Endometriosis of the body of the uterus - what is it in an accessible language and what you need to know about this pathology. Clinical ultrasound signs of uterine endometriosis

The date: 24.04.2019

To understand the essence of the disease, it is necessary to understand the key medical terms.

Let's consider the most basic ones.

endometriosis- one of the common diseases in gynecology, in which endometrial cells grow in the thickness of the uterus or even go beyond the reproductive system.

endometrium- the mucous membrane that lines the walls of the uterus. The rejection of the endometrium regularly every month during menstruation is considered the norm.

Myometrium- muscular tissue of the uterus.

Causes of pathology

Scientists do not name the exact reasons contributing to the development of such a pathology, but among them there are:

hormonal background, or rather its violation. In the event of a malfunction endocrine system, estrogens - female sex hormones in the ovaries are formed much more than normal. Endometrium in the first half menstrual cycle fills the thickness of the uterus, and when rejected causes severe bleeding.
weakening of the immune system. With reduced immunity, the body does not effectively fight the reproduction of endometrial cells.
frequent abortions, curettage, surgical interventions. Various operations damage the integrity of the membrane. And, despite its recovery, scar tissue contributes to the germination of endometrial cells.
menses. Prolonged heavy menstruation, early puberty can also cause the development of the disease. Discharge during menstruation contains not only blood, but also particles of the endometrium. At heavy bleeding discharge not only finds an exit through the vagina, but also enters the abdominal cavity. Normally, these cells are destroyed, and in pathology they are able to be fixed in the tissues of various organs.
stress, environmental impact, food quality. stressful situations, toxins and backbreaking physical exercise on the body lead to hormonal disorders.
hereditary factor. At risk are girls whose mothers, grandmothers or sisters suffered from a similar ailment, or in case of an anomaly in the structure of the genital organs. Pulling pain in the lower abdomen in girls may appear 2-3 years before the onset of the first menstruation.

How to recognize endometriosis

The first signs that should alert a woman are deviations from the regular menstrual cycle, pain during menstruation and during sexual contact.

2-3 days before and after menstruation, spotting with blood may appear. Often bleeding occurs in the middle of the cycle. Menstruation becomes more abundant and painful.

If the patient already advanced stage, endometrial cells can affect the bladder, rectum and, as a result, cause pain during urination and defecation. After menstruation pain syndrome usually subsides, but this is not a reason to postpone a visit to the doctor. If you notice at least one of the signs, be sure to get tested.

Forms of endometriosis

Endometriosis of the body of the uterus is divided into diffuse, focal and nodular form.

The diffuse form of endometriosis is characterized by a uniform compaction of the walls of the uterus, affecting each layer. The most difficult in terms of therapy is diffuse endometriosis of the body of the uterus. However, the most common focal form occurs, in which either the anterior or back wall uterus. In the thickness of the myometrium, one can also find small or large nodules that do not have definite boundaries. In this case, there is a nodular form of endometriosis of the uterus. Due to these neoplasms, the uterus increases in size. But for the appointment of a course of treatment, there is practically no difference between the focal and nodular form of the lesion.

With a diffuse form, pathological processes can cover different depths of the walls of the uterus. In connection with what distinguish the following degrees distribution:

first degree - shallow lesions of the myometrium;
second degree - the depth of the lesion reaches the middle of the myometrium;
third degree - the uterine wall is completely affected, pathological changes.

affect the fallopian tubes, ovaries, adjacent organs.

How is uterine endometriosis diagnosed?

Diagnosis of the disease is complicated by a number of reasons.

First, asymptomatic, you can skip the initial stage.
Secondly, the symptoms of the disease may be similar to other gynecological pathologies.

For an accurate diagnosis, it is necessary comprehensive examination. It consists of a gynecological examination, ultrasound of the pelvic organs and abdominal cavity, colposcopy and laparoscopy.

The development of the disease occurs gradually, each time worsening the woman's well-being. By identifying endometriosis of the uterine body of the 1st degree, you can permanently get rid of the disturbing symptoms and eliminate the problem. Unfortunately, this is extremely rare, and happens for the following reasons:

obvious signs of the disease do not bother the patient;
pain during critical days woman equates to periodical women's days and is not considered as a pathology;
when undergoing an ultrasound scan, the doctor may not notice the changes, because they are extremely insignificant;
no problems with conception.

