Is it still necessary to screen for uterine fibroids? How to screen for uterine fibroids?

Uterine fibroids, also known as uterine leiomyoma, are the most common benign tumors of the female genitalia. Most of them are asymptomatic, but some patients may experience vaginal bleeding, abdominal contact with the tumor, and compression symptoms. So, how to screen for uterine fibroids under normal circumstances? How can patients with uterine fibroids perform self-examination?

Uterine fibroids are divided into four categories

1. Intramural fibroids

The most common type of fibroid is located within the muscle wall and is surrounded by muscle layer, accounting for about 60% to 70%.

2. Subserosal fibroids

Intramural fibroids develop into serosa, protrude from the surface of the uterus, and directly contact the serosa layer, accounting for about 20%. If they grow between the two leaves of the broad ligament, they are intra-ligament fibroids.

3. Submucosal fibroids

Intramural fibroids grow in the uterine cavity, protrude from the cavity, and directly contact the mucosal layer, accounting for about 10%-15%. This tumor can gradually enlarge and deform the uterine cavity, and the pedicle is often connected to the uterus. For example, a long pedicle can block the cervix or detach from the vagina.

4. Cervical fibroids

Cervical fibroids grow less frequently, but because they grow in a lower location, they can embed into the pelvic cavity, causing compression symptoms, making surgical removal difficult and easily damaging the ureter and bladder.

How do patients with uterine fibroids examine themselves?

1. Observe bleeding

Mainly refers to menstrual blood. Generally speaking, the amount of menstruation is larger than before. Postmenopausal bleeding and sexual contact bleeding are mainly caused by cervical disease or uterine fibroids. Therefore, in addition to bleeding caused by normal menstruation, the cause should be investigated as soon as possible and other conditions should be checked.

2. Observe leucorrhea

Leucorrhea is composed of vaginal mucosal exudate, cervical glands and endometrial gland secretions, including vaginal epithelial cells, leukocytes and some non-pathogenic bacteria. Normal leucorrhea is white, flocculent and viscous liquid, and its quantity and characteristics vary slightly with the menstrual cycle, such as the color of leucorrhea,

3. Touching the lump

There are changes in both quality and quantity, especially pus-like, bloody, and watery leucorrhea.

The patient can lie flat on the bed on an empty stomach in the morning, bend his knees slightly, relax his abdomen, and touch his lower abdomen with his hands to feel a larger lump.

In addition to the above situations, patients should also pay attention to pain in the lower abdomen, waist, and sacrum, and go to the hospital for examination in time to rule out uterine fibroids.

What are the examination items for uterine fibroids?

1. Ultrasound examination

Ultrasound is widely used to check uterine fibroids, with an accuracy rate of over 90%. Ultrasound can show the location, size, number of fibroids, whether they are uniform or liquefied, and whether they compress other organs around them. Ultrasound is not only helpful in diagnosing uterine fibroids and distinguishing whether they are degenerated, but also helps identify ovarian tumors and other pelvic masses.

2. X-ray film

When uterine fibroids are calcified, they appear on X-rays as a shell-like calcified capsule, or as a honeycomb with rough, wavy edges.

3. Diagnostic curettage

It is difficult to detect small submucosal fibroids, dysfunctional uterine bleeding, endometrial polyps, etc. through bimanual examination. Curettage can assist in diagnosis.

4. Hysterosalpingography

Hysterosalpingography helps in the early diagnosis of submucosal fibroids. The method is simple and can show the number, size, location, etc. of the fibroids.

5. Detection of the uterine cavity

Intramural and submucosal fibroids often enlarge and deform the uterine cavity. The probe is used to measure the size and direction of the uterine cavity. Compared with the double clinic, it helps to determine whether there is a mass and the nature and location of the mass.

In addition to the above situations, it can also be applied to patients with special needs who are waiting for CT and MRI examinations.