Serosometer
Serosometer is a unified concept for the presence of fluid in the uterine cavity, in fact, not a diagnosis. The expression "uterus serosimeter" is not correct. The presence of the Latin "meter"( uterus) in itself indicates the localization of the process in the uterus, so instead of "serosimeter of the uterus" it is correct to say "serosometer".
Serosimeters always have causes, among which there are both the most harmless, and quite serious. As a rule, the term "serosimeter" begins to appear in the patient's medical history after ultrasound scanning, which reveals the presence of a liquid component in the uterine cavity. Therefore, this term is functional, and not clinical, because echoes of serosomes are not always combined with clinical manifestations.
The uterus can accumulate fluid due to a variety of factors, and the clinical manifestations of this condition directly depend on the nature of the liquid content and its quantity, as well as on the immediate cause that provoked the sorosometer.
As a rule, they speak of a serosometer when there is a serous secretion in the uterus. The uterine cavity can also accumulate fluid of a different nature - purulent or bloody. Purulent contents of the uterine cavity are often the result of infectious inflammation in the endometrium with the participation of pathogenic microflora, in this situation they speak of a pyometra.
After delivery, scraping of the uterine cavity for the purpose of abortion or diagnosis, the blood can accumulate in the uterus, this condition is characterized as a hematometer. Serosometer after curettage of the uterus is often associated with an inflammatory process or complications during this manipulation.
If a physiological postpartum discharge( lochia) accumulates in the uterus, a lychiometer is formed. It is diagnosed in the first two months after delivery and by clinical signs( including ultrasound) is very similar to the serosimeter.
Conditionally the causes of serosymmetry can be divided into mechanical( organic) and functional: inflammatory and dyshormonal. Hormonal dysfunction provokes a serosimeter in women who have entered menopause, and inflammatory causes of serosomes are more often diagnosed in the reproductive period.
Any fluid accumulated in the uterine cavity can leave it naturally through the cervical canal. However, if there is any obstacle in its way, evacuation becomes difficult or even impossible. Mechanical causes of serosymmetry are associated with myomatous nodes, polyps, narrowing of the cervical cavity, and other conditions.
The presence of any of the listed conditions( inflammation, hormonal dysfunction or organic pathology) does not always provoke the development of serosomes. As a rule, in its formation an important role is played by provoking factors, which indirectly contribute to the accumulation of serous content in the uterus. They are often referred to as:
- "Harmful" addictions of a woman( alcohol, smoking), which significantly reduce the mechanisms of immune defense, provoke hormonal dysfunction and prematurely "age" the reproductive system;
- Traumatic injuries and surgical interventions on the uterus. Often after a mechanical damage, scars and adhesions form which deform the uterine or cervical cavities, creating the prerequisites for the retention of any accumulated secretion in the uterus, whether it is inflammatory fluid or menstrual discharge. Negatively, the condition of the endometrium is affected by abortions, especially multiple ones.
- Disorderly intimate relationships, especially without proper contraception. In addition to unwanted pregnancies, which often result in an artificial interruption, frequent changes in the sexual partner are fraught with the development of infectious inflammation, including specific etiology.
- Incorrect power. Deficiency of vitamins and biologically active elements provokes a menstrual cycle and immunodeficiency.
- Prolonged hormone replacement therapy, especially in severe menopause.
The presence of fluid in the uterus without significant signs of infection does not threaten women's health. However, it is impossible to leave the uterus in this state, since at any time of the serosimeter, more serious conditions, for example, purulent inflammation, can provoke.
Treatment of serosymmetry begins only after the establishment of a true diagnosis, it implies the elimination of the cause of its appearance. In some situations, a pre-emptying of the uterine cavity and subsequent antibiotic therapy are required.
What is the
serosimeter? As mentioned above, the serosimeter is a functional condition of the uterus( not a diagnosis), in which liquid is present in its cavity.
To understand the mechanism of formation of serosomes, it is necessary to recall how the uterus is arranged and how it functions.