The most reliable results will show ultrasound procedure and laparoscopy. So, to make a diagnosis, the doctor pays attention to the echo signs characteristic of internal endometriosis:

"Round uterus", that is, increased in size;
thickening of the walls of the uterus
the presence of open uterine cysts.

Treatment

As a treatment, hormone therapy is used to stop the growth of the endometrium for a while.

Treatment is selected based on the severity of the disease, the age of the woman and her plans related to pregnancy planning. After all, while menstruation and active hormonal work of the ovaries take place, the disease can return again and again. It is possible to guarantee complete relief from the problem only after the onset of menopause. For surgical intervention, the most gentle on this moment method

All about endometriosis from Elena Malysheva, video

Consequences of endometriosis

In the absence of proper treatment, the consequences of endometriosis of the body of the uterus are very dangerous.

First of all, endometriosis can lead to problems with conception or provoke difficulties in bearing a child. Pregnancy does not occur as a result of adhesions formed and dysfunction of the egg. Spikes are the result of continuous inflammatory process blocking the patency of the fallopian tubes.
In another case, the process of fertilization is hampered by the presence of endometrioid lesions on the ovaries. The process of maturation of the egg is disrupted. Foci of endometriosis can affect the quality of eggs, as well as prevent the attachment of a fertilized egg. With a hormonal imbalance, ovulation may not occur at all.
The possibility of pregnancy in women with a similar diagnosis remains. However, it will be extremely difficult to carry a child safely. Significantly increases the risk of developing ectopic pregnancy or miscarriage.

In most cases, endometriosis is treatable and the problem of infertility is eliminated. Only in the most advanced cases, when all methods of treatment have been tried, the uterus has to be removed.
Every woman should monitor the regularity of her menstrual cycle and undergo routine examinations.

Endometriosis is a benign growth of the endometrium beyond its adequate localization (mucous membrane of the body of the uterus). Genital endometriosis is one of the most common diseases of the genital organs in women, along with uterine fibroids and inflammatory diseases of the appendages.

Who is at risk?

Endometriosis is a polyetiological disease. There are several theories of the origin of endometriosis foci, the main of which are transport and embryonic.

Based on these theories, it is possible to identify the main causes of endometriosis

Implantation and growth of endometrial cells outside the uterine mucosa occurs against the background of hormonal and immune dysfunctions.

The main risk factors for the development of the disease are identified

Heredity (endometriosis in mother, sister).
Immune and hormonal imbalance.
Late start of sexual life.
Inflammatory processes of the genital organs.
Various manipulations on the uterus.
Prolonged use of the IUD.
Late onset of menstruation.

The first signs of endometriosis

Experts have identified the most characteristic symptoms

With severe pain during menstruation, copious secretions, discharge outside of menstruation, you must consult a doctor and in no case self-medicate.

Modern diagnostic methods

Diagnosis of endometriosis is carried out on the basis of a patient survey: complaints, anamnesis (endometriosis in close relatives, childbirth, abortion, use of the IUD, inflammatory diseases of the genital organs).

Laboratory and instrumental methods diagnosis of endometriosis

Hormonal studies.
Ultrasound procedure.
Colposcopy.
Hysterosalpinography.
Laparoscopy.
Magnetic resonance and computed tomography.

Hormonal studies : determination in the dynamics of the concentration of FSH, LH, progesterone, estradiol.

Manifestations of endometriosis of the uterus during ultrasound examination: echo-negative tubular structures extending from the endometrium to the myometrium, irregularity of the basal layer of the endometrium, small oval or round hypoechoic structures in the basal layer, asymmetry in the thickness of the walls of the uterus, an increase in its size, the appearance of areas in the myometrium increased echogenicity and other signs

Ultrasound signs of ovarian endometriosis: finely punctate internal structure, rounded shape of the formation with a double contour, location of the formation to the side and back of the uterus, echo-dense capsule of the cyst, no changes in the echo structure during examination in dynamics at different periods of the menstrual cycle.

