One of the most painful and dangerous gynecological diseases is retrocervical endometriosis. This disease is characterized by shooting, sharp pains radiating to the vagina, rectum, hips, perineum, genitals. Pain syndrome intensifies with bowel movements and sexual intercourse. Before and after menstruation, spotting is observed .
Retrocervical endometriosis is a disease accompanied by proliferation in the rectovaginal fiber of endometriosis. According to the clinical classification, this disease is divided into 4 stages:
1 - foci of endometriosis are located only in rectovaginal fiber;
2 - there is a germination of endometriotic tissue in the cervical region, the vaginal wall (at this stage, the formation of small cysts);
3 - the pathological process goes to the sacro-uterine ligaments, serous integument of the rectum;
4 - the mucosa of the rectum, rectal uterine space is involved in the proliferation of endometriotic tissue. The formation of adhesions is characteristic of this stage.
Retrocervical endometriosis is diagnosed on the basis of clinical data and medical studies. It is differentiated with cancer of the ovaries and rectum.
During a vaginal examination of the posterior fornix, a tuberous dense node (sharply painful) is palpated. Its value may be different. During a gynecological examination, small endometrioid cysts, looking like bluish “eyes” , are often visible in the mirror. It is from them during menstruation that dark blood is secreted. The main method of medical research for a disease of this localization remains a biopsy.
With damage to the tissues of the rectum, sigmoidoscopy, targeted biopsy and irrigoscopy are performed. In patients, the intestinal lumen is significantly narrowed. If endometrioid heterotopia has spread to the area of the retrocervical septum, with parietography its strong thickening is observed, having an even, clear contour. With sigmoidoscopy, swelling and hyperemia of the mucosa, swelling of the walls of the intestine inward are detected.
Retrocervical endometriosis is treated in several ways (depending on the stage). The first stage of therapy for this disease is the excision of its focus through the vagina. It is made for medical and diagnostic purposes. Excised tissues are given for histological examination.
At stages 1 and 2, it is possible to remove endometriosis within healthy tissue without the use of posterior colpotomy. After surgery, the vaginal wall is sutured with catgut sutures. If the medical institution has a cryosurgical technique before suturing the wall, it is advisable to carry out cryodestruction of the endometriosis bed. This procedure helps to reduce the number of relapses.
At 3 stages of retrocervical endometriosis, when a posterior colpotomy is necessary, the lesions are excised from the serous integument of the rectum, sacro-uterine ligaments. Additional laser and cryoprocessing of ligaments may be necessary.
At stage 4, in young patients, it is advisable to excise a part of the endometriosis focus for histological examination. After that, hormone therapy with antigonadotropins and progestogens of the norsteroid series is carried out. In the complex treatment of retrocervical endometriosis, sanatorium treatment (iodine-bromine, radon baths), sedative therapy, and symptomatic treatment are used.
Only by contacting a doctor in a timely manner can endometriosis-removing treatment be removed without a trace. Patient reviews indicate that in the initial stages of this disease, it is treated fairly quickly without possible relapses. Among the medicines that are used at the initial stage, there are combined contraceptives: “Diane-35”, “Logest”, “Regulon”. One of the most effective is the drug "Janine". With endometriosis, its use is due to the presence of dienogest in it - a progestogen, which has an inhibitory effect on endometrioid heterotopies. This drug causes their regression. To get a good result, small doses of the medicine are enough. The composition of the drug "Janine" also includes estradiol, which ensures the restoration of the menstrual cycle.