So, the uterus is a unique structure, intended for bearing the fetus and procreation. To ensure the performance of these functions, the tissues of the uterus must be strong and elastic, so the base of the uterine wall is formed by powerful smooth-muscle fibers( myometrium), which intertwine with each other and form a kind of spiral turns. The muscular layer of the uterus is able not only to hold the growing fetus in the uterine cavity for a long time, but also to push it out during the delivery.
Another layer of the uterine wall - the perimetry, formed by a serous( peritoneal) tissue - is located outside the myometrium. Perimetry protects the uterus from negative external influences.
The uterine cavity is lined with endometrium, it is formed by a cylindrical epithelium that reacts actively to hormonal cyclic changes. Endometrium, in turn, has two layers: external( functional) and internal( basal).The functional layer is completely rejected during the period of menstrual bleeding, and then again restored from the reserve cells of the basal layer.
The narrowed part of the uterus is called the neck. It also has a cavity in the form of a canal lined with a cylindrical epithelium. The cervical canal has two physiological constrictions - a pharynx. They are located on the border with the uterine cavity( inner throat) and with the vagina( external shed) and act as an anatomical "flapper".
In the corners of the uterus located at its base, there are holes leading to the cavity of the fallopian tubes.
The endometrium contains a variety of blood vessels and glandular structures capable of producing a serous secret. It can also secrete numerous glands of the cervical canal. More often the serosimeter is formed with the participation of glandular structures of the endometrium, but cervical glands can also become its source.
It should be noted that fallopian tubes are capable of accumulating a serous secret. If the blood supply and lymph drainage in the tube are disturbed, it begins to fill with fluid and becomes impassable, such a pathological condition is classified as hydrosalpinx. Sometimes the contents of the tube with the hydrosalpinx breaks into the uterine cavity.
An ectopic( namely tubal) pregnancy can also provoke a serosimeter.
Symptoms and signs Serosometer
The serosimeter has no specific symptoms. More often its manifestations depend on the cause, that is, on the pathological condition that provoked the accumulation of serous secretion in the uterine cavity. Often echoes of serosomes are diagnosed on the background of the absence of any clinical signs.
More common with a serosometer are:
- Palpatory signs of an increase in the size of the uterus. They appear with a significant amount of accumulated fluid in the uterus, which overstrains the uterine cavity, and with gynecological examination, the enlarged uterus is palpated.
There are cases when excessive accumulation of serous secretion has increased the uterus so much that the organ was visualized during routine examination, as it literally protruded above the abdomen.
- Dysfunction of uterus-adjacent organs. If the uterus increases significantly, it presses on the bladder, provoking a disorder of urination. In patients with a retroflection( backward deflected) uterus with a serosimeter, rectal dysfunction( difficulty in defecating) may appear.
- Pain. The severity of the pain syndrome directly depends on the size of the uterus and the presence of a concomitant inflammatory process. The more fluid in the uterus, the more it is increased, and the more intense the pain sensations. Usually patients with serosometry characterize pain as blunt and pulling, intensifying with intimate affinity. In the inflammatory process, pain is also associated with pathological changes in the tissues of the uterus.
Serosometer after scraping the uterine cavity is more often associated with the inflammatory process.
- Unaccustomed( both in appearance and quantity) of vaginal discharge. They appear if the uterine cavity is not "closed" completely, and the accumulated secret can gradually be evacuated beyond its limits. The discharge at the serosimeter is watery, light, grayish in color. If the uterine cavity is infected with a pathological microflora, the discharge becomes purulent and is often accompanied by other signs of infectious inflammation: fever, severe pain, malaise.
As a rule, physical activity and sexual intercourse provoke augmentation of the vaginal discharge.
- Menstrual dysfunction. The intensive work of the glandular structures of the endometrium disrupts the normal mechanism of rejection of the mucosa and distorts the habitual menstrual rhythm.
If fluid accumulates in the cervical cavity, over time it can transform into a cyst. The most common cause of cervical canal cysts is the infectious process.