In colposcopic examination with endometriosis of the cervix, the following are noted: pseudo-erosion with hemorrhagic contents, endometrial foci different shapes and size, polypoid lesions in the area of the cervical canal.

Hysterosalpinography carried out on the 5-7th day of the cycle. Signs of internal endometriosis: the uterine cavity is an irregular triangular shape.

Laparoscopic picture of endometriosis determined by the degree of spread of the pathological focus and the duration of its existence. Modern optical technology makes it possible to diagnose foci of endometriosis on early stages.

MRI and CT make it possible to determine the localization and nature of endometriosis. In the myometrium, formations without clear contours are noted, inside the pathological foci there are high-intensity signals. With endometriosis of the ovaries, a dense capsule with uneven contours is determined.

Answers of specialists to all questions on symptoms and diagnosis

Are there necessarily pains with endometriosis, and what kind of pains indicate endometriosis in women?

Pain in endometriosis depends on the location of the pathological focus. Drawing pain in one side, pain when lifting weights may indicate the development of endometriosis of the ovary. With endometriosis of the uterus, pain coincides with menstruation. The intensity of pain sensations is different: from mild pressing or pulling to strong spasmodic.

Can pain during intercourse be a sign of endometriosis?

Yes, endometriosis can occur pain during sexual intercourse.

What discharge can be with endometriosis in women?

With endometriosis, between periods, there may be bloody issues dark (sometimes brown and even black) color. The discharge also changes during menstruation: they become more abundant and darker.

How often should I be tested for endometriosis?

An annual preventive examination by a gynecologist is recommended for all women. If you have symptoms characteristic of endometriosis, you should consult a doctor as soon as possible for diagnostic studies and timely treatment.

Reviews of women

First, the pain appeared during menstruation. Although before endometriosis, menstruation was painless. But then the pains appeared even before menstruation, in the lower abdomen, in the lower back, very strong. There was also a slight discharge between periods. Based on the symptoms and ultrasound, the patient was diagnosed with endometriosis. Now I drink hormonal, pains are not present. If I don't get pregnant within six months, I'll go for a laparoscopy.

I had no symptoms as such, only pain during menstruation. And I thought it was ok. But I couldn't get pregnant for 3 years. Laparoscopy revealed endometriosis.

Symptoms may vary. I had very heavy bleeding and severe pain during menstruation, hormones are normal. They did hysteroscopy and ultrasound. Ultrasound showed a strong increase in the uterus. I am writing in the past tense, because now I am being treated with drugs that cause an artificial menopause. I feel better and hope for a full recovery.

I had irregular periods with fever severe pain. The diagnosis was made by ultrasound, then confirmed by laparoscopy. I am currently undergoing hormone therapy. Then I plan to get pregnant.

Endometriosis is a serious gynecological disease that is asymptomatic in the early stages. Pathology is characterized by the growth of the mucous layer of the uterus (endometrium), while the lesions spread throughout the abdominal cavity, interfering with the normal functioning of vital organs and systems. At early diagnosis and timely treatment development can be prevented severe complications, save female reproductive functions.

First of all, the patient should be alerted by long-term and painful menstruation, spotting between cycles, pain during sex. These are the first signs that may indicate the presence of endometriosis. With these symptoms, a woman needs to urgently consult a gynecologist. It is important to undergo a comprehensive examination in a timely manner using the necessary diagnostic methods.

Ultrasound examination is prescribed in the first place, but whether it is possible to see endometriosis on the monitor is a moot point. In the early stages of pathology reproductive organs practically not observed structural changes. Therefore, an accurate diagnosis can be made only after complete examination. If you suspect the development of pathology, when to do an ultrasound should be determined by the doctor, since changes in the endometrium during the cycle affect the results of the examination.

Ultrasound is one of the primary methods for diagnosing endometriosis, allowing you to confirm the preliminary diagnosis, which was made on the basis of an examination by a gynecologist. Ultrasound diagnostics gives a complete picture of the state of the pelvic organs, and also allows early detection of pathological processes in the muscular and mucous membrane of the uterus.

