Regarding the issue of corpus luteum rupture, those who stay in bed and hold their urine on weekends should pay attention

The alarm hasn't rung yet, but you've been forced to wake up from holding your urine. Do you continue to sleep or go to the bathroom? I believe many people will choose to stay half asleep and half awake, constantly wavering between peeing and continuing to sleep... until the alarm rings.

However, there was a piece of news that made people excited: "Recently, a 23-year-old girl in Changsha suffered a ruptured corpus luteum due to staying in bed and holding her urine."

What? What is the corpus luteum? How can holding urine be related to it?

01

What is the corpus luteum?

Every month after a woman's follicle completes ovulation, the remaining follicle wall cells in the ovary will become an endocrine gland rich in blood vessels under the action of luteinizing hormone. The glandular cells that make up this endocrine gland contain a large amount of carotene oxides, which are yellow in color, so this endocrine gland is called the corpus luteum.

Ovaries, image source: Modern Histology

If the egg discharged by the follicle is not fertilized, the corpus luteum formed after ovulation is called the menstrual corpus luteum, which degenerates 10-14 days after ovulation (the corpus luteum cells gradually shrink and become smaller, and are replaced by connective tissue, with a white appearance, called the white body). If the egg is fertilized and becomes a fertilized egg, the corpus luteum continues to grow under the action of human chorionic gonadotropin secreted by the embryonic trophoblast cells, and becomes the corpus luteum of pregnancy. After 3 months of pregnancy, its function gradually declines and is finally replaced by the placenta.

The corpus luteum atrophies and degenerates into the corpus albicans. Image source: Physiology

02

The corpus luteum is very important for women

The corpus luteum is composed of two types of cells: luteal cells and granuloluteal cells. Among them, the luteal cells mainly secrete estrogen, while the granuloluteal cells mainly secrete progesterone (a type of progesterone).

We all know that estrogen is an essential hormone for women to complete their reproductive functions. During puberty, estrogen binds to receptors in the cells of the ovaries, fallopian tubes, uterus and vaginal mucosa, promoting the synthesis of cell proteins and cell division and growth, thereby promoting the growth and development of these organs and maintaining their normal functions.

At the same time, it can also promote the proliferation of mammary ducts and connective tissue, and is the main hormone that promotes breast development during puberty. In addition, estrogen can promote the movement of fallopian tubes, which is beneficial to the movement of sperm and egg cells.

The main place of synthesis of ovarian progesterone (including progesterone) is the corpus luteum cells. Progesterone works on the basis of estrogen, and its main function is to ensure the implantation of the fertilized egg and maintain pregnancy. Estrogen causes the endometrium to proliferate, and progesterone further thickens the endometrium on this basis, preparing for the implantation of the fertilized egg. During pregnancy, progesterone can inhibit the contraction of uterine smooth muscle and provide a suitable growth environment for the fetus. (In the early stages of pregnancy, if progesterone secretion is insufficient, it may cause miscarriage of the fetus)

Therefore, the corpus luteum is very important for women. Why would a healthy corpus luteum rupture?

03

The mystery of corpus luteum rupture

Corpus luteum rupture is a very common gynecological emergency. As mentioned above, the corpus luteum contains abundant blood vessels. Bleeding caused by corpus luteum rupture can occur in women of childbearing age at all stages, mostly between the 18th and 30th days of the menstrual period.

Generally speaking, there are three types of factors that lead to corpus luteum rupture, including corpus luteum cysts, external force compression and abnormal coagulation mechanism.

A normal corpus luteum is generally about 2 cm in size and is non-cystic, but some corpora luteum can reach 8-9 cm in size, forming a corpus luteum cyst. In this way, an overly large corpus luteum is more likely to rupture.

Secondly, when the female abdomen is squeezed by external force (such as accidental collision, fall, gynecological examination and squeezing during sexual intercourse), the pressure in the abdominal cavity increases and the mature corpus luteum may rupture.

In addition, abnormal coagulation mechanism in some people may also be the cause of corpus luteum rupture and bleeding. Under normal circumstances, some tiny blood vessels in the corpus luteum can stop bleeding on their own after rupture, but for people with abnormal coagulation mechanism, stopping bleeding is a difficult task, and the blood in the corpus luteum surges, eventually leading to corpus luteum rupture.

04

Why does holding urine cause corpus luteum rupture?

Now that we know the reasons for corpus luteum rupture, many women are most concerned about whether holding urine can cause corpus luteum rupture.

The lady in the news gave a positive answer! The distance between our internal organs is closer than we think. When you hold your urine, your bladder will expand. If it expands to a certain extent, it will squeeze the ovaries. As the urine increases, the bladder expands more and more, and the squeezing force on the corpus luteum in the ovaries will also increase. When it reaches a certain level, there is a possibility of rupture.

Although it is not common for corpus luteum rupture to occur due to holding urine, there are people who have experienced it.

So, all the girls who are in the late stage of cancer, don't take chances, it would be better to go to the toilet and take a nap~

05

How is Corpus Luteum Rupture Diagnosed?

The diagnosis of corpus luteum rupture is mainly based on the patient's clinical manifestations and combined with auxiliary examinations such as ultrasound, human chorionic gonadotropin content in blood or urine, and posterior fornix puncture.

The main clinical manifestation of corpus luteum rupture is lower abdominal pain, which may be accompanied by vaginal bleeding, anal swelling, nausea and vomiting.

Ruptured hemorrhagic corpus luteum cyst in a 16-year-old girl. Image source: radiopaedia

If it is really unfortunate that the corpus luteum ruptures due to holding urine accidentally (I sympathize with this child for a minute), ladies, don't hesitate, go to the hospital immediately.

If the condition is mild, the doctor will adopt conservative treatment, use drugs to stop the bleeding of the ruptured corpus luteum, and then cooperate with anti-inflammatory and anti-infection treatments to relieve pain.

If the situation is serious and the amount of bleeding is large, surgery is required immediately. The corpus luteum can be removed with the help of laparoscopy or after laparotomy, and finally sutures are performed to stop the bleeding.

Reviewer: Zeng Ling, deputy chief physician of gynecology department, Tianyou Hospital affiliated to Wuhan University of Science and Technology

END

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