Discharge with endometritis and uterine polyposis (diagnosis, treatment)

Endometritis - one of the inflammatory diseases of the pelvic organs - is characterized by inflammation of the inner lining of the uterus.

There are acute and chronic endometritis. Treatment for chronic endometritis will be longer and more difficult than for the acute form.

The causes of chronic endometritis

The chronization of the process is due to several reasons:

• Incomplete treatment of the inflammatory process. Many patients, faced with inflammation and after listening to advertisements on television, prescribe their own treatment. Usually, drugs are given in a short course. And as soon as it becomes easier, and the first unpleasant symptoms go away, women quit treatment. This leads to the formation of first a subacute, and then a chronic process.
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• Formation of resistant strains of microorganisms. It leads to the appointment of antibacterial drugs, which do not always adequately affect the flora that causes inflammation. A short course of antibiotics and the choice of the wrong antibacterial drug leads to the formation of resistant strains of microorganisms that constantly maintain a sluggish inflammatory process.
• Poor immunity. It is no secret that today's generation of patients has weaker immunity than the previous one. This is due to many reasons: poor ecology, stress, chronic fatigue, frequent infections, taking various medications, etc.

Signs of chronic endometritis

• hyperemia (redness) of the mucous membrane of the uterus, usually not over the entire surface, but in certain areas;
• uneven endometrium;
• the presence of increased bleeding of the mucous membrane;
• very small glandular fibrous polyps (especially common in the area of ​​the tubal corners) can be found.

Even if no signs of endometritis are found during hysteroscopy, it is still necessary take a biopsy of the endometrium (ie, "pinch off" a piece of the endometrium) and send it to the histological study. About 30% of endometritis have an ideal hysteroscopic picture.

Histological examination

The diagnosis of chronic endometritis is a histological diagnosis. Only the conclusion of the pathologist can confirm or deny it.

Currently, there are several morphological criteria for chronic endometritis:

• infiltration by lymphocytes and / or plasma cells of the stromal layer of the endometrium;
• sclerosis of the spiral arteries of the endometrium (arteries that feed the endometrium);
• focal hypertrophy of the basal layer of the endometrium;
• fibrosis or sclerosis of the stromal layer of the endometrium (the presence of sclerosis indicates the remoteness and "neglect" of the process).

Endometritis manifestations: pain, discharge, fever

The manifestations can not always be pronounced and vivid, therefore it is important for a woman to pay attention to any changes in discharge, soreness in the lower abdomen, and ailments. It is especially necessary to closely monitor the condition in the coming days after intrauterine interventions. Dangerous manifestations such as a sharp rise in temperature to 38-39 ℃ against the background of sweating and chills, spotting from the genital tract, or purulent, mucous membranes. It is also typical to have general weakness and malaise, pallor and pain in the lower abdomen, which radiates to the region of the sacrum or pubis. Especially carefully it is necessary to evaluate the discharge and the general condition after childbirth or miscarriage, abortion. The presence of dangerous symptoms should be the reason for immediate hospitalization.

The manifestations of chronic endometritis are even more scarce, they include temperature fluctuations within 37-38 ℃, uterine bleeding of an irregular nature, the appearance of blood between menstruation. Dangerous discharge with an unpleasant odor and admixture of mucus, greenery, yellow. May be suspicious of endometritis pain during bowel movements, sexual intercourse or recurrent discomfort in the lower abdomen, problems with conception, or frequent miscarriages.

Endometritis diagnostics: what tests need to be passed

To detect the disease, they are prescribed:

• Smears from the genital tract, in which blood, pus, pathogenic microbes are found with endometritis.
• Tests for genital infections. The best option is the Femoflor study, which reveals even hidden infectious lesions, including those caused by viruses.
• Ultrasound of the small pelvis, showing the condition of the reproductive organs.
• Hysteroscopy - examination of the inner surface of the uterus with the taking of tissue samples for cellular analysis (histology or cytology). Hysteroscopy performed in the first 10 days of the menstrual cycle with endometrial specimens is considered the "gold standard" of diagnosis. The samples show changes characteristic of this disease.

In case of infertility caused by endometritis, a study of the patency of the fallopian tubes is prescribed. During the procedure, a slightly salted solution is fed into the oviducts, the movement of which through the tubes is monitored using ultrasound.