An ultrasound examination is prescribed by a doctor if the patient has symptoms such as:

pain in the lower abdomen and lower back, which tend to increase during menstruation;

the presence of spotting between periods;

increase in the period of menstruation and the amount of discharge;

prolonged absence of pregnancy.

Carrying out ultrasound diagnostics

Ultrasound diagnosis in case of suspected development of the disease is carried out in two ways: transabdominal and transvaginal. The first involves conducting research directly through the anterior abdominal wall, the second - the introduction of a special sensor into the vagina. To conduct an ultrasound diagnosis of endometriosis, the transvaginal method does not require any preliminary preparations. A transabdominal examination is usually performed with a full bladder, so 2 hours before the procedure, you need to drink about a liter of water and do not go to the toilet.

On which day of the cycle it is better to do an ultrasound scan for endometriosis - the doctor should determine. Pathology develops in the inner layer of the uterus (endometrium), which is rejected during menstruation and excreted with menstruation from female body. Immediately after menstruation, the thickness of the endometrium is only 2-5 mm, in the middle of the cycle it increases to 9-13 mm, and in the second half it thickens to 20 mm. It is recommended to do a scan no earlier than a week after the end of menstruation. But since every day the endometrium thickens and becomes thicker, only the attending physician can determine when to do an ultrasound in your case.

Many gynecologists agree that the diagnosis of endometriosis of the uterus will have more reliable results in the second half of the menstrual cycle (by day it is 14-20 days). It is at this time that the echogenicity of pathological foci increases, which simplifies their detection.

results

Can ultrasound show endometriosis? When conducting a diagnosis, the doctor examines the following parameters:

the size of the reproductive organ;

outer contour of the uterus;

punctate structure of internal tissues;

echogenicity of the muscular layer of the uterus and its cavity;

changes in the cervix and fallopian tubes;

the condition of the appendages;

the presence of nodular seals.

Roughness and fuzziness of the contour of the uterus indicates the presence of a pathological process. In a healthy woman, the normal parameters of the uterus are as follows:

length - 7 cm;
width - 6 cm;
thickness - 42 mm.

Deviations from these parameters indicate the presence of a pathological process. With endometriosis, uneven thickening of the uterine walls is clearly visible. How pathological foci look, and the changed structure of the uterus, see the photo.

Normally, the echogenicity of the endometrium has a uniform, uniform character, and the uterine cavity should have a uniform structure and smooth edges. Detection of hyperechoic structures on ultrasound indicates the presence of endometriosis. The presence of the disease can also be indicated by changes in the structure of the cervical canal and the cervix itself, which normally has a length of 4 cm and a homogeneous echostructure. On ultrasound, you can see all the deviations from the norm.

With the help of ultrasound examination, the localization of pathological foci is determined. The most common form is ovarian endometriosis. Ultrasound can detect polyps and cysts of endometrioid origin, determine their structure and size. This is important in cases where differential diagnosis. Due to the structural similarity of endometrioid neoplasms with luteal and hemorrhagic cysts, it is often difficult to make an accurate diagnosis.

It should be noted that despite high efficiency ultrasonic method diagnosis, endometriosis on ultrasound can not always be detected, especially if there are small foci located in the deep layers muscle tissue organ. Therefore, the results of an ultrasound examination are not an absolute confirmation of the absence of pathology.

To clarify the diagnosis, a woman must undergo a comprehensive examination using instrumental and laboratory diagnostics. Patients diagnosed with endometriosis during treatment should be systematically examined for ultrasound, this allows us to evaluate the effectiveness of the therapy. In order to prevent each woman is recommended to regularly visit the antenatal clinic.

Endometriosis of the body of the uterus is a disease characterized by a pathological process of growth of endometrioid tissue outside the uterine cavity.

Other names for pathology - internal endometriosis, endometriosis of the uterus and.

Normally, the endometrium lines the interior of the uterus. During fertilization, the function of the endometrioid tissue is to hold the embryo in the uterus. If conception does not occur, the endometrium exfoliates and comes out along with menstrual flow monthly.

In the pathological process, endometrial cells move to other organs of the small pelvis, continuing to function there.

Endometriosis of the body of the uterus in some cases occurs in combination with other diseases - endometrial hyperplasia and.

