Hematometra Pyometra: Causes Symptoms and Available Treatments

Hematometra pyometra is a serious medical condition that affects women. It occurs when a woman's uterus becomes filled with blood and pus, often due to a blockage in the cervix.

This condition can be extremely painful and may cause severe abdominal cramps, fever, and nausea. In some cases, women may also experience vaginal discharge or bleeding.

If left untreated, hematometra pyometra can lead to serious complications, such as sepsis or infertility. It's essential to seek medical attention immediately if symptoms persist or worsen over time.

Treatment options for hematometra pyometra typically involve surgery to remove the blockage and drain the infected fluid from the uterus.

Haematometra is an accumulation of blood within the uterus. This condition can cause discomfort and pain for those affected.

The uterus is a muscular organ that plays a crucial role in the female reproductive system. It's a vital part of a woman's body, and any issues with it can be concerning.

Haematometra occurs when blood collects in the uterus, often due to a blockage or obstruction in the fallopian tubes. This can be a serious condition that requires medical attention.

Symptoms of haematometra may include pelvic pain, heavy bleeding, and discomfort during sex. These symptoms can vary in severity and may be different for each individual.

In some cases, haematometra can be a precursor to more serious conditions like pyometra, where pus accumulates in the uterus. This is a serious health issue that requires prompt medical attention.

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Hematometra pyometra can cause amenorrhoea, but there may be some menstrual blood flow.

Lower abdominal swelling and tenderness are common symptoms, which can be severe enough to cause significant discomfort.

It may present with severe primary dysmenorrhoea, making everyday activities a challenge.

Symptoms can be associated with pyometra, especially after termination of pregnancy, when the patient may have a high fever and other evidence of infection.

If due to an imperforate hymen, the hymen may bulge and exhibit a bluish discoloration, which can lead to elevations of CA-125 and CA19-9.

Haematometra can be caused by a variety of factors, including Müllerian duct anomalies. These anomalies can affect the development of the reproductive system, leading to a range of possible issues.

One possible cause of haematometra is an imperforate hymen, a condition where the hymen is completely closed, preventing menstrual blood from flowing out of the body.

In older women, haematometra may be secondary to carcinoma of the cervix or cervical stenosis, such as after a cone biopsy. This can cause the cervix to become narrowed or blocked, preventing menstrual blood from flowing out.

Haematometra can also result from childbirth, either by normal vaginal delivery or assisted deliveries like forceps.

Some medical procedures, such as uterine curettage, cervical cryocoagulation, or electrocoagulation, can also lead to haematometra.

Here are some possible causes of haematometra, grouped by category:

Haematometra can manifest in different ways, depending on the individual and their circumstances.

Cyclic, cramping pain in the midline of the pelvis or lower abdomen is a common symptom of haematometra. This pain can be severe and may be accompanied by other symptoms.

Urinary frequency and urinary retention can also occur in patients with haematometra. In some cases, patients may experience abnormal vaginal bleeding, including dysmenorrhea or amenorrhea.

The uterus may feel firm and enlarged when palpated, due to the accumulation of blood. This can be a key indicator of haematometra.

Here are some common symptoms of haematometra:

Jindo and Poongsan dogs are the most popular breeds in Korea, with Poongsan dogs being commonly used for hunting and a representative native breed in North Korea.

Poongsan dogs are prone to Canine CEH-pyometra complex, a life-threatening disease of the reproductive system that can be diagnosed in younger dogs than previously reported.

Hematometra, a rare condition among cases of CEH-pyometra complex, is an emergency that requires early diagnosis and rapid therapeutic intervention to prevent a fatal outcome.

In cases of hematometra, differential diagnosis can be made based on cytological examination, complete blood count, serum chemistry analysis, urinalysis, and ultrasonography.

Clinical signs of pyometra in dogs include vomiting, abdominal distension, dehydration, anorexia, and polyuria/polydipsia, with symptoms often developing gradually and insidiously.

Symptoms of hematometra in dogs can include vomiting, anorexia, depression, dehydration, and continuous hemorrhage, as seen in the case of a young Poongsan dog.

Ovariohysterectomy is the recommended treatment for hematometra, and should be performed as soon as possible due to the risk of lifethreatening complications associated with bacteremia and endotoxemia.

