Endometriosis

Endometriosis is a heterotopy of the endometrium in organs and tissues, where it normally does not exist. The implantation theory of endometriosis is the leading one; The torn off areas of the endometrium are implanted into other tissues and organs; It is possible to carry the hematogenous way. Endometrioid inclusions can be observed in the thickness of the uterus (adenomyosis), in the lumen of the fallopian tubes, on the pelvic peritoneum with germination into the underlying tissues (rectovaginal septum), in the vagina, cervix, ovary with the formation of cysts ("chocolate" cysts), scars after cesarean Sections, rarely - in the organs and tissues far from the uterus. Often, endometriosis is accompanied by perifocal inflammation. The spread and development of endometriosis is closely related to the function of the ovaries. With natural or artificial menopause, foci of endometriosis undergo reverse development.

Symptoms, course. Pain and enlarged formations and organs affected by endometriosis during menstrual bleeding. Then the pain subsides, and the education decreases. Adenomyosis is characterized by hyperpolymenorrhea. These symptoms are due to premenstrual swelling and partial rejection of endometrioid cells and entirely depend on the cyclic activity of the ovary, with the onset of menopause disappear. Recognition is based on the detection of cyclic symptoms that correspond to the menstrual cycle, and changes in the volume of formations. Sometimes it is possible to identify adenomyosis in radiography of the uterus with a water-soluble contrast agent (diodone, cardiotrust), produced on the 3-4th day of menstruation.

Treatment. Conservative treatment is based on the use of hormonal drugs that cause suppression of ovarian function. Young women use combined estrogenogestagens (bisekurin, non-vellon, etc.) according to the scheme: from the 5th to the 26th day of the cycle for 10-12 months, and then take a break for 6 months and again repeat the courses. Useful remedies that enhance the immune system's resistance (levamisole 0.05 g 3 times a day for 3 days, then a weekly break and another 2-3 similar courses). In women older than 40 years you can use androgens (methyltestosterone 5 mg4 times a day for A-6 months) or roentgenocastratsii. To surgical treatment resorted to the formation of ovarian cysts, with adenomyosis of the uterus, accompanied by bleeding, or with endometriosis rectovaginal fiber with germination in the gut. The surgical treatment should be preceded by hormonal therapy, and only in the absence of effect during the observation for 3-4 months the operation is performed.

The prognosis for life with timely treatment is favorable.