In this article, we will consider the signs of endometriosis of the uterus. What it is?
Endometriosis was first mentioned in the mid-nineteenth century. Nowadays, scientists are closely studying the reasons for the development of this insidious pathology. A disease such as diffuse endometriosis of the uterus is often congenital and inherited by women. It is the diffuse form of this disease that is the main cause of infertility in most women. I must say that this problem is striking in its scale. As part of choosing the right treatment, doctors need to determine all the features of this disease in each woman individually.
Clinical manifestation of pathology
In medicine, several forms of the development of uterine endometriosis are distinguished:
- Diffuse type. This form of pathology is also called internal uterine endometriosis. It should be noted that this is the most common form of the disease. She can often be found among women who are unable to conceive a child. Myometrial tissues with this type of disease are affected only at the cellular level. They spread evenly in the uterus, and therefore the possibility of their focal removal is excluded.
- The development of the nodal form. This type, unlike the previous one, is very rare in women. For this form of pathology, the appearance of foci of endometriosis in the uterine body is not characteristic, but the occurrence of nodular formations on the surface of the uterus is characteristic. During the progression of the disease, polyps can grow, which differ in the creeping form of the lesion. In the event that the patient is diagnosed with this particular type of endometriosis of the uterine body, doctors will most likely insist on surgery. It should be noted that such formations cannot be treated with a medication.
- The development of endometriosis of the external type. This species is also called genital. Against this background, pathological formations occur on all reproductive organs with the exception of the uterus. In most examples, they can affect the fallopian tubes with the ovaries. Such a pathology also often becomes the main cause of infertility in many women.
Against the background of the development of diffuse endometriosis, uterine muscle tissue is affected in the uterus. Pelvic tissue, ligaments, and excretory organs may also be affected. This type of disease does not have an individual form, but arises as a result of the development of certain pathologies. It entails negative consequences and requires special treatment. It is important to note that scientists recently managed to find out that any form of endometriosis of the uterine body can metastasize, in this regard, it is very important to determine the disease in its early stage of development. Due to timely treatment, metastases disappear on their own.
Diffuse endometriosis: general signs and stages
The diffuse form is able to affect uterine tissue in a sequential and uniform manner. Foci of lesion are formed deep into the body, after which they begin to grow. The main problem in the treatment of this pathology is the lack of characteristic signs, since the uterus is completely affected. The diffuse type of endometriosis of the uterus has its own developmental stages.
- At the initial stage, endometrial cells affect the uterus to a depth of one centimeter. At the same time, patients do not feel any pain or discomfort. At this stage of development, bleeding during menstrual cycles can intensify, which can cause anxiety and anxiety.
- In the second stage, the diffuse nature of endometriosis is manifested in the germination of cells to the middle of the uterus. The pain may become more noticeable. Against this background, internal puffiness occurs, often leading to the omission of the organ. Discharges with small streaks of blood may occur, which is observed between menstruation.
- The third stage is considered the most dangerous, since at this time diffuse endometriosis affects the uterus through and through, spreading to the fallopian tubes. In addition, he passes to the vaginal area and affects the walls of the abdominal cavity with ovaries.
The main problem of doctors with diffuse endometriosis of the uterus (ICD N80) is that they are unable to remove the foci of formation.
What can indicate the development of pathology?
As a rule, this disease brings significant discomfort to a woman, however, at the first stage, symptoms may be completely absent. Typically, patients notice the following changes in their state of health:
- The appearance of pain in the pelvic area.
- Observation of premenstrual and menstrual pain.
- The presence of excessively heavy bleeding during menstruation.
- The presence of an ointment between menstruation.
- The presence of discomfort in the background of intimate relationships.
- No planned pregnancy.
Often, the symptoms of the diffuse form of endometriosis of the uterine body is manifested as a complication against the background of the inflammatory process. It may also be the result of an unsuccessful gynecological intervention. Influences the formation of pathology, in addition, and the unhealthy state of the immune and endocrine system.
Diffuse endometriosis and the degree of its development
On the scale of the spread of cells, the course of this disease is divided into the following four degrees.
