In recent years, due to a variety of reasons, the incidence of intrauterine adhesions in young women has been increasing, which has become one of the important reasons for female infertility today. However, many young female friends treat this with contempt, and often go to the doctor when the condition is very serious. Although the treatment can eventually be cured, it is time-consuming and laborious, and missed the optimal childbearing age.
Causes of intrauterine adhesions
There are many specific reasons for the adhesion of the official cavity, and the clinical findings mainly include the following four aspects.
1. History of uterine cavity surgery. There are two main aspects, namely pregnancy factor surgery (abortion and curettage, etc.), non-pregnancy factor surgery (other official cavity operations, infection, etc.).
2. Surgery inflammation. Such as the secondary infection after the official cavity operation, or the infection of the uterine tuberculosis in the official cavity, and the secondary infection after the placement of the intrauterine device.
3. Curettage causes damage to the inner membrane. It is common that there are multiple curettage, and the basal layer of the uterus is easily damaged. The resulting adhesions in the uterine cavity are also called traumatic adhesions. Therefore, when curettage, the doctor must grasp the depth. Women of childbearing age have to do a good job of contraception themselves, try not to perform abortion surgery, especially the first birth abortion may lead to the adhesion of the official cavity, resulting in secondary infertility.
4. Human interference. The basal layer of the endometrium was artificially damaged, and adhesions occurred in the cavities. Such as intracavitary microwave therapy, electrical endometrial resection, etc.
Clinical manifestations of intrauterine adhesions
1. Periodic abdominal pain. Within 1 month after the operation, some patients suddenly had symptoms of anal bulging or lower abdominal pain, and most of them had periodic attacks.
2. Secondary amenorrhea and secondary oligomenorrhea. In some women, the uterine cavity is completely adhered and blocked, which will lead to secondary amenorrhea, and it takes a long time. If it is incomplete uterine cavity adhesion, it will cause too little menstrual flow.
3. Female infertility. Among female infertility, the most common symptom is the adhesion of the official cavity, and it is the most serious. Because of the adhesion of the official cavity, the endometrium is damaged, and the volume of the uterus becomes smaller, which is not conducive to embryo implantation, resulting in infertility or abortion after pregnancy.
What is intrauterine adhesions
What we usually call the adhesion of the official cavity is actually the adhesion of the endometrium. Medical research has found that as long as the factors that can cause damage to the endometrium can cause this disease. According to data, the proportion of adhesions related to pregnancy is about 91%, especially after spontaneous abortion and curettage, induced abortion, etc. The resulting infertility is not uncommon.
The adhesion of the official cavity will have a lot of impact on the patient’s daily life. It mainly includes 4 aspects.
① Periodic lower abdominal pain. Adhesion of the cervical canal or the uterine opening makes it difficult for menstrual blood to flow out smoothly, which will reflexively stimulate the uterine contraction and cause pain in the lower abdomen. Most of the cervical canal adhesions are located in the cervix. The changes in the endometrium are periodic. The menstrual blood from the tissues can not be discharged due to the adhesions of the cervical canal. .
②Fear of sex. Under the overall effect of physical and mental factors such as fear of re-pregnancy or fear of pain, patients with official adhesions are usually more afraid of sex. This leads to disharmony in married life.
③ Abnormal menstruation. During cervical adhesion, menstrual blood is difficult to flow out smoothly, and even reverse flow occurs, which greatly increases the probability of endometriosis, causing dysmenorrhea, abdominal pain, etc., which greatly affects pregnancy.
④ Reproductive dysfunction. The adhesion of the official cavity can cause habitual abortion and infertility. Statistics indicate that about half of patients with intrauterine adhesions have experienced habitual abortion or secondary infertility. Studies have also pointed out that among infertility patients, about 20% have official adhesions.
Treatment of intrauterine adhesions
Many patients and even primary doctors believe that as long as they suffer from adhesions, surgery is necessary. Actually not necessary. Because one of the pathogenic factors for the adhesion of the official cavity is the official cavity surgery. Since surgery is inherently traumatic, if the treatment is not appropriate, adhesions are more likely to form. Therefore, when treating related diseases, all aspects of the situation must be fully considered before making a decision on whether to perform surgery.
Experts now agree that if there are no clinical symptoms and no fertility requirements, then there is no need for surgical treatment of the adhesion of the official cavity. In addition, if the patient’s menstrual flow is low, but there is no fertility requirement, no hemorrhage, or dysmenorrhea, then there is no need for surgical treatment. However, if the patient has a fertility requirement, and has repeated miscarriage, infertility, and too little menstruation, it should be the first choice during the treatment of the separation of the adhesion between the official cavity and the cavity. If the patient’s official cavity adhesion is moderate to severe, it is recommended that the balloon or IUD be placed in the office at the same time during the operation to effectively block the contact of the official cavity wound surface to avoid recurrence of adhesions. Cooperating with estrogen therapy after surgery will also play an effective role. However, for patients with severe adhesions, there is no effective and feasible method to restore menstruation and fertility to a completely normal state.
Some patients will have adhesions again after surgical separation of the adhesions. Studies have pointed out that the re-adhesion rates of patients with severe and moderate to mild adhesions after treatment are 62.5% and 30%, respectively. Therefore, the patient needs to undergo a second endoscopic examination after the separation of the adhesion of the official cavity to evaluate the actual condition of the official cavity and the repair of the endometrium. These can be used as key data for conception and adjuvant treatment in the later stage. Each patient’s situation is different. Therefore, appropriate adjustments must be made to the specific situation of the patient during treatment, and treatment should not be blindly treated to effectively prevent the re-adhesion of the official cavity after the adhesion is separated. For patients with official cavity adhesions, they should actively learn and master relevant knowledge when choosing treatment methods, and choose the most appropriate method according to their own actual conditions. At the same time, doctors will also select the most suitable surgical method based on the patient’s situation to minimize the patient’s pain. The patient has a positive attitude towards treatment and actively cooperates to make the treatment of the disease more efficient.
Patients with intrauterine adhesions
Precautions for daily life
Patients with adhesions in the official cavity should do the following points in their daily life.
1. Cut off all causes of infection, so that the perineum is always in a dry and clean state. Wash the vulva with clean water every night, but do not wash the vagina with your hands. The water temperature should be appropriate.
2. Sexual life is not allowed after abortion, menstrual period, etc., and bathtub bath is not allowed to avoid the invasion of germs and cause infection.
3. There must be regularity in sleep and a positive attitude, so that one’s own immunity can be improved.
4. In terms of diet, try to be as light as possible, eat more chicken, crucian, lean meat, fruits, cabbage, winter melon, kelp, etc.
For women of childbearing age, if there are periodic abdominal pain, low menstrual flow, amenorrhea, etc., and those who have not been pregnant for a period of time, it may be that there has been an adhesion of the official cavity. You should go to a regular hospital in time to avoid aggravation.