Case sharing of ultrasound ablation of subserosal fibroids and intramural fibroids

This is a patient with subserosal fibroids and intramural fibroids. The patient was 39 years old and found uterine fibroids for many years. Initially, the fibroids were relatively small, less than 1 cm. Later, the fibroids increased and increased. Although the patient has no obvious symptoms, the patient is relatively young and the patient is worried that the fibroids will continue to grow in the future. , So I want further treatment. Patients can choose traditional surgery or laparoscopic surgery to remove fibroids and preserve the uterus. However, after the surgery, they generally need to rest for about 1 month, and there will be scars on their stomachs. The patient is currently working and cannot take vacations and is unaccompanied after surgery. Therefore, surgery or laparoscopy are not considered for the time being. Hysteroscopic surgery cannot treat intramural fibroids and subserosal fibroids, and it is not considered. Interventional surgery is to block the blood vessels of the fibroids and make the fibroids ischemic and atrophy, but it has radiation and affects the ovarian function. It is generally used for patients with heavy menstrual flow and no fertility needs. Haifu focused ultrasound ablation treatment is to use ultrasound to focus in the body to form high temperature to directly kill fibroids. At the same time, it has no radiation hazard, does not affect ovarian function, and has no surgical scars. It can return to normal work and life on the day after surgery, and it can also be used once. Sexual ablation of subserosal fibroids and intramural fibroids is the best indication. In the end, the patient received Haifudao focused ultrasound ablation treatment a week ago, and the patient went home the same day after the operation. Came here for a review today and it showed that the fibroids were completely ablated and the patient had almost no discomfort. Some doctors and patients always worry that the subserosal fibroids cannot be seamed and will damage the surrounding normal tissues. The patient can see that the necrosis boundary of the fibroids is very clear and there is no damage to the surrounding tissues. Therefore, Haifu focused ultrasound ablation treatment for subserosal fibroids is also safe and effective. &nbsp.

Cheng Yahui said: How does uterine fibroids cause female infertility?

Today, Dr. Cheng Yahui tells you what kind of uterine fibroids can cause infertility? For uterine fibroids combined with infertility, we must first look at the location of their growth. According to the relationship between fibroids and the uterine wall, they can be divided into three categories: Surrounded by muscularis. Subserosal fibroids: fibroids grow to the serosal surface, protruding from the surface of the uterus, and the surface is only covered by serous membrane. There may be a pedicle connected with the uterus. Submucosal fibroids: Fibroids grow toward the uterine cavity and protrude from the uterine cavity. Uterine fibroids can be multiple, or multiple types of fibroids can grow on the same uterus. If there are more than two fibroids, we will call it “multiple uterine fibroids.” For those suffering from uterine fibroids, they must be particularly curious about how uterine fibroids cause female infertility? Different types of uterine fibroids have very different effects on pregnancy. Subserosal uterine fibroids have the weakest effect, followed by intramural fibroids, and the most compact is submucosal fibroids. The main effects of submucosal fibroids on pregnancy are as follows: implantation rate, pregnancy rate, abortion rate and normal delivery rate. Intramural fibroids also affect the implantation rate and pregnancy rate, but the impact is far less than that of submucosal fibroids. 1.&nbsp. Uterine fibroids lead to changes in anatomical structure affecting pregnancy&nbsp.&nbsp.Uterine fibroids in different locations may cause changes in the morphology of the cervix, uterine cavity and fallopian tubes, block the uterine cavity and fallopian tubes, and directly affect the transport of sperm and fertilized eggs And embryo implantation. 2. In addition to the location and size of uterine fibroids, the paracrine effect of uterine fibroids cannot be ignored. It can cause excessive growth of the endometrium next to uterine fibroids, leading to abnormalities. Uterine bleeding, implantation failure, and even pathological changes in the endometrium, reduce fertility. 3. Uterine fibroids cause uterine contraction and peristalsis dysfunction. Uterine contraction is not only very important in childbirth, but also plays an important role in sperm and egg transportation and fertilized egg implantation. Insufficient uterine contraction may lead to ectopic pregnancy, menstrual blood reflux, and uterus Endometriosis and infertility. Uterine peristalsis has a similar effect to uterine contraction. It is obviously enhanced before ovulation and during menstruation, but the direction of peristalsis is opposite. It moves from the cervix to the fundus of the uterus before ovulation, and it is the opposite during menstruation. Studies have found that uterine fibroids can significantly affect the contraction and peristalsis of the myometrium, which may explain why some patients with intramural fibroids have no obvious abnormalities in uterine cavity morphology and endocrine levels, but suffer from infertility or repeated in vitro fertilization Planting failed. 4. Abnormal angiogenesis in myometrium compared with myometrium tissue, uterine fibroids differentially express a variety of growth factors and participate in intratumoral angiogenesis, which is similar to the regulatory network of angiogenesis factors in normal myometrium. In contrast, the regulation of intratumoral angiogenic factors is disordered and pathologically up or down. They play an important role in the occurrence and development of uterine fibroids, including abnormal angiogenesis, fibroids growth, abnormal hypoxic environment and vascular response. At the same time, along with changes in the composition of extracellular matrix, poor hormone levels and nutrient supply, it affects the adhesion and implantation of fertilized eggs and reduces fertility. 5. Chronic inflammatory reaction or immune disorder of the body&nbsp. Fibroids degeneration, ulcers or necrosis can lead to chronic inflammatory reactions in local uterine tissues. Acute and chronic inflammations can change the receptivity of the endometrium and affect the endometrium Repair and reconstruction of the organization.