How does the nature of menstruation change with the development of endometriosis?

In most cases, monthly bleeding becomes profuse and painful. There are situations when menstruation becomes scarce. Hypomenorrhea is typical for women with impaired ovarian function or hormonal deficiency. If secretions accumulate in the uterus, it increases in size and becomes denser. If endometriosis develops in the cervix, then blood flow is observed during a gynecological examination. Ovulation is impaired, leading to temporary infertility until the problem is corrected.

Endometriosis leads to hormonal disorders, which negatively affects the monthly cycle. Signs of premenstrual syndrome are increasing. Pain in the pelvic area occurs before the start of the cycle. Depending on the individual situation, menstruation is prolonged and abundant, scanty, acyclic or in the form of smearing discharge.

More often women are worried about hypermenorrhea - excess blood secretion, which is characterized by the following general symptoms:

1. Pain is felt at the beginning of the menstrual cycle, but the discharge is scanty.
2. With the weakening of the pain syndrome, profuse blood loss begins.
3. Blood clots are present in the menstrual flow.
4. During the first three days, the discharge is abundant, on the 4th-5th day, the amount of discharge is small. For 6-8 days, spotting without blood may be observed.

What not to do with heavy periods: take a hot bath, be zealous with physical activity.

Hypermenorrhea is dangerous for women of childbearing age. Frequent and prolonged blood loss provokes a dangerous disease - iron deficiency anemia. The disease is manifested by weakness, decreased performance, dizziness, shortness of breath. If these signs occur, a doctor's consultation is required.

Hypomenorrhea (when scanty periods are observed with endometriosis) is a low rate of menstrual flow. Small bleeding is observed only on the first day. Further, within 2-3 days, a woman's discharge resembles a daub. The amount of blood is so small that only sanitary pads are enough. This variant of menstruation with endometriosis is much less common.

The absence of menstruation should be alarming. The delay in menstruation with endometriosis can be associated with various reasons. Lack of blood is a signal of serious problems, so you need to visit a doctor. Delay indicates both pregnancy and hormonal imbalance.

In endometriosis, delayed menstruation may be due to the ectopic attachment of the fetus in the fallopian tubes, leading to abortion. That is why it is important to consult a specialist at the slightest disturbing signs. An alarming sign is the absence of discharge for more than a month.

More about polyps

Uterine polyps or endometrial polyps are benign growths that rise above the surface of the inner layer of the uterus. Their sizes range from a few millimeters to several centimeters. These are single and multiple formations that are fixed to the inner lining of the uterus due to a thin stem or wide base.

As a rule, endometrial polyps do not grow outside the uterine cavity, but in rare cases they can exit through the cervix into the vagina and be detected during a routine examination. Formations are found in patients of different age groups: young girls, middle-aged women and those who have already passed the menopause stage. The incidence of pathology is from 6 to 20%.

Intrauterine polyps are often combined with polyps of the cervical canal of the cervix. In gynecology, these formations are considered as a background or precancerous condition and must be removed.

Classification

Since a polyp is a derivative of the endometrium, the same thing that sometimes happens to other tissues can happen to a neoplasm: infection, necrotization, ulceration. Structurally, the neoplasm consists of the following components: epithelium (integumentary tissue), stroma and vessels.

Depending on which tissue prevails in the structure, the following types of polyps are distinguished:

• glandular;
• fibrous;
• adenomatous;
• mixed glandular-fibrous.

The glandular type of polyps is more common in young girls. Mixed polyps, in addition to glandular tissue, also contain connective tissue. They are more common in adulthood. Fibrous neoplasms are predominantly composed of connective tissue. Adenomatous neoplasms are the most dangerous in terms of degeneration into cancer. Therefore, they try to remove them immediately after detection.

In addition to the listed species, the placental form is isolated, in which case the polyp is formed after childbirth or artificial or spontaneous abortion. As the name implies, the polyp comes from the placenta, part of which, for some reason, has not been removed from the body. This form of the disease has more pronounced symptoms: prolonged bleeding appears, and infection often joins.

Placental polyp

Placental polyps in the uterus are a special type of neoplasm that forms in the organ cavity due to the retention of particles of placental tissue after childbirth, medical abortion or miscarriage. To the remnants of the placenta, which is tightly attached to the walls of the uterus, many blood clots are attached, from which the polyp is formed.

