Endometriosis (synonym: adenomyosis, endometrioma) is granulomas inclusion and growth of endometrial tissue in various organs. The pathogenesis of endometriosis is not clear.
Endometriosis occurs in women aged 30 to 50 years; girls before puberty is not detected. In climacteric period endometriosis reverses its development.
The most frequent localization of endometriosis is the pelvic area (genital endometriosis affects the uterus, fallopian tubes, ovaries, external genitals). However, endometriosis may metastasize to the lungs, kidneys, intestines, bladder and other organs (extra genital endometriosis).
Macroscopically in the affected organ found large and small sites, not having precise borders with the contiguous tissue; in the context of fabric cellular structure, with glandular structures, surrounded by tithenai the stroma.
Endometriosis cancer occurs most often. Patients complain of a violation of the menstrual cycle - cyclical bleeding type menorrhagia (Hyper - and polimenoreya), rarely observed metrorragiya. Bleeding are persistent in nature, can not be conservative methods of treatment, and even repeated curettage of the uterine mucosa not effective. In endometriosis, uterine there was a sharp pain in the abdomen, lower back, before and during menstruation and light tarry selection before menstruation and after it. Uterus endometriosis increased in size (as at 5-8 weeks of pregnancy), the shape of her more often asymmetric, consistency uneven.
Diagnosis of endometriosis cancer is very difficult, especially if it is combined with fibroids. Suspected endometriosis midwife should direct the patient to doctors for examination.
Treatment in the early stages of the development of endometriosis, uterine symptomatic, appoint hemostatic means, a means of improving the contractility of the uterus,Katarina chloride 0.05 g 3-4 times a day, a vasoconstrictor, analgesic drugs, are hormone therapy. If no effect is shown surgery: supracervical amputation of uterus or its extirpation.
Endometriosis, ovarian unilateral observed twice as likely to be bilateral. On postmortem drug ovarian when endometriosis, as a rule, macroscopically visible pouches of various sizes, filled with dark fluid ("chocolate cysts"). Endometriosis, ovarian accompanied commissural process.
Diagnosis is difficult. One of the characteristic symptoms are persistent pain, worse during menstruation. Very often observed primary infertility.
The treatment is surgical removal of the uterus. With bilateral ovarian endometriosis in women of childbearing age (before 40 years) produce sparing surgery - partial resection of the ovaries.
When pozavchera endometriosis affects Sacro-uterine ligaments, premonicion-vaginal tissue, the vaginal wall and rectum. Main complaint of patients with this form of endometriosis pain that can be so intense that make a woman disabled. In the propagation of endometriosis in the rectum can cause bleeding, coinciding with menstruation.
Gynecological examination through the rear vaginal vault behind the cervix palpable nodules of various sizes, often merging with each other, thick consistency, fixed and sharply painful.
Treatment is not always effective. Recommended hormone therapy, electrophoresis with potassium iodide, microclysters with a 1% solution of potassium iodide, candles with the extract of belladonna, a papaverine and Ichthyol. Surgical treatment often gives only a temporary effect.
When extragenital forms of the disease in the period of menstruation observed bleeding from metastases affected organs (for example, from the intestines, conjunctiva, and others).
If any location and form of endometriosis in the postoperative period possible relapses. Radiotherapy is shown only in old age.