Endometrial polyps found in eight per cent of women between twenty and seventy-four years. Until recently it was believed that endometrial polyp - a lot of women of reproductive age, and the disease itself is associated with a history of childbirth. But modern studies have shown that endometrial polyp can be both girls puberty and postmenopausal women Postmenopause - is it possible to control it? .

Endometrial polyps

Endometrial polyps - a benign endometrial proliferative (overgrowth) of the basal cells (sprout) layer lining of the uterus. The final formation of the polyp in a completed germination fibrous and muscle fibers. Endometrial polyps has a leg and body. Outside polyp covered by epithelial cells which are on the histological structure to the uterine lining and thus undergo cyclic changes (depending on the day of the menstrual cycle). The structure consists of legs polyp vessels feeding education. With legs polyp attached to the uterine wall.

Accepted provide three types of polyps:

• gland polyps, which consist of stromal and glands;
• glandular-fibrous polyps are composed of connective tissue and a small amount of iron;
• fibrous polyps (entirely composed of connective tissue).

As a separate type emit more placental polyp. Placental polyp formed after the partial removal of the gestational sac during medical abortion.

Causes of endometrial polyps

Significant reasons for the formation of endometrial polyps is unknown. The emergence of polyps associated with hormonal disturbances that take place and endometrial hyperplasia (an excess of estrogen and a lack of progesterone). In addition, the formation of polyps is not the last role for inflammatory diseases of genitals (endometritis, cervical erosion) and endocrine and metabolic disorders (obesity, diabetes).

Endometrial polyps are divided into primary and secondary. Primary polyps are formed as a result of inflammation, hormonal or endocrine disorders. Secondary polyps or recurrent are the result of incompletely resected primary polyp.

The clinical picture of endometrial polyps

Most endometrial polyps are asymptomatic and detected on the planned US as a random finding. Clinic endometrial polyps varied and depends on the woman's age, hormonal and reproductive function of the ovaries, the presence of concomitant diseases (uterine fibroids, adenomyosis, inflammatory processes of the uterus).

The most characteristic feature of polyps is a violation of the menstrual cycle. If a polyp was formed against the background of the normal functioning of the endometrium in women of reproductive age, in this case marked intermenstrual and premenstrual sukrovichnye allocation (while maintaining the menstrual cycle), as well as an increase in menstrual blood loss. When anovulatory cycles and the presence of polyps in glandular structures on a background of endometrial hyperplasia observed metrorragii (heavy irregular bleeding). In postmenopausal women are more common fibrous polyps, which are manifested by single moderate bloody discharge Spotting - it is important to rule out pathology   from the genital tract. Often these patients worried whites and pain that occurs at high (more than two centimeters in length) polyps. The pain is cramping in nature and is the consequence of the "birth" of a polyp or a violation of his power.

Treatment for endometrial polyps

In most cases, the polyp is benign endometrial lining of the uterus. But polyps tend to degenerate into cancer of the uterus (especially glandular) and in order to oncological vigilance must be removed. The best method is to remove endometrial polyps hysteroscopy. The hysteroscope (a device with a video camera) is introduced into the uterine cavity and under the control of a leg cut off the polyp. Unlike uterine curettage Curettage - how dangerous it is? Which is conducted blindly, hysteroscopy can reliably locate the polyp and remove it completely. Women of childbearing age who have polyps detected on a background of endometrial hyperplasia Hyperplasia endometrial cancer - requires timely detection and treatment After their removal prescribe hormone therapy.

Anna Sozinova

Uterine fibroids larger revealed today is not so often. Modern medicine can detect much smaller fibroids. The most common symptoms grow to a large size fibroids are located under the top, serous layer of the uterus. These fibroids may not manifest itself in any way as long as the uterus will compress the surrounding organs.

What determines the growth and the timely detection of uterine fibroids

A benign tumor of the uterus - fibroids can grow slowly or quickly. Noted the rapid growth of fibroids is possible in the case where it is located under the inner lining of the uterus (submucosal fibroids) - such fibroids seen a number of characteristic symptoms associated with menstrual irregularities.

It is more difficult to notice the symptoms of fibroids located inside the muscle layer of the uterus (interstitial fibroids). It can grow inside the uterine wall and cause the typical menstrual irregularities.

Subserous fibroids (located under the outer serous membrane of the uterus) is able to for a long time does not manifest itself. If it is not marked hormonal disorders Hormonal disorders - oversupply and a lack of equally dangerous Accompanied by uterine bleeding Uterine bleeding outside of menstruation - a sign of a serious breach , The first manifestations of this tumor may be symptoms of compression to the uterus adjacent pelvic organs.

Symptoms of uterine fibroids larger

Longer be considered the size of fibroids, the corresponding 12-15 weeks of pregnancy and more. Thus symptoms usually depend on the location of fibroids in the uterus. The uterus can be positioned as a myoma node, and a few that often have a different localization. Therefore, large fibroids often manifest themselves by a characteristic set of symptoms.

The main feature is a large fibroid uterine bleeding. Uterine bleeding can be manifested as a prolonged and heavy menstrual bleeding (menorrhagia), bleeding not related to the menstrual cycle arising, for example, at its midpoint (mertorragy) as well as combinations thereof. Large fibroids require the continued presence of such violations. Therefore, during the initial identification of a large fibroid appearance of a woman she says she has an advanced iron deficiency anemia.

Signs of anemia are pallor of the skin and mucous membranes, lethargy, apathy, decreased performance, constant headaches and dizziness, fainting. If time does not treat a fibroid, the iron-deficiency anemia can lead to irreversible damage to the woman's body.

Bleeding in the large uterine fibroids are always accompanied by aching pain in the abdomen Abdominal pain: when to sound the alarm?   and in the lumbar region. A large fibroid on a stalk may threaten the torsion legs, which is accompanied by blood circulation and tumor tissue necrosis (dying away). This is a very serious complication that is accompanied by severe abdominal pain and require emergency surgery.

Some types of fibroids can be shown, only reaching larger sizes in the form of symptoms of compression of surrounding pelvic organs. When squeezing the urethra and bladder may develop progressive renal failure and urinary tract. Stagnation of urine will also contribute to the formation of stones, and additional bacterial infection - cystitis and pyelonephritis developed. In this case, the woman often refers not to a gynecologist and a urologist and fibroids detected only in the course of the survey.

With the growth of fibroids in the direction of the rectum, disturbed defecation, there are chronic constipation, which can lead to persistent digestive disorders, as well as to the development of hemorrhoids and infectious and inflammatory processes in the rectal area. When such symptoms first woman turns to the proctologist.

Diagnostics

Uterine fibroids large well detected during ultrasound (US), which allows you to identify all the components of fibroids, their size and location. The size and location of the fibroids can also be set with the help of magnetic resonance or computed tomography.

To clarify the diagnosis is sometimes performed hysteroscopy Hysteroscopy - examination of the uterus inside   (endoscopy, which allows to consider in detail the inner surface of the uterus) and hysterography (X-ray examination of the uterus).

Treatment

Large fibroids that grow quickly, causing severe anemia and compress the surrounding organs, usually removed. Depending on the age of the woman and her desires to have or not to have children or are held organ sparing surgery (only removes fibroids), or together with it completely or partially removed the uterus (such an operation is usually performed after the menopause).

For large fibroids can also be performed uterine artery embolization by introducing into them a substance that blocks the artery feeding fibroids. This leads to tissue death (necrosis) of the tumor, its germination with connective tissue (sclerosis) and encapsulation.

Uterine fibroids larger sizes can threaten the health and lives of women.

Galina Romanenko