Abnormalities of the Endometrium.

Hi guys, I am back again with another Post. This time I am covering Abnormalities of the Endometrial cavity, and this is in preparation for a series I’m creating called,” ON THE WAY TO GET PREGNANT”. The abnormalities on the Uterine cavity are crucial on the process of getting pregnant because of possible Miscarriages or Infertility.

The last post I covered Fibroids and we spoke about Submucosal fibroids. This can be a cause for miscarriages or infertility on the first trimester. I will link that post down below for you.

All you need to know about Fibroids.

OK so we start on the new topic here:

Abnormalities of the Endometrium.

img_2466

  • Benign Endometrial polyps.

Benign endometrial polyps occur in about 10% of women and they may cause significant vaginal bleeding. These polyps contain Endometrial glands, Fibrous stroma, and Blood vessels and they may be sessile or pedunculated, they may be small or large in size.

img_2459      Endometrial Polyp within the cavity.

Endometrial polyps are most often Benign as mention before however they may be cancerous or develop into cancer if they are not treated, Hormonal factors play a role in polyps, Polyps can affect all women but are more frequent on women between the age of 40 to 55.

Most polyps Should be removed because of the small risk of cancer, They can be removed by a procedure called Hysteroscopy or Dilatation and curettage ( D & C) where a Biopsy is also done to Rule out Malignancy.

To have a better assessment on small endometrial polyps and/or small submucosal Fibroids most of the time a Sonohystogram is ordered to make a clear diagnosis.

img_2458       Sonohystogram is the procedure where through a thin catheter Saline Solution is injected into the cavity to open it up, so everything is clearly evaluated.

img_2464

Big polyp within the cavity.

img_2467 Blood flow within the polyp, this is known as the Polyp Feeding Vessel.

OK so for my Postmenopausal Followers here are 2 other Endometrial Abnormalities to be aware of.

Endometrial Hyperplasia:

img_2462

Thick Heterogeneous endometrial cavity with cystic changes inside.

Endometrial Hyperplasia is Often related to chronic Estrogen Stimulation, On Ultrasound is seen as Thick Endometrial cavity with Cystic changes.

Abnormal symptoms: Premenopausal, perimenopausal or Postmenopausal women with Abnormal Vaginal Bleeding and thick endometrial cavity measuring 0.5 cm or more. An Endometrial Biopsy is required for confirming the diagnosis.

And Last but certainly not least Endometrial carcinoma.

img_2472

Most Adenocarcinomas of the Endometrium ( 90% ) arise in postmenopausal women. It is the most common Gynecological malignancy in North America.

Ultrasound Findings are A thick endometrial cavity measuring 0.5 cm or more and Increased Blood Flow within the cavity , a biopsy is required to confirm the diagnosis.

So this is the summary of Endometrial Abnormalities, Next post we will talk about Most common types of Ovarian cysts, leave a comment below if you have any question, Thank you very much if you stay until the end and I hope you enjoy.

Zadi XO.

All you need to know about Fibroids.

                                                            img_2435

Fibroids: Clinical information.

1. Fibroids are the most common Benign uterine abnormality encounter in women these days.

2. Women often experience menstrual problems such as abnormal periods and/or painful periods.

3. Depending on the location fibroids can cause pressure on the pelvis and the bladder causing urinary frequency.

4. Depending on the location they may cause infertility as well.

 

Histology:

  1. Fibroids are composed of smooth muscles and connective tissue.

2. They may contain calcifications.

3. During pregnancy, fibroids might grow rapidly due to increased blood flow on the uterus.

4. A rapid fibroid growth might lead to infarction and degeneration causing significant pain.

Fibroids are classified by the location.

  1. Subserous Fibroids: These project to the uterine serosa which is the outer layer of the uterus. They are problematic when they are large and indenting surrounding organs.

  2. Pedunculated or exophytic Fibroids: This is the type of fibroid that is located entirely outside the uterus. They must be connected to the uterus by a stalk-like growth called peduncle.

  3. Intramural Fibroids: Those fibroids are predominantly located within the Myometrium ( uterine muscle ). They rarely lead to significant clinical problems unless they are large >5cm.

  4. Submucosal or Submucous Fibroids: These are the most clinically important fibroids, which account for only 5% of all uterine fibroids. Small and Medium Submucosal fibroids cause classic symptoms like Abnormal and Painful periods and more importantly, these are the fibroids that can cause Infertility. Submucosal fibroids can be removed from the cavity with a Procedure called Hysteroscopy.

Classification System used by hysteroscopic surgeons for submucous fibroids.

Type 0: Entirely within the cavity.

Type 1: Mostly within the cavity ( >50% of fibroid within the endometrial cavity.

Type 2: Mostly outside the cavity ( <50% of fibroid located outside the cavity within the myometrium.

      Type 2 of submucosal fibroids are NOT considered for hysteroscopy resection.

If the Fibroids cannot be Removed with a Hysteroscopy then a Myomectomy will be necessary.

img_2429Retroverted Uterus / Subserosal Fibroid / Transvaginal scan.

img_2427

Anteverted Uterus / Pedunculated Fibroid / Transabdominal scan.

img_2436

Anteverted uterus / Intramural fibroid / Transabdominal scan.

img_2430

Anteverted Uterus / Submucosal fibroid / Transabdominal scan.

img_2433

The last image represents the various degree of Submucosal Fibroids.

 

Well this resumes the most important aspects of fibroids, on my next post I will be talking about Abnormalities of the endometrium ( cavity), thank you for staying until the end.

DONT FORGET TO COMMENT IF YOU NEED TO ASK ANYTHING AND I WILL BE HAPPY TO ANSWER.

XO zadi.