ENDOMETRIOSIS AND ITS TREATMENTS

 

Do you suspect "growth of the inner layer of the uterine wall", but you do not know what endometriosis is? Then all that is written below is very useful information that will be useful in the course of further medical and diagnostic measures. The giandliverconsultants provide the best gastrointestinal consultants in USA.

Endometriosis is a hormone-dependent pathology of the female body, which is characterized by the emergence of benign growths of tissue, the functional properties, structure, color, etc. of the endometrium. The risk area for endometrioid disease includes the pelvic organs in women - ovaries, fallopian tubes, rectal ligaments, rectosigmoid part of the lower intestine and bladder.

Classification

There are several classifications of endometrial diseases. However, the main ones are the classification according to the spread of the disease and the classification according to the depth of the damage to the tissues of the uterus and periuterine organs.

Typology due to the spread of pathology distinguishes:

Genital endometriosis, which in turn is divided into internal endometriosis (affects the uterus) and external endometriosis (can affect the ovaries, fallopian tubes, vagina and external genitalia).

Extragenital endometriosis is a rare variant of endometrioid disease in which tissue grows in various organs of the pelvic peritoneum and even outside the reproductive system (intestine, appendix, pleural cavity, skin and other organs).

Etiology

The causes of endometriosis have not been fully studied. It is believed that its development is influenced by a number of factors, which include disorders of the immune system, humoral regulation, metabolism and others.

Development risk groups are persons who have:

·         hereditary predisposition;

·         childbearing age;

·         menstrual disorders, anovulation;

·         metabolic disorders;

·         endocrine pathologies;

·         exhausted and weakened body;

Overweight

The disease develops against the background of numerous abortions, late or complicated childbirth, and is also common in women who choose this type of contraception as the IUD.

Pathogenesis

Pathogenetic justification for the development of endometriosis includes 2 main aspects:

Genetic predisposition associated with endometrial metaplasia and realized against the background of hormonal and immunological changes in the body.

Transport factors

The development of heterotopias in the future may follow the general scenario: implantation, progressive invasion, lymphogenic and / or hematogenous dissemination. Disorders in the functioning of the immune and reticuloendothelial systems play a significant role in the mechanism of occurrence and development of genital endometriosis. The giandliverconsultants provide the best Ercp in USA.

Clinical manifestations (symptoms)

The clinic of endometriosis is characterized by a variety of manifestations due to the variety of forms, severity, focus of the disease. However, in patients with endometriosis, the symptoms are similar. Therefore, we can identify common signs of endometriosis.

·         Algodismenorrhea;

·         Hypermenorrhea;

·         Uterine bleeding;

·         Irregular menstruation;

·         Discharge with blood between periods;

·         Other pathologies of menstruation;

·         Paleness and yellowing of the skin and mucous membranes;

·         Manifestations of dysuria;

·         Progressive weakness, fatigue;

·         Fix;

·         Chills;

·         Pelvic pain of varying severity and duration (permanent, worse before and during menstruation);

·         Increase in body temperature for a long time in the range of 37.1-38.0 ⁰c;

Complication

The main complication of endometriosis is difficulty conceiving, which leads to infertility. Therefore, if a woman has been diagnosed with mild to moderate endometriosis but is planning to have a baby, no doctor will advise you to delay pregnancy. The development of endometrioid implants leads to premature depletion of ovarian reserve and premature ovarian depletion syndrome.

Diagnosis

Diagnosis of endometriosis is based on physical examination, history taking, gynecological examination, histological and instrumental diagnosis.

When collecting anamnesis, special attention is paid to age, genetic predisposition to endometriosis (heredity), the first menstrual bleeding (menarche), pregnancies and abortions, the presence of gynecological and extragenital diseases.

Instrumental diagnosis of endometriosis:

·         Colposcopy;

·         Dopplerometry;

·         Ct;

·         Mrt;

·         Diagnostic hysteroscopy;

·         Metrosalpingography;

·         Ultrasound examination of the uterus and ovaries;

Treatment

Treatment of endometriosis includes conservative and surgical methods.

Drug therapy includes hormonal, vitamin and immunotherapy.  The giandliverconsultants provide the best stent in esophagus in USA. In such cases, doctors of the MEDICOM clinic use in their practice such hormonal drugs as: oral contraceptives (estrogen-gestagen drugs), progestins and antiprogestins, antiestrogens, gonadotropin agonists, gonadotropin inhibitors. The main purpose of the use of hormones in the treatment of endometriosis is the development of atrophic changes in the tissue of endometrioid heterotopias. But, in addition, conservative drug treatment is aimed at:

·         Removal of pain and discomfort.

·         Calming effect / relieving emotional tension.

·         Elimination of the inflammatory process.

·         Normalization of the functioning of the pituitary gland, hypothalamus, adrenal glands, thyroid gland and other organs and systems.

·         Improving the work of the genitourinary system.

·         Correction of neurological disorders.

Surgical treatment of endometriosis and the choice of type of surgery are determined by age, condition of the patient's reproductive system, location and degree of tissue damage. Removal of endometriosis involves maximum mechanical removal of pathological foci.

Types of surgical interventions:

·         laparoscopic surgery;

·         mini-laparotomy;

·         sacroiliac denervation;

·         presacral neurectomy.

The least traumatic way to promptly eliminate the problem is laparoscopy. The optical capabilities of the laparoscope allow you to recognize and remove even the most inaccessible foci of endometriosis. However, with common and combined forms of endometriosis, large endometrioid cysts, as well as the presence of other contraindications to the use of laparoscopic surgery is impossible. It is then that laparotomy is used, which is an invasive cavity operation.

Complex therapy also involves the presence in the list of special gymnastics appointments, being in the fresh air, no stress (mental, mental, physical), treatment of concomitant diagnoses.

The results of ultrasound diagnosis of the uterus and ovaries with the assessment of the thickness and structure of the inner mucous membrane of the uterus.

Pregnancy planning

The main thing in the treatment of endometriosis - to preserve or restore the integrity of the fallopian tubes and their patency - without this it is impossible to conceive naturally. Hormone replacement therapy allows you to restore the ovaries and the maturation of follicles in them. After discontinuation of such therapy, the ovaries begin to function normally. The giandliverconsultants provide the best liver consultants in USA.

After laparoscopy of endometriosis, the symptoms of the disease are relieved, the reproductive capacity of the body is restored.

Prevention

To prevent endometriosis, visits to the gynecologist should be systemic and occur at least once every six months. Also, it is necessary to timely treat genital diseases, even the most minor.

Intrauterine contraception should be avoided in young women in cases of adverse hereditary endometriosis. For women at risk, select progestogen and estrogen-progestogen contraceptives.