What are the 7 major causes of uterine infertility?

The uterus is located in the central position of the female pelvic cavity, which is an important organ for menstruation and fetal pregnancy. Therefore, when there is a problem with the uterus, it is bound to affect women’s ability to conceive. Uterine infertility mainly has the following types: Uterine infertility accounts for about 30% -40% of female infertility, and the causes of uterine infertility are many and complicated, mainly including the following: 1, uterus Abnormal endometrium The abnormal endometrial hyperplasia is related to the long-term stimulation of estrogen and the absence of progesterone, which leads to excessive growth of the endometrium, which affects the implantation of fertilized eggs. 2. Chronic endometritis is a pathological change of chronic pelvic inflammatory disease, which can cause uterine infertility or miscarriage. The cause may be genital tract infection after the history of uterine cavity operation, or occult genital infection. 3. Endometrial tuberculosis Endometrial tuberculosis is often secondary to tuberculosis in the lungs, intestines, mesentery, peritoneum and other organs. The common symptoms are infertility, rare menstruation and even amenorrhea. Tuberculosis of the endometrium disrupts the environment in which the fertilized egg implants and develops, resulting in uterine infertility. 4. Endometrial polyps Endometrial polyps are caused by focal hyperplasia of the endometrium, and the incidence is higher in uterine infertility. The causes of endometrial polyps inducing uterine infertility include: interference with sperm, embryo transport, changes in endometrial development in the secretory phase, and reduced endometrial receptivity. Hysteroscopy is currently the gold standard for diagnosing endometrial polyps. 5. Uterine fibroids Uterine fibroids are divided into subserosal fibroids, intermuscular fibroids, and submucosal fibroids according to different parts. Smaller subserosal fibroids have no significant effect on fertility outcomes. Mural fibroids can reduce pregnancy rates and increase miscarriage rates. Mural fibroids can not significantly increase the clinical pregnancy and live birth rate of patients. Submucosal uterine muscle Patients with tumors are often accompanied by menorrhagia, intermenstrual bleeding, uterine infertility or miscarriage. 6, uterine cavity adhesion Uterine fibroids are divided into subserosal fibroids, intermuscular fibroids, and submucosal fibroids according to different parts. Smaller subserosal fibroids have no significant effect on fertility outcomes. Mural fibroids can reduce pregnancy rates and increase miscarriage rates. Mural fibroids can not significantly increase the clinical pregnancy and live birth rate of patients. Submucosal uterine muscle Patients with tumors are often accompanied by menorrhagia, intermenstrual bleeding, uterine infertility or miscarriage. 7. Uterine developmental abnormality, also known as abnormal uterine development, is a congenital disease and a common type of reproductive organ malformation. Uterine developmental deformities are common in the following types, such as: incomplete or complete mediastinal uterus, single-horned uterus, double-horned uterus, primordia uterus, etc. However, some patients with uterine malformations have no abnormal performance in menstruation, sex life, pregnancy, childbirth, etc., so that it is not easy to be found. Early detection, early diagnosis and early treatment of uterine infertility are of great significance to the efficacy and prognosis of the disease. Therefore, when female friends discover the symptoms of the disease, they also need to find out the reasons in time and treat them symptomatically.