Menopause and polyps
Especially after menopause, the risk of pathological changes in the lining of the uterus and the reproductive organs is increased. It is therefore important that women go for regular check-ups after the menopause as well. Ultrasound can quickly detect changes in the uterus or ovaries.
If the ultrasound reveals a thickened lining of the uterus, this should definitely be further examined by means of a uterine scrape. The advantage of a uterus scrape is that the diseased tissue can be removed quickly and safely and then examined. In most cases these are benign tumours of the uterine lining, so-called polyps, which are harmless but can lead to irregular and heavy bleeding even after menopause.
Removal of the polyps quickly relieves symptoms. However, in some cases, behind a thickened endometrium, a malignant tumour can be found, especially endometrial carcinomas, a hormone-dependent cancer of the uterine body. The greatest risk of cancer of the uterus is the use of hormone replacement products (especially oestrogens, without progestin protection).
Other risk factors include early menarche and late menopause, few or no births, a history of breast cancer, tamoxifen therapy, obesity, diabetes mellitus and high blood pressure. Uterine body cancer manifests itself early on through sudden postmenopausal bleeding. Here, too, uterus scraping is indicated in order to remove and examine the diseased tissue more closely and to initiate appropriate therapy. However, since this form of cancer is usually detected very early, it can be treated well and usually has a good prognosis.
Myomas
Myomas are benign, estrogen-dependent tumours of the uterine musculature. They are completely harmless in themselves, but, depending on their location in the uterus and their size, they can cause cycle disorders, menstrual problems, pain and, in rare cases, infertility. The most common reason for removing fibroids is heavy, irregular menstrual bleeding.
They are usually diagnosed by ultrasound. Therapeutically, drugs can be taken, for example progestin-based anticonceptives. If this is not sufficient, fibroids can also be removed surgically.
Small fibroids that are located on the lining of the uterus can be removed by means of a uterine scrape. Another surgical option is laparoscopic removal. In this procedure, instruments and a special camera are inserted into the abdominal cavity through three small abdominal incisions, the abdomen is expanded with carbon dioxide and then the fibroids are cut out of the uterus under visual control.
However, fibroids have a high risk of recurrence and can regrow in different parts of the uterus. After menopause, however, they atrophy and no longer cause symptoms. In very difficult cases and with very large fibroids, uterus removal is sometimes indicated. – Uterus – Uterus
- Cervix – Fundus uteri
- Endometrium – tunica mucosa
- Uterine cavity – Cavitas uteri
- Peritoneal cover – Tunica serosa
- Cervix – Ostium uteri
- Uterine body – Corpus uteri
- Uterine constriction – isthmus uteri
- Vagina – Vagina
- Pubic symphysis pubica
- Urinary bladder – Vesica urinaria
- Rectum – rectum