Uterine fibroids occurred in more than 40 years of age and over 50-year-old age group. In the United States, the incidence of black higher than whites, but in the growth of black African native notification rate is very low, and that its occurrence has nothing to do with genetic.
1, definitions:
For uterine tumors, also known as fiber fibroids (fibromyoma), uterine fibroma (fibroid). But mainly composed of smooth muscle fibers, the smooth muscle of the uterus known as (uterine leiomyoma) is more precise. As uterine fibroids (uterine myoma).
To see most of the female pelvic tumor, it is estimated that 35 women over the age of every four or five people out of a uterine fibroid patients. Many uterine fibroids and asymptomatic patients in the census found, or because of other diseases laparotomy or autopsy found. At present, all over the reported incidence rates are from the Department of the number of hospitals for treatment.
Uterine fibroids occurred in more than 40 years of age and over 50-year-old age group. In the United States, the incidence of black higher than whites, but in the growth of black African native notification rate is very low, and that its occurrence has nothing to do with genetic.
2, pathophysiology:
The largest growth in the womb of the Department, even some who grew up in the Department of the cervix. Most of the growth in muscle intramural (intramural fibroids intramural myoma), accounting for 62% of the total number of fibroids, or in subserosal (subserosal fibroids subserousmyoma, for the muscle to the intramural fibroids subserous prominent, highlighted the extent Different, and sometimes serosal fibroids-only based Linked), accounting for 15% or submucosal (submucosal fibroids submucousmyoma, also highlighted the extent of different, sometimes there are still some muscle intramural fibroids, and sometimes completely To highlight intrauterine), accounting for 21 percent. More and more of uterine fibroids (multiple uterine fibroids mutiplemyomata), the same type or a different type can also be a single, great disparity between the size, can be only a small grain of rice, even under the microscope can only identify large to achieve the full Pregnancy, the uterus; general for the middle, over five to six months of pregnancy, the uterus is rare, there may be regional differences, such as in Africa can see that larger (but may also be in attendance for the poor of late it) to Attendance at more than two to three months of pregnancy the uterus. Tumor growth can change shape of the uterus, especially multiple uterine fibroids or subserosal fibroids, but only a single muscle submucosal fibroids or intramural tumor may also maintain the original shape of the uterus, but larger than normal. In the uterus wall can extend the growth of fibroids before and after the same side of the broad ligament between, known as the broad ligament fibroids (intrabroadligamentous myoma). But there is a broad ligament of the fibroids in the uterus by the broad ligament adjacent smooth muscle fiber from the growth in the broad ligament in growth, and completely unrelated to the uterus wall.
Submucous fibroids grow up gradually from the cervix after prominent in the vagina, it is the Book of Changes vaginal examination found that gradually grow up extraoral also prominent in the vagina. Submucous fibroids may Pokui, infection, with submucosal fibroid growth, from outside, the attachment of the pedicle wall can be inside the Palace depression, as depression degree of attachment location and extent of tumor emerge vary Palace at the end of attachment, the degree of ptosis Weight, the greater the degree of depression, or even a Man Xingzi intrauterine up.
Subserous individual, based on their growth process more detailed, finally cut off from the original attachment site, and the tumor was attached near the organ, or peritoneal omentum to survive, grow and become parasitic tumor (parasitictumor).
Cervical fibroids can grow in the first lip of the cervix, after the lip or the entire cervix, the size of normal at this time is located in the Palace on the cervix. Swell rich blood supply and the cervix, greatly increasing the difficulty of the surgery and dangerous. XIONG Qing Lung, and other reports two cases of cervical huge leiomyoma, an isthmus in the cervix, after a cervical lips, Jieru size of the first child, has abdominal growth, the growth has always been the vagina.
There is no package wall uterine fibroids, muscle intramural, fibroids oppression around the muscle fibers, when the incision surrounding tissue, fibroids prominent, with clear boundaries around the organization, around the uterine muscle wall compression organizations like fibroids "capsule "Fibroids around very easily from the" envelope "of separation.
Sedan fibroids surface, shiny, smooth, profile visit was vortex, cable Strip.
For the smooth transfer of a very rare disease, and foreign literature about a dozen cases reported so far. Uterine tumors associated with lung metastasis, but also in the para-aortic lymph nodes, limbs rhabdomyosarcoma, and the scar on the skin, vagina stump, etc. are smooth organization. Guoguan in the autumn of 1957 reported cases of a tumor was smooth transfer of the right lung on the lesions, see under the muscle fibers of the disease.
Peritoneal dissemination of the smooth muscle of smooth muscle in ovarian tumors, round ligament, in the genital serosal surface, the omentum, mesenteric wall and gastrointestinal cancer, etc. like the cultivation, roughly the same shape and smooth muscle tumor, sometimes cell rich, but Few split of the surrounding tissue without infiltration or sabotage, clinical process as benign, that is, when the whole uterus and bilateral annex removal, abdominal lesions can retreat. The causes of this disease is not clear, generally considered to be a multi-center.