Causes

The exact cause that contributes to the development of endometriosis has not been established. It is believed that provokes the development of the disease in most cases, a hereditary factor, that is, a genetic predisposition to the development of endometriosis.

Other factors contributing to the occurrence of pathology:

curettage of the uterus - according to indications or during artificial termination of pregnancy;
prolonged use of an intrauterine contraceptive device;
violation of the natural hormonal balance in the body;
inflammatory and infectious disease pelvic organs;
decrease in the immune forces of the body.

The following types of diseases are distinguished:

Diffuse (diagnosed in 80% of patients).
Diffuse-nodular (occurs in about 10% of women).
Focal (diagnosed in 7% of patients).
Nodular (this form occurs in a small part of patients - 3%).

Depending on the degree of damage, diffuse endometriosis is divided into stages:

1 stage. Adenomyosis affects the submucosa internal cavity uterus and transitional zone.
2 stage. The spread of pathological foci to the myometrium, but they do not reach outer fabric uterus.
3 stage. The defeat of the entire muscular tissue of the uterus, up to the defeat of pathological cells of the serous membrane of the organ.
4 stage. The exit of endometrioid foci outside the uterus. Localization of lesions on other organs and tissues of the small pelvis.

Endometriosis of the body of the uterus and its symptoms

One of the symptoms of endometriosis of the uterine body is pain. Pain occurs in the lower abdomen, in the lower back. Its intensity depends on the day of the menstrual cycle. The strongest sensations

Other signs that may indicate the presence of endometriosis include:

pain during sexual intercourse;
prolonged menstruation;
spotting before and after menstruation;
spontaneous abortion in the early stages;
impossibility of conception, i.e. infertility;
bright - premenstrual syndrome.

Disease danger

The danger of the disease is as follows:

the development of anemia due to heavy periods;
infertility;
malignancy of endometrial lesions;
deterioration in general well-being, a decrease in the quality of life.

Is pregnancy possible?

The presence of adenomyosis in most cases prevents natural conception. But there are also cases of pregnancy in the presence of endometriosis of the uterine body, but it is combined with a high risk.

Causes of infertility with endometriosis:

violation of the normal functioning of the endometrium in the uterine cavity (an obstacle to the implantation of the embryo);
inflammatory process in the uterine cavity;
myometrial dysfunction;
ovarian dysfunction due to hormonal imbalance.

The onset of pregnancy after the course of therapy is not a 100% guarantee. If a woman is also given infertility after treatment, IVF is indicated in this case.

Diagnostic methods

Initially, a gynecological examination is carried out. An enlarged uterus can indicate the presence of endometriosis.

However, for an accurate diagnosis, a more detailed examination is necessary:

Ultrasound examination by transvaginal method.
Hysteroscopy and biopsy.
Laparoscopy.

Treatment Methods

Treatment is possible in two ways - medical and surgical.

In the first case, assign hormonal preparations, the purpose of which is:

elimination of symptoms of the disease;
reduction of endometrial lesions;
normalization of hormonal balance;
recovery reproductive function.

Used medicines:

Gestagens - Duphaston, Norkolut, Byzanne.
Combined oral contraceptives – .
Gonadotropin-releasing hormone (A-GnRH) agonists - Diferelin.
Progestogens - Depo-Provera.
Hormonal IUD (intrauterine device) -.
Antigonadotropins - Danoval, Danazol.

It should be borne in mind that the effect of drug treatment is often temporary. The disease is prone to relapse, and therefore there is a high probability that it will develop again over time.

Such therapy is aimed primarily at women planning a pregnancy in the near future.

In combination with hormones, painkillers and anti-inflammatory drugs, immunomodulators, and vitamins are prescribed.

If adenomyosis is asymptomatic, stage 1 or 2 is diagnosed, then expectant management makes sense. The woman is under the supervision of a doctor, hormones are not prescribed, and physiotherapy, immunostimulating drugs, anti-inflammatory drugs are prescribed as strengthening of the body.

The duration of hormone therapy is from three months to six months or more. In the absence of effectiveness, an operation is indicated.

Watch the video about the treatment of endometriosis:

Surgical intervention

The method of the operation and its volume depend directly on the form and stage of endometriosis, the desire of a woman to become a mother in the future.

