The etiology and pathogenesis of endometriosis

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  • Important in the detection of congenital endometriosis is a thorough study of family history (especially menstrual function in the mother, grandmother, sisters - having pronounced algodismenorea, ceasing only during pregnancy and postpartum period of amenorrhea, early recovery month after delivery, long-term functional infertility patients, gynecological diseases and operations).
    The increased attention to the examination of patients child, adolescent and young adults suffering from severe algodismenorrhea, is resistant to standard treatment, using laparoscopy will allow early detection of congenital endometriosis in young patients and early treatment without waiting development unpleasant, and even heavy complications (ingrowth into the lumen of the rectum, bladder, the posterior fornix of the vagina, stricture formation of the ureter), which still have to face.
    2. The theory of endometrial origin of endometriosis still help to explain the emergence and development of endometriosis of various localization. According to these theories, endometriosis develops from elements of the endometrium, which is offset in the thickness of the uterus, ovaries, fallopian tubes, other departments sexual apparatus and beyond. Sprouting endometrial thickness of walls contribute to violations of the regime (balance) of sex hormones [Levinsky O. B., 1940; shinkareva L. F., 1965; Salty M. I., 1974, 1977] and surgicalabortions, diagnostic curettage of the uterus, manual examination of the uterus after delivery, delivery, cesarean section, enucleation fibromatous sites and other operations). Surgical trauma endometrium may cause hit elements of the mucous membrane of the uterus in the blood, lymph, and their dissemination to other organs and tissues.
    N. I. Horizons (1911), J. Halban (1925), J. C. Bachman and L. I. Kostina (1965, 1977), A. Bardos (1973) convincingly showed the possibility lymphogenous distribution of elements of the endometrium in other organs and tissues. The same was confirmed F. Spirito (1927," 1928), J. Manzi (1928), J. Hobbs, A. Bortnick (1949) and others in respect of hematogenous Genesis of endometriosis.
    Apparently, it is a valid assumption of lymph hematogenous dissemination of particles endometrium, as is the case with malignant processes.
    In addition, it is possible mechanical particles entering the endometrium hands of a surgeon and tools in the edges of the wound and other organs during obstetric and gynecological operations related to the opening of the uterus and surgical trauma of the endometrium. This is the same mechanism of occurrence of endometriosis during surgical interventions made during or soon after your period, when in utero-pryamokishechnye deepening goes retrograde tubal ligation menstrual blood. In this blood viable elements endometrial hands of the surgeon (during the audit of the pelvis and abdominal cavity) and the toolbar can be moved to another location. For the first time the idea about the viability of the particles of the endometrium, which is in menstrual blood, expressed J. Sampson (1921, 1922), which is rightfully considered the founder of transplantation theory of the origin of endometriosis.
    After the experiments R. The Linde, R. Scott (1950), R. Scott et al. (1953), in which the surgery was established outflow of menstrual blood in the abdominal cavity monkeys, which resulted in generalized endometriosis abdominal cavity and pelvis, the theory of J. Sampson got a convincing confirmation.
    And finally all doubts concerning the viability of the particles of the endometrium, which is shed with menstrual blood, were scattered experiences J. Ridley, and I. Edwards (1958). The authors managed to cause the development of endometriosis in women by introducing into the abdominal wall collected from them of menstrual blood.
    Clinical observations of various authors [Frosch F., 1936; Fallas R., 1956; Scott R. et al., 1959, etc.] over women with extensive endometriosis, pelvic and abdominal cavity, evolved as a result of hit in the abdomen menstrual blood from the stand-alone extension of the horns of the uterus, or if no message of the uterus from the vagina, also confirm validity of transplantation theory.

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