Stein - Leventhal syndrome

Stein - Leventhal syndrome - scleractinia changes ovarian cancer in combination with endocrine disorders, disturbances of the menstrual cycle. Sick women at a young age. The cause of the disease is not installed. The process is characterized by a profound violation of correlation between the ovaries, the pituitary and adrenal glands.
For syndrome Stein - Leventhal characteristic: scleractinia, large, thick ovaries, persistent violation of the menstrual cycle, often in the form of amenorrhea, optimizarea, rarely uterine bleeding after delay menses, infertility; sometimes there obesity, hirsutism (see). Diagnosis requires a great experience and dynamic monitoring of the patient.
Treatment - hormonal and surgical (wedge resection 1/3 - 2/3 of the ovaries). In most patients after 1-3 months. after the operation is set to normal menstrual cycle, and many possible pregnancy. Immediately after the operation within 6-8 months is recommended to prevent pregnancies.

Stein-Leventhal syndrome (I. F. Stein, M. Leventhal) - large scleractinia ovaries (for the most part with the lack of yellow body - big gray ovaries); changes in the menstrual cycle in the form of amenorrhea or very rare (at intervals of 3-5 months. and more) menstruation; infertility; in varying degrees expressed hirsutism. Large scleractinia the ovaries are a special form of the disease and differ from ooforit inflammatory conditions and small cystic changes in the ovaries.
In the follicles sclerocystic ovarian find degenerative changes, many small cysts in the magnitude of millet grain to cherry, little primordial follicles, thickness, poor cores current. Endometrium often atrophic or defunct, rarely in the stage of proliferation, sometimes there geleisteten hyperplasia.
The formation of large, gray ovarian not determined for sure. There is an assumption that fibroid growth in the ovary are congenital. Fibrous tissue tunica albuginea prevents maturing follicles; follicles do not burst, degenerate, forming cysts with a thin layer of granular tissue; ovulation does not occur. The follicles of the surface layers suppress the development of the follicles that are in deeper zone.
Stein-Leventhal syndrome is usually women of young age. The most common symptom of this disease is considered a amenorrhea (primary or secondary). However, the nature of menstrual function is very different: there are infrequent menstruation, less frequently, bleeding, loss of circularity. Characteristically, the menstrual cycle in these patients is not restored even under the influence of long-term treatment with hormones. The menstrual function is not always the primary, it may occur after a certain period of time after the establishment of the menstrual cycle, and even after a normal delivery. The uterus may be normal values, reduced and in some cases increased. In most cases determined by bilateral ovarian enlargement, less one-sided, in some cases, they are normal size. Determined by palpation ovaries thick consistency, the surface is not smooth, they are mobile and painless.
In addition to the violation of the menstrual cycle, increase of one or two ovaries, found verily syndrome, accompanied by obesity and hirsutism, i.e. such pathological symptoms that develop during hyperplasia, or tumors of the adrenal cortex, the syndrome Itsenko - Kushinga, arrhenoblastoma.
Hirsutism is quite a common symptom observed in these patients, however, the intensity of its different. Vegetation is often in the legs and abdomen. Abnormal hair growth is celebrated on the breast, back, thighs and face.
Gynecological examination in most cases there is the normal development of the external genital organs.
For further diagnosis study ovarian function tests of functional diagnostics (rectal temperature, the phenomenon of " maybe", colpocytology, histological examination of scraping mucous membrane of the uterus). Produce x-ray examination area of the Turkish saddle, examine the urine and 17-ketosteroids. If bimanual study ovarian enlargement is not detected, and patients have symptoms characteristic of the syndrome Stein-Leventhal, for further diagnosis produce kuldo - or laparoscopy.
When ovarian the Genesis of the syndrome showing surgery - wedge resection of the ovary. In most cases the operation is efficient. It is recommended prior to surgery to have a course of courtisanerie so that the amount of 17-ketosteroids decreased to 6-8 mg
The operation method is also known role in the normalization of menstrual and reproductive functions. So, excision minor part of the ovaries is less effective than significant resection, leaving the gate of the ovary. After resection of the ovaries recommended temporarily (6-8 months). to prevent pregnancies.
The belief that the high figures excretion of 17-ketosteroids before surgery are unfavorable for the pregnancy is not confirmed. Syndrome Stein-Leventhal meet and combined forms of violations with Unsharp pronounced changes ovarian function in combination with dysfunction of the adrenal cortex. Out of urine 17-ketosteroidov Unsharp increased while increasing output pregnandiol, These forms syndrome Stein-Leventhal treated with prednisolone.