, cachexia.

Uterine hypertrophy treatment

Generally, conservative treatment is considered in uterine hypertrophy and other conditions; androgen treatment can reduce bleeding. If conservative treatment fails, consider hysterectomy. Those under 50 years of age with normal ovaries should be retained.