This pathology is very common among those who resorted to artificial termination of pregnancy or had a spontaneous abortion. The presence of endometrial polyps increases the likelihood of miscarriage by 5-8 times. The placental polyp is treated surgically.

Endometrial polyp symptoms

Often the polyp does not manifest itself at all. It becomes an accidental find during a gynecological examination, planned or for another disease. But some women may have the following symptoms:

• menstrual irregularities - too abundant and prolonged menstruation, smearing discharge in the middle of the cycle;
• pain in the lower abdomen, which is cramping;
• spotting during or after coitus;
• sometimes unusual discharge, leucorrhoea, mucus with an unpleasant odor appear;
• in the case of excessively abundant and prolonged menstruation, anemia occurs, a woman develops weakness, and her working capacity decreases;
• if there is a violation of blood circulation in a polyp, a woman may experience sharp pains.

One of the most severe symptoms can be infertility. The successful attachment of the embryo to the endometrium depends on the condition of the upper mucous layer of the uterus. With endometrial polyps, especially large and multiple polyps, a woman may have problems with conception. Then she learns about polyps as a result of going to the doctor for infertility.

Polyps of the uterus in women in menopause can lead to bloody discharge. Such discharge requires immediate medical attention to rule out uterine cancer or hyperplasia.

On ultrasound, endometrial polyps are very clearly visible, some of them are better visualized in the middle of the proliferative, others in the secretory phase of the cycle.

You can suspect a polyp by typical signs - heavy menstruation, smearing discharge in the middle of the cycle, pain during intercourse. All these signs may indicate another disease, for example, about endometriosis. A woman should go to a gynecologist and undergo an ultrasound scan, only then can an accurate diagnosis be made.

Treatment of a polyp of the uterus is necessary, because sometimes (no more than in 1-2% of cases) its malignancy can occur. At the clinic Dr. AkNer will provide women with all the necessary assistance regarding the diagnosis and treatment of uterine polyps.

Diagnosis of polyps in the uterus

After the onset of symptoms of pathology (heavy menstruation, bleeding outside the cycle, pain in the lower abdomen), you should consult a gynecologist. Polyps can also be detected at an early stage during a routine check-up. Therefore, it is important to visit your gynecologist at least once a year.

To diagnose neoplasms, the doctor will perform a gynecological examination with palpation of the uterus and prescribe an ultrasound scan. A polyp in the uterus on ultrasound looks like an oval or round growth more often on the leg. During the study, the doctor pays attention to the expansion of the uterine cavity and local thickening of the endometrium.

A more informative diagnostic method is hysteroscopy of the uterine polyp. During its implementation, the doctor observes neoplasms in the uterine cavity of various localization. They can have a smooth or knobby surface, pink in color. Neoplasms can be red if inflammation has begun in them, or grayish with individual blotches of variegated color in case of malnutrition of the polyp and the development of a necrotic process.

It is quite difficult to determine the type of polyp by its appearance (glandular, fibrous or adenomatous). Therefore, it is removed for further histological examination.

Polyps in the uterus: treatment with modern methods

The most reliable way to treat polyps is to remove them. This operation is low-traumatic and safe. After removal, efficiency and sexual function are restored fairly quickly. In the postoperative period, a woman is prescribed drugs that restore hormonal levels and prevent the appearance of new growths.

Removal is carried out in the process of hysteroscopy - examination of the uterus. To do this, a hysteroscope equipped with a miniature camera is introduced into the uterine cavity.

First, the surgeon opens the cervical canal. Then he inserts a hysteroscope into it - a device in the form of a thin tube, equipped with a camera that transmits an image to a monitor. With its help, the doctor can monitor the progress of the intervention. All detected formations are removed using an electric surgical loop, after which the attachment sites of the polyps are treated with liquid nitrogen or 5% iodine tincture.

Single large polyps are removed with forceps, while capturing adjacent altered tissues. In this case, the vessels that previously nourished the polyp remain in a twisted state and do not bleed.

The most suitable period for hysteroscopy is considered to be 2-3 days after the end of menstruation. At this time, the lining of the uterus has the thinnest structure, and polyps are clearly visible on its surface. As for the pain of the operation, in reality it practically does not cause any unpleasant sensations, since it is carried out under local or general anesthesia.

