- Endometriosis reasons
- Endometriosis symptoms
- Treatment of Endometriosis
Endometriosis is a formation of the endometrial fabric inclined to the cyclic changes characteristic of a uterine endometria, in areas out of an internal mucous membrane of a uterus. Endometriosis is subdivided on genital if the uterine epithelium arises within internal or external genitals, and extragenital of which localization out of generative organs of the woman is characteristic.
Endometriosis is widely diagnosed for women of reproductive age. To 45% of the women having laparoscopic or laparotomichesky operation in the past have endometriosis. Genital endometriosis meets considerably more often, it is diagnosed in 95% of cases.
The reliable reason of development of endometriosis is not established. So-called internal endometriosis of a body of the womb develops in case of germination of a normal uterine endometria deep into of a uterus wall. Such situation quite often arises after the carried-out intrauterine manipulations – Cesarean section, diagnostic and medical a scraping, including abortions, etc. At damage of a uterine wall epithelial cells can get to blood and a lymph, thus extending on all organism.
In an endometriosis etiology a considerable role is played by the embryonal theory. It is revealed that with various anomalies of generative organs endometriosis meets several times more often.
There is a point of view about a role of a metaplasia of a coelomic epithelium or an embryonal peritoneum in development of endometriosis. Such theory quite explains development of this disease in girls prior to the beginning of menarche, and also exceptional cases of endometriosis at men.
Existence of a hormonal imbalance and pathology of immune system are risk factors on incidence. Value of disturbances of neuroendocrinal regulation in the general concept of a pathogeny of endometriosis is defined that allows to consider this disease hormonedependent. It is considered that endometriosis – a disease of reproductive age, almost not arising during the period after a menopause. Activity of a disease sharply decreases up to remission during artificially created amenorrhea or pregnancy.
Endometriosis of a body of the womb is called the term "adenomyosis". The first clinical symptoms of an adenomyosis is disturbance of a menstrual cycle on algodismenoriya type. At desquamation an epithelium during periods the pain syndrome is observed. Upon transition of pathological process to sacrouterine sheaves or an isthmus of a uterus pain becomes more expressed. Considering the nature of irradiation of pain, it is possible to define localization of the center: defeat in area of corners of a uterus is characterized by irradiation of pain to the inguinal area. Pain gives to a rectum or a vagina at uterus isthmus endometriosis. Practically always pain decreases after the termination of periods. As a rule, periods plentiful and long that the hyper polymenorrhea is designated by the term. Several days before and after periods are observed the smearing dark allocations. The started endometriosis is followed by massive bleeding, is more often during the intermenstrual period. Due to frequent bleedings the posthemorrhagic anemia which is followed by such symptoms as the general weakness, pallor of skin, perhaps yellowness, problems with nails and hair develops.
Clinical displays of endometriosis of a neck of uterus differs in small expressiveness. Sometimes the woman notes insignificant bloody allocations before periods or after sexual intercourse.
Endometriosis of a vagina more often is secondary process, developing at germination from the retrotsevikalny center. The pain syndrome of various degree of manifestation, inclined to recurrence, is noted. At distribution of the center on a rectum pain amplifies.
Expressiveness of complaints at retrocervical endometriosis is caused by a close arrangement of a rectum and pelvic neuroplex. Irradiation in a wall of a basin or the lower extremity is noted. At neuroplex affection pain gains the pulsing character. To distinguishing diagnostic characters the bleeding cyanotic "eyes" seen at gynecologic survey are.
No expressed specific characters at endometriosis of ovaries are noted. As well as at other forms of endometriosis, the patient can report about dull ache which gives to a rectum, and morbidities at sexual intercourse.
Uterine tubes are surprised endometriosis in 10% of cases. Often it leads to infertility due to formation of commissural process and impassability of uterine tubes.
Treatment of Endometriosis:
The complex of treatment of endometriosis consists in medicamentous hormonal therapy and an operative measure. The therapeutic program joins methods of the prevention of an adhesive desease, stopping of a pain syndrome, correction of anemia. Endometriosis of a neck of uterus demands use of radio coagulation, laser vaporization, applications of solution of a solkovagin. At endocervical localization of endometriosis carrying out conization of a neck of uterus, radio coagulation and laser vaporization is possible. After an operative measure performing hormonal therapy for up to 6 months is necessary. An operative measure at retrocervical endometriosis is carried out in volume of a hysterectomy with appendages.
For carrying out correction of the immune status appoint immunomodulators – Thymalinum, the immunofan, циклоферон and other drugs. Also vitamin therapy, especially ascorbic acid and vitamin E is shown.
Pain at endometriosis is eliminated by use of non-steroidal anti-inflammatory drugs (indometacin, an ibuprofen), spasmolysants and analgetics. Due to the possible psychological disturbances at patients with endometriosis inclusion in complex therapy of calmatives, including tranquilizers is possible (Phenazepamum, to gidazepa, афабозол, etc.). Iron preparations are recommended when diagnosing iron deficiency (posthemorrhagic) anemia.