Organ-preserving surgical intervention performed by laparoscopy. During the operation, endometrioid nodes are removed, as a result of which the walls of the uterus are restored. The disadvantage of this technique is an extremely high risk of recurrence of the disease.

The last resort in carrying out surgical treatment A hysterectomy is the complete removal of the uterus. Shown as a result of late diagnosis of adenomyosis and its advanced forms.

Indications for hysterectomy for endometriosis:

lack of effectiveness of hormone treatment;
intense pain;
uterine bleeding, what causes severe form anemia;
the presence in parallel with adenomyosis of endometrial hyperplasia, uterine fibroids and other pathologies;
unwillingness of the patient to give birth in the future;
suspected development of malignant cells.

Prevention measures

The following recommendations will help prevent the development of endometriosis of the uterine body or its recurrence:

use of contraception to avoid the need for abortion;
elimination of excess weight;
prevention of stressful situations;
increase the immune forces of the body;
quitting smoking, alcohol;
healthy food.

Endometriosis of the body of the uterus or adenomyosis is not a sentence. If you look after your women's health and contact the doctor in a timely manner, it is possible to identify the pathology in the early stages, which will allow you to successfully complete the course of therapy. And, on the contrary, the neglect of the disease leads to its further development and bad consequences, which will have to be eliminated only by surgery.

Endometriosis is in the TOP-3 in terms of frequency of occurrence among gynecological pathologies yielding inflammatory diseases and uterine myoma.

In the vast majority of cases, it is detected in women of childbearing age at the age of 25-45 years, less often in adolescent girls, very rarely in patients during menopause. Most often found in nulliparous women at the age of 30-40 years.

This pathology is difficult to diagnose, can be asymptomatic for a long time, so it is assumed that in fact it occurs much more often. In recent decades, there has been a trend towards "rejuvenation" of endometriosis.

Let's figure out what it is - endometriosis of the uterus in women - an explanation in plain language is presented in our article.

What is this disease

What does uterine endometriosis mean? Endometriosis is called hormonally dependent systemic disease caused by the growth of the glandular layer of the endometrium outside the uterine cavity. The course is long and recurrent.

The mucous membrane of the uterine cavity (endometrium) consists of a cylindrical epithelium and a connective tissue basal layer.

In the thickness of the endometrium is a dense capillary network and tubular glands. In a healthy woman, such tissue is located only in the uterine cavity.

For unknown reasons, fragments of glandular tissue, structurally and functionally similar to the endometrium, can be found on the surface or in the thickness of the walls of organs, where they do not normally exist. Such formations are called heterotopic.

Sites of heterotopy can be located in the muscular layer of the uterus, fallopian tubes, in the ovaries, on the walls Bladder, intestines, on the peritoneum and other organs of the small pelvis.

This tissue is subject to the same cyclic changes as the normal endometrium.. During menstruation, heterotopic areas of the endometrium bleed, this condition is accompanied by pain.

With each cycle, the size of the pathological formation increases., as the pathology progresses, other organs of the small pelvis may be involved.

Reasons for development

The disease is understudied, there is still no consensus on the causes and mechanisms of its development. Among the risk factors for the development of this disease are:

Actually The most common causative factors are hormonal disorders and violations immune protection in particular immunodeficiency states.

Prerequisites for the development and progression of pathology arise with an excess of estrogen and, as well as metabolic disorders of progesterone, hormones that regulate the normal course of menstrual cycles.

Live healthy! Endometriosis:

What is dangerous: consequences and complications if not treated

Is endometriosis dangerous for life and what does it lead to? very difficult, often patients develop secondary infertility.

Against the background of this disease, the formation of endometrioid is possible.

In advanced cases, they form adhesions in the pelvis and/or abdomen which can lead to or fallopian tubes.

In many patients due to heavy menstrual bleeding sustainable.

Depending on the location of the focus of pathology and its size, the course of the disease may be accompanied by symptoms of neurological disorders resulting from mechanical effects on the nerve roots and nerve endings.

In the absence of treatment, it is possible for the pathological tissue to grow through the wall of the uterus and its further spread to the pelvic organs.