Diagnostic curettage is used for multiple polyps and hypertrophy (thickening) of the inner uterine layer. During the procedure, the doctor, using a special dilator, opens the cervix and, holding it in this position, with the help of a sharp instrument removes the altered tissue along with the polyps. Subsequently, the removed biomaterial is sent for histological examination, which allows you to determine whether there are cancers in the removed cells.

Sometimes hysteroscopy and curettage are combined. This is done to remove the remaining parts of the polyps and test the tissue for cancer.

All manipulations are carried out through the genital tract, so there are no stitches and other signs of interference on the woman's belly.

Bloody discharge after surgery

Due to the trauma of the uterine mucosa after surgery from the place where the polyp was removed to the uterus, for several days there may be spotting spotting, as well as bother the pain of spasmodic character.

Bloody discharge can be observed for several days, however, profuse bleeding can only bother in the first hours after the operation.

About normal discharge

Normally, fluid should be released from the woman's vagina. But not all discharge is normal. The "good" discharge is clear, not abundant (from 50 mg per day) odorless mucus. Normal discharge does not cause discomfort, does not cause itching, burning or irritation of the vagina. If you take a smear for microflora, then a normal number of leukocytes with a predominance of lactobacilli should be found in it. Mucous discharge gradually increases in quantity until the day of ovulation (approximately 14 days after menstruation). During this period, the mucus changes its properties. The feeling of moisture in the genital area at this time is absolutely normal.

But brown discharge should be treated very carefully! A brownish brownish tint of the liquid clearly indicates bloody or bloody additions to the mucus. And this, in turn, may indicate violations of the female genital area. Further about such violations and their reasons.

Discharge after biopsy: norm and pathology

A cervical biopsy is a traumatic procedure, after which a woman will be bothered by small bleeding. In this case, the patient notes non-intense, pulling pains in the lower abdomen. Such symptoms may bother you for 5 to 7 days. As the damaged tissue heals, the volume of secretions gradually normalizes. After menstruation, the cervix will be completely cleansed and blood anesthesia will stop.

Throughout this period, a woman should control her health, monitor the symptoms and, if it worsens, immediately seek medical help. It is necessary to call an ambulance if the discharge becomes more intense and plentiful, the temperature rises body, joined by an unpleasant odor, which indicates the progression of an infectious-inflammatory process.

Yellow discharge after cervical biopsy

Yellow discharge after a cervical biopsy is also considered normal. They can last for about 5 to 10 days. Alert should be abundant vaginal discharge with a fetid, pungent odor, indicating the attachment of a bacterial infection. In this case, delaying a visit to the doctor is fraught with dangerous complications. Also pathological are yellow discharge with green inclusions, which indicate the progression of a purulent process.

How to treat endometritis of the uterus

Most cases of endometritis are associated with the proliferation of harmful bacteria. That is why acute endometritis of the uterus is treated exclusively with broad-spectrum antibiotics, and when a viral the nature of inflammation, antiviral drugs and immunomodulators are added to the treatment regimen, such as “Primrose oil evening ". Gynocomfort. The tool was developed by the specialists of the pharmaceutical company VERTEX. Like all Ginokomfort products, Evening Primrose Oil has the necessary documents and quality certificates.

Chronic endometritis of the uterus requires deeper work. In addition to antibiotics (in the form of suppositories or tablets) and antiviral drugs, doctors prescribe proteolytics, drugs to improve blood microcirculation, vitamin complexes and physiotherapy procedures. All auxiliary treatment is aimed at improving the blood supply to the uterus and restoring the protective properties of the inner surface. That is why, when treating the chronic form of the disease, it is so important to strengthen the immune system in general.

Reducing stress loads, changing the diet in favor of fruits and vegetables, giving up bad habits - all this should be carried out simultaneously with the course of treatment prescribed by the doctor.

Sometimes hormone therapy is needed to treat endometritis. This applies to cases where the disease is caused by a violation of the growth process and endometrial rejection. In this case, a woman may notice a permanent violation of the menstrual cycle, therefore, the treatment of such a condition most often comes down to the appointment of birth control pills, which help restore normal menstruation. The treatment lasts 3-6 months.