- Endometriosis of the uterus of the 1st degree. This is a pathological process that affects the upper layer of the myometrium.
- Endometriosis of the uterine body 2 degrees. A process that affects half the myometrium.
- Pathology that affects the myometrium completely.
- The process of spreading pathology to areas of neighboring organs, for example, to the intestine, and, in addition, to the genitourinary sphere.
Focal type
Focal endometriosis of the uterus is a separate form of the disease. In this case, pathological neoplasms are formed unevenly, affecting not the entire surface of the uterus. Against this background, foci of small size can be formed, which are at a certain depth. Such a pathology is treatable, due to the fact that doctors see the affected area and can remove it.
Against the background of focal diffuse endometriosis, the patient may feel severe, and at the same time, sharp pain with constant discomfort. The affected area of tissue increases in size. Such areas are constantly developing, causing soreness with slight bleeding.
Diffuse endometriosis and its symptoms
Doctors distinguish the following symptoms of uterine endometriosis:
- This type of disease is able to affect the entire uterine cavity. The distribution of nodules in this case occurs in a chaotic manner, they very quickly grow into the region of neighboring internal organs. Thus, the affected area quickly enough increases in size, and then swells.
- In the event that the neoplasm appears on the cervix, then endometriosis can be noticed only with the help of a colposcope. At the same time, doctors notice in patients the presence of characteristic bulges of a small size, which differ in a dark brown shade.
- Often, damage to the fallopian tubes can occur. In this case, adhesions with nodules clog the passage, and, in addition, prevent the onset of a desired pregnancy. Such formations are primarily subject to mandatory removal, since they cannot disappear on their own. After the operation, women in most cases are infertile.
Echoes of uterine endometriosis
The first diagnostic method used by a doctor in cases of suspected pathology is ultrasound scanning. Echo signs can be very informative for the initial detection of the disease and diagnosis. The technique is simple and safe, and the ultrasound criteria are clear and objective, which allowed ultrasound to become an indispensable way of preliminary diagnosis of the disease.
Detecting echoscopically endometriosis of the uterus is quite simple.
Ultrasound signs of adenomyosis
The doctor pays attention to:
- uterine wall thickness;
- a change in myometrium (uterine muscle layer);
- how the thickness of the inner tear-away layer has changed;
- change in the basal layer of the endometrium;
- small or large inclusions in any layers of the uterus.
Nodular and focal adenomyosis will give the following signs on ultrasound:
- in the thickness of the uterine wall, rounded or oval nodes with smooth contours or foci with blurred outlines form;
- there is a large number of cystic cavities and small inclusions (diameter not more than 6 mm);
- uterine wall thickness changed;
- the internal uterine cavity is deformed due to the formation of a node in the basal layer of the endometrium.
Treatment
Treatment of diffuse endometriosis in most cases is carried out using various medications. For this, the patient is prescribed hormone therapy. Hormonal preparations, which must be selected individually for each woman individually, help to cope with the foci in which inflammatory processes occur.
As part of the treatment, women using an artificial method stop their menstrual cycles for six months. Against the background of this process, the body can independently fight with the cells of the endometrium. Hormone treatment is accompanied by various drugs, the effect of which is aimed at strengthening immunity, and in addition, increasing the resistance of the whole organism as a whole.
In the event that women do not monitor their health and do not undergo regular preventive examination by a doctor, often diffuse endometriosis is diagnosed in them at the last stage. In such situations, a complete removal of the uterine body is prescribed.
The simultaneous formation of uterine body fibroids in combination with endometriosis usually occurs against the background of sharp hormonal surges or malfunctions in the postpartum period, against the background of abortions or inflammations, traumatic injuries or miscarriages, etc.
Usually, treatment is based on surgical interventions. A specific technique is selected in accordance with the form of myoma tumors, the condition of the patient, age characteristics and the degree of neglect of pathological processes.
Hormone therapy and its features
The only drawback of hormonal treatment is the need for prolonged use of such drugs, even against the background of a minor lesion of the uterus. But thanks to this treatment, it is possible to completely restore the work of the reproductive organs without resorting to surgical intervention. Therapy of diffuse endometriosis directly depends on the form, and, in addition, on the degree of the disease. Often there are situations in which doctors consider surgery the only way out. There are a number of the following features of hormone therapy.