In cases of severe anemia, a whole blood transfusion should be performed prior to surgery, as seen in the case of the young Poongsan dog.

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Diagnosis of hematometra can be confirmed by ultrasound, which shows blood pooled in the uterus and an enlargement of the uterine cavity.

A pyelogram or laparoscopy may assist in diagnosing any congenital disorder that is suspected to be the underlying cause of the hematometra.

Ultrasound is the first imaging modality for diagnosis, showing the endometrial cavity distended with turbid fluid material of low-level echoes till the level of obstruction and stretched myometrium.

MRI is important to confirm the diagnosis, assess uterine anatomy and level of obstruction, and provide information on other associated changes like hematosalpinx.

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Diagnosis of hematometra can often be made based on a patient's history and physical examination, but imaging tests like ultrasound and MRI are also crucial.

A palpable pelvic mass on examination is a common finding in patients with hematometra.

Ultrasound is the first imaging modality for diagnosis and can show blood pooled in the uterus and an enlargement of the uterine cavity.

MRI is important to confirm the diagnosis and assess uterine anatomy, as well as provide information on other associated changes.

The retained fluid in the uterus may show different intensities on MRI according to the age of the retained blood.

Hematocolpos, a collection of menstrual blood in the vagina, is a related condition that may be diagnosed through ultrasound.

In some cases, a pyelogram or laparoscopy may be necessary to diagnose any underlying congenital disorders.

Uterine sounding is a procedure that can help doctors gather information about the size and shape of the uterus, as well as the presence of any remaining version and flexion.

The sound is typically 8-9 cm long, which is the average length from the external os to the fundus.

To perform the procedure, the doctor will use a tenaculum to apply traction to the cervix while inserting the sound. The sound should be held lightly between the thumb and first finger to avoid causing any discomfort.

Cervical stenosis, or a narrowing of the cervix, may require dilation before the sound can be placed.

Treatment for hematometra pyometra typically involves surgical intervention to relieve the obstruction and drain the infected fluid.

The goal of surgery is to remove the blockage, repair any damaged tissues, and restore normal menstrual flow.

A hysterectomy, which is the removal of the uterus, may be necessary in some cases if the infection is severe or if the patient has other health conditions that make surgery more complicated.

Complications from untreated hematometra pyometra can include infertility, chronic pelvic pain, and increased risk of developing ovarian cancer.

Abnormal uterine bleeding is a common indication for a diagnostic dilation and curettage. This can include irregular bleeding, menorrhagia, or suspected malignant or premalignant conditions.

Retained material in the endometrial cavity is another indication for a diagnostic dilation and curettage. This can be due to an incomplete abortion, missed abortion, septic abortion, or induced pregnancy termination.

A diagnostic dilation and curettage may be necessary to evaluate intracavitary findings from imaging procedures. This can include abnormal endometrial appearance due to suspected polyps or fibroids.

If an office endometrial biopsy is insufficient for diagnosis or has failed due to cervical stenosis, a diagnostic dilation and curettage may be necessary. This is especially true if the endometrium is difficult to access due to shadowing from leiomyomata, a pelvic mass, or loops of bowel.

Diagnostic dilation and curettage can also be used to evaluate and remove retained fluid from the endometrial cavity. This can include hematometra, pyometra, and relieving cervical stenosis.

Here are the indications for a diagnostic dilation and curettage:

Complications can arise from various factors during treatment, including the underlying condition itself, the treatment approach, and individual patient characteristics.

One potential complication is infection, which can occur due to the insertion of medical devices such as catheters or surgical implants.

In some cases, treatment may lead to allergic reactions or sensitivities to certain medications or materials used in the treatment process.

Kidney damage is another possible complication, particularly when certain medications or contrast agents are used in conjunction with imaging tests like CT scans or MRIs.

The risk of bleeding or hemorrhage is also a concern, especially when anticoagulant medications are used to prevent blood clots.

In rare cases, treatment may cause damage to surrounding tissues or organs, such as nerve damage or bowel perforation.

It's essential to be aware of these potential complications and discuss them with your healthcare provider to understand the specific risks and benefits associated with your treatment plan.

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