All available clinical signs of serosymes, regardless of their severity, are not specific, since they coincide with those in many other gynecological ailments. It is only possible to establish the presence of serosomes with ultrasound scanning. During the scan, they are more often visualized:
- enlarged uterus;
- irregular outline( outer contour) of the uterus;
- expanded uterine cavity with a deformed contour;
- possible narrowing of the cervical cavity( up to complete closure of the walls) or its deformation;
- the presence of fluid in the uterine cavity.
Lochiometer also has similar echoes, but the structure of the liquid contents of the uterus in those who have given birth is characterized by the presence of coagulated blood( small hyperechoic areas) and "foreign" inclusions( scraps of the decidua or small fragments of the placenta).
Ultrasound scanning diagnoses the presence of serosymmetry, but does not always help to establish its exact cause. Sometimes, in order to obtain a reliable diagnosis, it is necessary to study the condition of the uterine mucosa, obtained with diagnostic curettage. The results of the subsequent histological examination help to choose the right therapeutic tactics.
Menopause Serosomer
Menopause occurs in most( 70%) women at the age of 50 - 52 years, but it is impossible to determine the exact age criteria for the phases of menopause, since it is characterized by individual characteristics.
Menopause is the shortest phase of menopause. True menopause is the last independent( if you do not use hormones that affect the menstruation).As a rule, menopause begins with menstrual irregularities, when menstruation loses its habitual rhythm and often lingers for a long time. Under such conditions, it is difficult to determine which menstruation is last, so it is accepted that if the next menstruation did not come within a year, the woman had menopause. Some specialists established this period in two years.
During menopause and especially menopause, the female body experiences a severe estrogen deficiency, as the ovaries cease to synthesize them. Since the reproductive function of the ovaries is not fulfilled, the organism gradually modifies the genital organs and tissues. The endometrium is not an exception. By losing the necessary estrogenic effect, it becomes thinner, loses its natural protective properties, and its ability to regenerate weakens.
The most common cause of serosomes in menopause is formed atresia( narrowing) of the internal pharynx, which is not a pathology in this period.
Symptoms of serosomes in menopause differ little from those in women of the reproductive age.
Serosometer in the postmenopausal
The serosimeter is diagnosed in almost 40% of patients entering postmenopausal women.
Postmenopause completes the climacteric period. The first five years of absence of menstruation are defined as early postmenopause, and the next ten years - as late.
Prolonged absence of estrogenic effects on the endometrium provokes pronounced atrophic processes, when the mucous membrane becomes thinner, the glandular structures are reduced, and vaginal discharge is practically absent.
Any unusual vaginal discharge in postmenopause requires detailed study. Atrophic mucosa, which lacks strong immune defense, poorly resists the aggression of infectious agents, and is easily traumatized, and the deficiency of lactobacilli in the vaginal microenvironment has a local dysbiosis.
In late postmenopausal, the serosimeter can be associated with both inflammatory and malignant processes in the endometrium.
It should be emphasized that no phase of menopause is an independent cause of serosomes.
Treatment of serosymmetry
Regardless of the selected method of therapy, serosymmetry, it is necessary to fulfill two key tasks - to pump out the liquid and to eliminate the cause of its accumulation in the uterus.
The method of treatment of serosomes depends on the presence and severity of complaints, the results of a laboratory test and the age of the patient.
If there are no signs of infection and the amount of fluid is small, monitoring with mandatory ultrasound monitoring is possible. In this case the uterus should be "helped" to get rid of the disease on its own. Therapy is aimed at stimulating local blood circulation, enhancing the regeneration of the endometrium and increasing the immune defense.
Sometimes, the method of instrumental expansion of the cervical cavity is used to release the uterus from the liquid.
In case of infection, adequate antibiotic therapy is necessary, and the contents of the uterus are evacuated by drainage. After the termination of menstrual function, it is advisable to use hormonal therapy on the principle of substitution to improve the regenerative properties and blood supply of the endometrium.
Removal of the endometrium by curettage is both diagnostic and therapeutic manipulation, which allows one-time disposal of the uterus from the "problematic" mucosa and establish the cause of serosymmetry. The procedure is performed through hysteroscopy. Particularly relevant to its conduct in menopause entered into menopause.
