What Is an Adenomyoma?

Endometrial benign lesions with limited invasion into the muscularis. Can cause reactive hyperplasia of muscle fibers around the intima. The age of onset is similar to that of uterine muscular adenopathy, and it is also manifested by the progressive intensification of secondary dysmenorrhea, excessive menstruation or prolonged menstruation, and uneven uterine enlargement. Diagnosis: Differentiate from uterine fibroids. Treatment: Similar to adenomyosis, but the effect of adenomyoma seems to be better.

English name: adenomyoma

Common locations: Endometrium

Causes of adenomyoma :

1. Posterior uterus, backward uterus, poor drainage of menstrual blood, because there is a large amount of endometrial tissue in the menstrual blood, stay in the uterus for a long time, such as accompanied by dysmenorrhea caused by spasm contraction of the uterine muscle layer, increased intrauterine pressure The endometrium may be ectopic to the myometrium.

2. Iatrogenic causes: (1) curettage. The curettage can destroy the basal layer of the endometrium, and the endometrial tissue can invade into the uterine myometrium through the damage of the basal layer. During the monthly menstrual cycle changes, the uterine myometrium invades and reproduces widely. Sexual endometrial tissue can also cause bleeding, forming many bleeding points in the myometrium. (2) The birth control ring is placed for a long time, the ring is incarcerated into the uterine muscle layer, and the endometrial tissue is also brought into the uterine muscle layer to form a uterine myoma. (3) Caesarean section. It is extremely easy to bring endometrial tissue to the myometrium and other places when performing a cesarean section, and some can also form chocolate cysts at the incision site.

Common types of adenomyoma :

The causes of uterine fibroids are divided into two types: diffuse and local.

1. Diffuse type is common, and the uterus increases uniformly, and generally does not exceed 12 weeks of pregnancy. Intrauterine lesions are generally diffuse, but the posterior wall is more pronounced, so the posterior wall is often thicker than the anterior wall. The muscle layer at the lesion is obviously thickened and hardened. The thick brown muscle fibers are usually yellow-brown or blue small cysts, and the cavity is a thin brown liquid.

2. Confined type refers to the growth of ectopic endometrium in the local myometrium, which is also known as adenomyo-ma, but it is different from myoma and has no pseudocapsule and no surrounding myometrium. Clear demarcation makes it difficult to remove them from the muscular layer. There are island-shaped endometrial glands and stroma in the muscle layer under microscopy. Because they are mostly derived from the basal layer endometrium, they are not sensitive to ovarian hormones, especially progesterone, so they are often in the proliferative phase, but local areas may Changes in the secretory period. Adenomyosis (adenomyosis), is a benign lesion caused by the endometrial invasion of the myometrium. Pathologically, myometrial hypertrophy was seen, with endometrial glands and interstitial island-shaped distribution between muscle walls, with smooth muscle fiber hyperplasia.

Clinical manifestations of adenomyoma :

The most common clinical manifestation is dysmenorrhea. Pain usually occurs the week before the menstrual period. The symptoms are relieved after the menstruation is clean. There may also be increased menstrual flow, prolonged menstrual cycles, and even pain during intercourse and difficulty in defecation. Hysteromyoma is not highly malignant, but it can occur at any age of women. It is most common in women with high ovarian function (reproductive age) and menopause (menopause). The key to this disease is early detection and early diagnosis. Early treatment.

Treatment principles of adenomyoma :

Conservative treatment of adenomyoma

For young patients with fertility needs and women who are close to menopause, conservative treatment is the first consideration to try to keep the uterus from total resection. Drug treatment is the main treatment method. For example, non-steroidal anti-inflammatory drugs can relieve symptoms. Oral contraceptives are also effective, but are not appropriate for long-term use by menopausal women. Lutein also has a certain effect. Danazol (high treatment) can block the aromatase activity of adenomyosis tissues. The myometrium becomes thinner and the uterus becomes smaller during the medication period. However, this is a hormonal derivative. Long-term use may cause low voice and youth. Acne, beard and other side effects. There is also a new drug, Gestrinone, which has fewer side effects. It only needs to take two tablets per week, but each one costs about four hundred yuan. It is still not commonly used today. In addition, there is another injection, GnRH agonist, which is a pituitary hormone antagonist. One injection every month can also inhibit this disease. It can be used as a supplementary therapy before or after surgery or to relieve symptoms. Unfortunately, a single injection is about 8,000 yuan and the health insurance is Health insurance is not paid.

These drugs all relieve symptoms and control the condition temporarily. Once the drug is stopped for a period of time, the lesion will gradually return to its original state, so it is only suitable for young patients with fertility needs.

Menstrual periods will be paused, so there is no more dysmenorrhea, and continuous medication for three to six months can make

Uterine adenoma

For localized adenoma, as long as the adenoma is surgically removed, the uterus can be retained. If it is diffuse adenomyosis, the uterine diaphragm can be cut thin and then given postoperative drug treatment, there is a chance to conceive, but there may still be a relapse for a period of time. Recently, some doctors also use laparoscopic surgery to insert a fork-like electric burner rod into the uterus, and then "cook" the uterine cavity. Postoperative follow-up has found that the volume of the uterus can be reduced, but the long-term effect remains uncertain. These uterine-preserving surgical methods are suitable for patients with fertility needs.

For patients over the age of 40, who have completed fertility tasks, suffer from severe menstrual pain or excessive menstrual blood, which affects the quality of life, the cure is hysterectomy.

In short, the cause of adenomyosis is still unclear, and women with a predominant age ranging from 20 to 50 years old, especially those who enter menopause. Although women under the age of 30 have a lower chance of getting the disease, it is one of the possible causes of difficulty in getting pregnant. Therefore, various medications and conservative surgical therapies are used to relieve symptoms and preserve the uterus, but all have their limitations. The most fundamental solution is to improve with hysterectomy or medication until menopause. For young patients who want to give birth, it is best to try to conceive while the conservative treatment is still effective and not relapse, and there is still a chance of successful pregnancy.