The incidence of adenomyosis varies from 5% to 70%, and it has a rising trend. It has become a common gynecological disease. In recent years, the incidence of adenomyosis has increased significantly, and the age of onset is younger. About 15% of them were complicated with endometriosis and 50% with leiomyoma. So it is necessary to diagnose in time.
The diagnosis basis of myoadenosis of uterus mainly includes the following six tests:
Whether patients have secondary dysmenorrhea, progressive aggravation, or they may be accompanied by heavy menstrual flow, prolonged menstruation, or dystocia, infertility, and habitual abortion.
2. Gynecological examination
The uterus has more globules and obvious tenderness. Through gynecological examination, we can see whether the spherical womb enlargement, tenderness is obvious or not. If there is no typical history of dysmenorrhea, adenomyosis may be considered when the uterus is enlarged, hard, or accompanied by tenderness nodule.
3. Ultrasonic examination
At present, the B-ultrasonic examination is more common. The accuracy rate of myopathy identification is 93.1%, it can show the enlargement of the uterus, irregular shape, the number, location, size of myopathy, whether the myopathy is even or liquefied, and there is compression of other organs around. B ultrasonic examination is not only helpful for the diagnosis of myopathy, but also for the differentiation of ovarian or other pelvic masses.
It was found that the serum CA125 level of patients with adenomyosis or adenomyosis combined with hysteromyoma was significantly higher than that of patients with hysteromyoma. The sensitivity and specificity of CA125 > 35KN / L were more than 85%. And CA125 has a certain value in monitoring the curative effect.
5. Diagnostic curettage
Small submucosal myopathy or dysfunctional uterine bleeding, endometrial polyps are not easy to be detected by double diagnosis, can be assisted by curettage diagnosis. In the case of submucous myopathy, the curette feels a raised surface in the uterine cavity and then slides down after it starts to rise, or feels something sliding in the uterine cavity. Curettage should be sent to the pathological examination to see if it is adenomyosis.
MRI is also called magnetic resonance imaging. MRI can distinguish hysteromyoma and adenomyosis and can diagnose both at the same time, which is helpful in determining the treatment method. It is recognized as the most reliable method to diagnose adenomyosis at home and abroad. Because of the relatively high price, it is generally used when other methods can not effectively diagnose or affect the operation.
The pathogenesis of adenomyosis is related to estrogen, progesterone, even immune, and genetic factors. Dysmenorrhea is the most common symptom of adenomyosis. It is reported that the dysmenorrhea rate of adenomyosis patients varies from 15% to 77.8%. About half of the patients have menorrhagia and infertility.
In addition, although most of the patients with adenomyosis have completed childbearing, there are still many patients with infertility, especially with endometriosis. So how to treat adenomyosis?
There are many methods to treat adenomyosis, such as medicine, operation, intervention, and HIFU, but it is difficult to have a method that does not damage the uterus, is obviously effective, and can avoid recurrence. Each treatment has its advantages and disadvantages.
At present, there are many methods to treat adenomyosis, including surgery and drugs. Clinical treatment should be based on patients' age, symptoms, and reproductive needs to make a decision. Surgery and medication options can be selected at the same time. But patients need to understand the risk of dissatisfaction and recurrence.
Fuyan Pill, a traditional Chinese herbal medicine, can promote blood circulation and remove blood stasis, clear away heat and toxin, invigorate the spleen and remove dampness, and has a good effect on pain and dysmenorrhea of adenomyosis.
At the same time, it can treat endometriosis at the same time and can comprehensively regulate the environment of the uterus. For young patients with fertility requirements, enucleation of intrauterine focus can be considered, but there is also a risk of recurrence after surgery, so you can take Fuyan Pill for consolidation treatment.
For patients with heavy menstrual flow and no fertility requirements, endometrial resection can be performed; for patients with a large amounts of menstruation, severe symptoms, no fertility requirements, and poor drug treatment effect, hysterectomy can be performed.