- Change and violation of the hormonal background can lead to the appearance of pathogenic cells in the uterus. It is drugs that are based on hormones that help stabilize any disorders in the body. Such treatment is required under the strict supervision of the attending physician.
- Endometrial cells, as a rule, work quite cyclically, only during menstruation they begin to bleed heavily. In that case, if the patient is made an artificial interruption of the monthly cycle, then the body gets the opportunity to cope with the appeared pathological foci on its own. Endometrial cells throughout the treatment are in a state of complete rest.
- The average period of interruption of menstruation by artificial method is six months. Only on the basis of the doctor’s testimony can it be extended. But this process can negatively affect the activity of the reproductive organs, in this regard, in the future, a problem with the onset of pregnancy may arise.
Focal treatment
The focal form of diffuse endometriosis in most cases is treated exclusively using the surgical method. Formed foci must be completely removed. Only after a comprehensive diagnosis, the doctor will be able to decide on the appointment of hormonal therapy to the patient. Diagnosis in this case is directed to the complete weakening of the foci, which are subsequently removed.
Pathological foci can also appear on the ovaries, and therefore doctors can also operate them. Unfortunately, treatment of the focal form often does not bring a positive result, and the removal of part of the appendages can lead to relapses. The focal form of the disease significantly reduces the likelihood of a complete restoration of reproductive functions. But, nevertheless, as practice shows, in many cases, patients still manage to conceive and give birth to a child after a full course of hormone treatment.
Therapy Features
It should be noted that, as a rule, exclusively active forms of diffuse endometriosis of the uterine body, which manifest themselves with severe bleeding, and, in addition, pain, are usually subject to treatment. Many experts believe that the treatment of an inactive disease can contribute to its further spread. In this regard, such patients should simply be observed.
Treatment of endometriosis of the uterus involves hormonal adjustment. In this case, in particular, it is necessary to suppress the production of female hormones - estrogen. It is also very important to treat inflammatory areas that are located near the immediate foci of endometriosis. Equally important in the course of treatment is the restoration of a woman's immunity. Among other things, women suffering from diffuse endometriosis often have all kinds of metabolic, and, in addition, endocrine abnormalities in the form of obesity, diabetes and so on. They should also be identified and treated.
In cases where conservative treatment is ineffective, doctors perform an operation during which patients cauterize foci of endometriosis. In the presence of adenomyosis or in cases of a combination of this ailment with myoma, supravaginal amputation of the uterus is recommended. This type of surgery is often performed in women who are in the postmenopausal period.
How to treat endometriosis of the uterus, we now know.
Prevention of diffuse endometriosis
Preventive measures against the background of the danger of developing diffuse endometriosis in women, which are carried out in medical centers, as a rule, include a number of the following procedures:
- A thorough examination of girls in their teens, and, in addition, young women who have severe pain during menstruation.
- In cases of abortion or against the background of any other surgical interventions that are associated with penetration into the uterus, it is necessary to observe patients in order to timely identify, and, in addition, eliminate possible pathologies.
- Treatment of inflammatory pathologies of the genital area.
- Regular testing.
Complications of diffuse endometriosis
The main, and at the same time the most serious complication of diffuse endometriosis is infertility. Approximately every second woman who suffers from this disease has big problems in order to conceive a child and bear him during pregnancy. The fact is that the progression of endometriosis can lead to the spread of pathological processes to the fallopian tubes, because of this, the eggs simply do not meet with sperm. Thus, it is the obstruction of the fallopian tubes that occurs against the background of diffuse endometriosis to a large extent that prevents conception. Even in the case of the formation of a zygote, it does not germinate along with implantation into the walls of the uterus.
Another complication is ovarian cancer, which is an oncological pathology of the ovaries. Among patients with diffuse endometriosis, it develops much more often, however, according to some statistics, the risk of a tumor as a whole is small. According to previous studies, it was found that endometriosis in some way can increase the risk of cancer in women. Thus, in some rare cases, the development of endometriosis-associated adenocarcinoma in women with a complicated history is possible.
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