Vascular smooth muscle of the uterine tumors can enter the vein, less into the lymphatic vessels. Organization of benign lesions, but into the vein, like emboli can be induced into the death. General inspection of uterine anomalies increased, as a leiomyoma, bladder and uterus broad ligament deconvolution peritoneal Biancu harden the vein, intravenous the leiomyoma was gray polypoid, 1 ~ 2 mm, 5 ~ 6mm or even 20 ~ 30mm thick, can still be extended to IVC, for more than 40 cm. 5 percent of patients confined to the blood vessels in the uterus, the vascular smooth muscle in blood vessels within the tumor can be pulled out, that is, there can be free in the cavity, can also be connected with the muscle wall. There are two sources of its argument, first, from vascular smooth muscle wall to the lumen in the development, first from outside the vascular smooth muscle of the vessel within Shenru. Examination of vascular smooth muscle cells within the tumor by the composition, such as smooth muscle tumor-like, on the rehabilitation of vascular endothelial cells, the tumor is thick wall of the small blood vessels. Cells were normal, with no split. Masson with three-color stain, that have different amounts of collagen fibers exist.
Strip-Search-muscle bundle was staggered by the connective tissue fibers interval, cutting fascicular muscle cells or muscle cells type face, small blood vessels. Muscle cells from the uterine muscle layer, and some people think that the source for small remnants of embryonic cells, but also from that intramural vascular smooth muscle cells, and that its occurrence and to stimulate estrogen-related, occurred in reproductive age women, In the late menopause gradually shrinking. Oral contraceptives also contributed to its growth. Pregnancy swell of the entire muscle muscle hypertrophy, and not due to the increase in the number (Randoll and Odell).
Endometrial examination process to the smooth muscle of the uterine endometrial have the machinery of oppression, so that endometrial thinning, crushed glands, and around each other. Epithelium was cubic or flat, after ovulation response to the lack of secretion. Intrauterine deformation, often shedding endometrial abnormal. Muscle intramural uterine fibroids to increase the area; simple subserosal fibroids, uterine cavity may increase. Both the endometrial images can be a normal shape.
3, diagnosis:
Most of the result of menorrhagia, can find a small number of abdominal mass or from infertility treatment, in the abdomen and do a double vaginal hysterectomy swell up when found, or nodular smooth surface, thus diagnosed as uterine fibroids And to identify tumor size, single or multiple, generally the growth of sites, activities or not, whether tenderness, a history of menopause should pay attention to whether the possible merger of pregnancy. 4, clinical manifestations: First, can no discomfort even if the tumor has reached a certain size, often due to other circumstances gynaecological examinations or occasionally to touch the abdomen when discovered.
Second, the majority of patients have menstrual changes in menstrual changes, for the period of performance and more by volume, menstrual prolonged menstrual extension, the volume does not significantly increase the number and volume of menstrual normal, but shorten the cycle, or for the volume, Date long, shorten the cycle; amount of bleeding more and more frequent, in submucosal fibroids and the larger intramural fibroids, endometriosis, submucosal area expanded significantly, and easy to necrosis, infection, bleeding, a long time , Or even shorten the cycle is an inevitable consequence of the large muscle intramural fibroids no doubt increased endometrial surface. Subserosal fibroids mainly for the growth period can not change. Normal endometrial cavity area of about 15 cm2, in the larger fibroids, endometrial area can be as high as 225 cm2, near the endometrial uterine fibroids are common in the large blood vessels, around a rich blood supply.
Can be associated with uterine fibroids without ovulation of menstruation, so that endometrial proliferation. It was reported 36 percent of uterine fibroids with endometrial proliferation. In addition to uterine fibroids volume increase, affecting uterine muscle fibers contract, for the reasons for the increasing volume of menstruation.
Third, oppression symptoms of tumor growth due to location and size of produce different symptoms. Such as the anterior growth in the womb of a diameter of about 10 cm or more, they can pressure the bladder, a frequency, urgency, growth in the posterior wall of the uterus, uterine backward after Qu, the uterus before the tendency to shift, or Growth in the cervix, urethra and oppression can be in urine retention or dysuria, the back wall of uterine fibroids can also be greater pressure rectum, a defecation difficulties uterine fibroids incarcerated in the pelvis can both urination and defecation in Difficulties. Growth in the broad ligament within the larger fibroids can be oppressive ureter, causing the side of the ureter, hydronephrosis.
Fourth, the general pain symptoms without pain, but in serous membrane under the pedicle fibroids may reverse acute abdominal cramps. In addition, the tumor may have degenerative changes have Duntong or more serious abdominal pain (red degeneration). Submucosal uterine fibroids through the cervix into the vagina from a more serious when the abdominal pain. Although large-uterine fibroids in the pelvic cavity, the same can be oppressed around the organs and tissues have Duntong and falling from flu, muscle intramural fibroids can produce or increase dysmenorrhea.
5, infertility uterine fibroids can change shape and uterine cancer itself as a foreign body can prevent implantation Yunluan, video sperm run, the growth of uterine fibroids in the corner of the fallopian tubes are changed or Gap between the Department of the Ministry of site or by Yunluan Sperm delivery. Syria on ovulation and menstruation without a higher rate. A lot of the uterine fibroids enucleation after conception is corroboration.
6, sometimes found in patients with abdominal change gradually Penglong abdomen, and even asymmetrical, easy to get up in the morning before the discovery, because often the bladder will swell to a pelvic uterine cancer, so that patients with relatively easy to hit hard, more surface is not smooth Mass, I found that because many of those attending come from.
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