Main features of diagnosis of endometriosis

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  • In the literature highlights the difficulties in the diagnosis of endometriosis [shinkareva L. F., 1958; Graschenkova 3. P., 1961; Portes L., Varangot J., 1940; Le Bourg, Bouchard, 1971; Samsula M. et al., 1973; Bardos, A., 1973; Legros R., Fain-Giono J., 1973; J. Bullock et al., 1974, and others].
    Is it possible progress in resolving this issue? Long experience of studying problems of endometriosis in various aspects allows us to give a positive answer. The vast majority of patients with clinically active endometriosis timely diagnosis of the disease is possible. For this, we have to remember about the existence of endometriosis and what he can give those or other clinical manifestations, sometimes pronounced at different ages, starting from the time of occurrence of menarche (10-12-14 years) and up to 50 to 60 years. It is with a diagnosis of endometriosis in young and older adults the situation is particularly unfavourable. Early recognition of endometriosis at a young age will help to reduce the frequency of advanced cases of the disease, improve treatment outcomes, which will benefit the rehabilitation of disability and specific features of the female body. The correct diagnosis in older women helps way of distinguishing it from cancer and to avoid overly radical surgical interventions, for example, when endometriosis cancer is cancer or when endometriosis lymph nodes of the pelvis qualifies as a sign inoperable bladder tumors [D. Lamm et al., 1971].
    On the other hand (this is evidenced by the material clinical hospital tsmsch-122 the USSR Ministry of health and the clinic of gynecology military medical Academy im. S. M. Kirov), in recent years have become more frequent observations of patients with advanced cancer, mistaken for endometriosis. This sick for a long time (up to a year or more) unsuccessfully cure for endometriosis. On the revision of the diagnosis, the question is not timely.
    Duration of disease of endometriosis before the diagnosis at 760 patients in the clinic of gynecology military medical Academy im. S. M. Kirov following:

    The duration of the disease The number of patients
    1-5 years
    6-10 "
    11 - 15 "
    16 and more years
    324 (42,63 %)
    314 (41,32 %)
    101 (to 13.29 %)
    21 (was 2.76%)
      Just 760 (100 %)

    The main part of the sick group, where the duration of disease more than 10 years (122), was patient with congenital form of the disease. The greatest length of time before the diagnosis of one of them was 30 years (patient K., 45 years).
    A similar correlation was detected in 200 patients with endometriosis observed in hospital and polyclinic tsmsch-122 in the period from 1984 to 1987, the vast majority of patients lived in Leningrad, and only 17 people in other cities of the country. They repeatedly consulted by specialists of medical universities, for a long time (from 3 to 17 years) were treated for allegedly inflammatory process, and the diagnosis of endometriosis was installed late.
    It is surprising that in the group of patients with a diagnosis of 10-15 years and more included women with endometriosis postoperative scar.
    In terms of diagnosis of Prime importance are the cyclical nature of the illness and the relationship of exacerbations with menstruation. This refers to pain, infringement of function of the intestines, urinary tract system, the emergence of bleeding from the scar or the navel, retidiviruuschem during menstruation the hemoptysis (lungs), the emergence of serosanguineous of fluid in the pleural cavity also during the month when endometriosis pleura; a number of patients in this period increased body temperature, you receive local itching in the foci of endometriosis.

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