All diseases of the female genital organs are dangerous to health, can lead to infertility. Particular attention should be paid to endometriosis, since the symptoms are often nonspecific and may mask other pathologies.
With a hidden course, there are no signs of uterine endometriosis. Therefore, regular preventive examination by a gynecologist is the best way to prevent the disease.
Uterine endometriosis - the essence of the problem
All hollow organs have an inner layer, in the uterus it is called edometry. These cells are specific. Their main feature is the ability to cyclically change under the influence of sex hormones. As a result, the inner layer is rejected, menstruation begins.
The endometrium in a healthy body is found only in the uterus. If these specific cells are found outside, we can safely talk about endometriosis.
Regardless of location, whether it is the peritoneum or bladder, cells are exposed to sex hormones every month. Rejection is accompanied by microbleeding, which leads to an inflammatory reaction, and subsequently to the formation of adhesions, scars. Therefore, the first symptom of uterine endometriosis is pain.
Cells of the inner layer of the uterus can grow in almost any organ, therefore, the following types of endometriosis are distinguished:
• Genital (growths are detected in other organs of the reproductive system).
1. Internal - changes do not extend beyond the uterus, the endometrium is found in the muscle or serous layer.
2. External - the ovaries, tubes, vagina, ligamentous apparatus are affected.
• Extragenital (endometrial cells are found in the bladder, kidneys, intestines, lungs, that is, outside the reproductive system).
Causes of uterine endometriosis
To date, scientists have not been able to identify a specific mechanism, which leads to the appearance of uterine cells in other organs. But there are a number of predisposing factors, which together can lead to the onset of the disease.
• Heredity. If one of the relatives suffered from endometriosis, the woman immediately falls into the risk group. The likelihood of developing the disease increases by 4-5 times.
• Genital surgery. During surgical interventions (diagnostic curettage of the uterus, cesarean section, the establishment of spirals, abortions), the inner layer of the uterus is damaged. Endometrial cells with blood flow can spread throughout the body, followed by proliferation in another organ.
• Reverse menstrual flow. The phenomenon of retrograde menstruation has been described for a long time and is well studied. A small amount of blood, along with endometrial cells, passes through the fallopian tubes into the abdominal cavity. This phenomenon is observed in almost all women. But in the presence of a genetic predisposition, disorders of the immune system, the endometrium can grow in an atypical place.
• Hormonal disorders - one of the causes of uterine endometriosis. Under the influence of high doses of estrogen, there is a risk of cell degeneration. In the medical literature, cases have been described where endometrial cells were detected in men with estrogen treatment for prostate cancer.
• Immunity - an important link in the development of the disease. Violation of the immune response, cellular defense factors in combination with other factors leads to pathology.
• Genetic disorders of development, differentiation of organs. Reproductive, excretory system, peritoneum have a common origin. In the process of development, mutations, genetic errors can occur, as a result of which cells of the inner layer of the uterus are found in other organs.
There is no single reason for the occurrence of uterine endometriosis. This pathological process develops under the influence of a combination of factors. Therefore, treatment should be comprehensive.
The first symptoms of uterine endometrosis
In most cases, the disease has a characteristic clinical picture, but sometimes it develops asymptomatically, which complicates the diagnosis and treatment of uterine endometriosis.
• Pain occurs a few days before menstruation, reaches a maximum during uterine discharge, gradually decreasing. Sometimes the pain is so strong that it leads to nausea, loss of consciousness. Their most frequent localization is the lower abdomen.
• If pain occurs during bowel movements, the rectum may be affected, with urination, the excretory system, and in the umbilical region, the intestine.
Note! If painful sensations intensify during intercourse, the lesion is most likely located in the adjacent space.
• Cycle disorders are an important sign of uterine endometriosis. The discharge is plentiful, lasts about a week, uterine bleeding is possible. The duration of the menstrual cycle is reduced to 25-28 days.
• Infertility is the main complaint of most women. This is facilitated by the chronic inflammatory process in the ovaries, tubes, which ends with the formation of adhesions. Violations of the immune and hormonal systems only worsen the situation.
Endometriosis is one of the main causes of infertility, giving way only to inflammatory diseases of the reproductive system.
• One of the first symptoms of endometriosis is the presence of an impurity of blood in the feces, urine, and tears. These signs are inconsistent, are rare with damage to the corresponding organs (intestines, bladder, eyes).
Diagnosis of uterine endometriosis
After the occurrence of the above complaints, a doctor's consultation is necessary.
It is difficult to make a diagnosis, since it is not always possible to detect a focus of pathological changes. For this, additional diagnostic methods are used.
Based on the patient's complaints, the doctor determines which organ or system is more likely to be affected.
• Gynecological examination allows you to assess the condition of the vagina, cervix, external genitalia.
• It is necessary to do not only pelvic ultrasound, but also abdominal organs in order to exclude extragenital damage.
• Colposcopy. If the foci of endometriosis are located in the vagina or on the cervix, cyanotic "eyes" will be found during the study - small areas of dark color.
• Hysteroscopy allows you to examine the uterine cavity.
• When symptoms indicate damage to the rectum, bladder, an examination of the appropriate organ is performed.
• Laparoscopy is the last stage of diagnosis. This surgical method is also used to treat uterine endometriosis. At the first stage, small incisions are made on the skin of the anterior abdominal wall. Using a special device, the abdominal organs are examined. If suspicious areas are identified, a biopsy is taken (a piece of tissue for examination), the affected tissues are removed.
The main methods of treatment of uterine endometriosis
The treatment of edometriosis is a complex process that takes a lot of time and does not guarantee complete recovery. In most cases, both medical treatment and surgical treatment are used. The choice of tactics depends on many factors:
• Age of the patient.
• The presence of children and the desire to have them in the future.
• The location of the sites of endometriosis, their size, quantity.
• Duration of the disease.
• The severity of symptoms, the presence of complications.
Medication for uterine endometriosis
The effectiveness of the conservative treatment of uterine endometriosis is low, especially in severe cases.
More often this is the preparatory part before surgery.
If the disease is detected in the initial stages, changes in the internal organs are minimal, with the help of medications it is quite possible to achieve recovery.
In medical practice, progesterone preparations, gonadotropin-releasing hormone, combined oral contraceptives are used. Non-steroidal anti-inflammatory drugs are indicated to reduce pain.
Surgical treatment of uterine endometriosis
The main task of surgical intervention is to preserve healthy tissues and the function of childbearing as much as possible. During the operation, the affected areas are excised. In severe forms, the surgeon decides to remove the uterus with appendages.
Prevention of uterine endometriosis
To prevent the development of the disease, it is necessary to follow simple recommendations:
• Timely treat inflammatory diseases of the reproductive system.
• Choose the optimal method of contraception, intrauterine devices increase the risk of disease.
• Personal hygiene.
• Abortions, diagnostic curettage contribute to the development of the disease. Avoid these procedures whenever possible.
• After surgical interventions, laparoscopy, a course of treatment with oral contraceptives is necessary.
There is no specific prophylaxis for uterine endometriosis. It is in the woman’s strength to adhere to the above rules and visit the gynecologist prophylactically once a year.