Pathological endometrium is a benign formation, however, there is a possibility of tissue degeneration into malignant tumor, which happens about 12% of the time.

The presence of progressive endometriosis is one of the risk factors for developing oncological diseases in other organs not directly related to the lesion.

Classification of species and code according to ICD-10

Endometriosis code according to ICD-10 - No. 80.

Forms: diffuse, nodular and focal

Depending on the location of pathological foci the disease is divided into genital and extragenital forms.

The genital form is lesions of the internal genital organs, to extragenital - all cases of lesions of other organs.

With multiple lesions, the form of the disease can be classified as combined. Endometriosis of the uterus is one of the varieties of the genital form of the disease.

Uterine lesions can be external, when the tubes, cervix and internal are involved in the pathological process.

It affects the body of the uterus, pathological foci are embedded in muscle layer(myometrium). This type of disease is known as adenomyosis.

According to the nature of pathological foci distinguish between nodular, diffuse and mixed forms.

With diffuse lesions, pathologically altered tissues are located relatively evenly in the myometrium, without forming structures with clearly defined boundaries.

With a nodular form, the foci are clearly defined. With a mixed form, signs of both types of lesions are found in the myometrium.

1, 2, 3 and 4 degrees

According to the severity of the lesion, 1, 2, 3 and 4 stages of uterine endometriosis in women are distinguished:

I degree (initial stage). The lesions are single, superficial;
II degree. A few lesions penetrating into the tissue of the affected organ;
III degree . Multiple areas of pathological endometrium are found, lesions penetrate through the wall of hollow organs almost through and through;
IV degree– multiple lesions germinate serosa. The pathological process spreads to other organs.

Diagnostics

How to diagnose endometriosis of the body of the uterus, what tests are taken and examinations are carried out when making a diagnosis? non-specific and resemble the manifestations of others gynecological diseases.

During a routine examination, the doctor may find an increase in the uterus, with a nodular form of the disease, large nodes are palpated.

Transvaginal ultrasound examination standard procedure examinations for gynecological diseases.

Asymmetry of the thickness of the walls of the uterus, an increase in the size of the organ, diffuse and nodular pathological formations in the thickness of the myometrium are revealed.

Colposcopic examination allows you to identify lesions that have spread to the cervix.

Hysterosalpingography, radiopaque examination The uterus makes it possible to assess the patency of the tubes and the prevalence of lesions. It is carried out on the 5-7th day of the cycle.

Early stages of endometriosis can be detected by laparoscopy.

With insufficient information content of the main studies, the patient MRI or CT may be ordered. During the study, the exact localization and size of the lesions are revealed.

Conducted if necessary histological examination.

Blood test sometimes reveals an increase in ESR. Hormonal background differs from normal, patients have an increased level of luteinizing and follicle-stimulating hormones, prolactin with a simultaneous decrease in the level of progesterone.

Most hallmark pathology is increase in the content of a specific marker CA-125.

Is it possible to identify yourself and how to determine

Endometriosis is one of the most insidious gynecological diseases that may be asymptomatic for a long time.

The latent disease is often detected by chance, during an examination for infertility. Symptoms of pathology resemble manifestations of other gynecological diseases.

Intensity varies from vague discomfort to unbearable pain. Some patients may experience fainting, nausea, or vomiting.

Depending on the location of the lesion and the severity of the disease pain of varying intensity can occur during defecation and intimacy.

Endometriosis changes the menstrual cycle. Bleeding becomes more abundant and prolonged, the cycle is often reduced.

A few days before the onset of menstruation or a few days after, many patients have spotting brown discharge.

This state is bad for drug treatment, in severe cases leads to the development of posthemorrhagic iron deficiency anemia.

Hormonal imbalance and so-called eruptive uterine bleeding, quite characteristic of the diffuse form of the disease, exacerbate the situation.

In some cases, symptoms of general intoxication may develop: fever, general weakness, fatigue, etc.

When to See a Doctor

Ideally preventive examinations from specialized specialists healthy people recommended to be done annually.

In practice, a visit to the doctor is often postponed indefinitely and the patient is at the reception when it becomes completely unbearable to endure.

The reason for going to the doctor are any changes in the menstrual cycle and the course of menstruation, manifestations of soreness, discomfort and any other symptoms that are not typical for normal menstruation.

It is better to be overly vigilant than to waste valuable time.

Treatment

Endometriosis is difficult, in most cases it is not possible to achieve a complete recovery of the patient.

Can endometriosis go away on its own? Cases of spontaneous healing after childbirth are described, but the likelihood of such a development of events is assessed as low.

After the extinction of the reproductive function, the manifestations of the pathology disappear due to a change in the hormonal status of the woman.

A comprehensive program for the treatment of uterine endometriosis is developed individually, based on the patient's examination data. In addition to the form, localization and severity of the lesion, the doctor takes into account the age of the patient and her desire to have children in the future.

At the initial detection of the disease, conservative treatment is prescribed. In course conservative therapy include:

non-steroidal anti-inflammatory drugs;
hormonal agents;
sedatives;
immunomodulators;
vitamin-microelement complexes.

Additionally appoint physiotherapy course.

In advanced cases, in the absence of effect from conservative treatment, the presence of contraindications to the use of medicines for the patient combined or surgical treatment is prescribed.

Surgical treatment can be radical or organ-preserving.. preference is given to laparoscopic surgical interventions, in which local removal of foci of pathological endometrium is performed.

With a high risk of degeneration of a neoplasm into a malignant one, a steady absence of the effect of conservative treatment, with a particularly aggressive course of the pathological process and in severely neglected cases, the uterus is extirpated.

After such an operation, a woman will not be able to have children., therefore, the technique is used for, in exceptional cases - at a younger age.

The success of treatment is determined by the preservation or restoration of fertility. The criteria for recovery are lack of subjective complaints and clinical symptoms recurrence within 5 years.

"Doctor I ..." - Endometriosis stage 4, laparoscopic surgery

Lifestyle with this female disease in gynecology

Prevention and treatment of any disease always includes a number of general recommendations to promote overall health.

So, how to live with endometriosis, what can and cannot be done with this diagnosis?

Diet and diet

There are no specific dietary restrictions, it is enough to follow the general recommendations for healthy eating. Food should be complete and varied.

It is recommended to enrich it with fruits, vegetables, whole grains, seeds and some types of nuts are useful. It is not necessary to restrict meat consumption, but part meat products better to replace with sea fish.

Bath, sauna, beach

Is it possible to visit the bath with endometriosis, go to the sauna or sunbathe? Thermal treatments are believed to contribute to the progression of endometriosis. However, the presence of a diagnosis is not an absolute contraindication.

If visiting a sauna, bath or bath leads to a deterioration in well-being, then it is better to refrain from them. This question should be asked to your gynecologist, who monitors the dynamics of the course of the disease, and follow his recommendations.

Is it possible to sunbathe with endometriosis, largely depends on the specific clinical case. If the doctor recommends to refrain from sunbathing, it is worth neglecting his recommendations.

Sports and physical activity

An active lifestyle has never harmed, provided that the loads are feasible, and training does not cause a deterioration in well-being.

Physical exercise helps to reduce the level of estrogen in the blood. When choosing your preferred sport, it is advisable to consult a doctor.

Is it possible to have sex

When the diagnosis is established, doctors strongly recommend refrain from intimacy during menstruation.

If sexual intercourse is accompanied by painful sensations, it is worth talking with a partner and changing the style of intimate communication.

Contraceptive methods

One of the treatments for endometriosis is hormone therapy . For therapeutic purposes, patients are prescribed oral contraceptives.

Is it possible to put a spiral with endometriosis? intrauterine device considered to be a factor in the development of this disease. Therefore, the decision on the possible installation of a therapeutic IUD is made on an individual basis, taking into account the characteristics of the clinical case.

Contraindications

They can impede the outflow of blood, which increases pain and provokes further progression of the disease.

Prevention

Since the causes and mechanisms of the development of pathology have not been elucidated, measures primary prevention reduced to early diagnosis and treatment of the disease.

Endometriosis is not a death sentence. With timely detection and treatment, the disease can be successfully controlled, it will hardly affect the quality of life in all its manifestations.