There are genital (genital) endometriosis, when the pathological process occurs on the genital organs (endometriosis of the uterus, ovaries, fallopian tubes, vagina) and extragenital if the foci are localized outside the genital organs. It can be localized in the bladder, rectum, appendix, kidneys, intestines, diaphragm, lungs and even on the conjunctiva of the eye. Genital endometriosis is divided into internal and external. The inner part includes endometriosis of the uterus and the interstitial part of the fallopian tubes. To the outer - tubes, ovaries, vagina, vulva.
This disease is most often found among women 35-45 years of age.
Among the causes leading to endometriosis, great importance is attached to injuries - surgical interventions, abortions. Diagnostic curettage of the uterine mucosa, uterine probing, pertubation can also contribute to the onset of endometriosis. Disease may appear after diathermocoagulation - then there is cervical and retrocervical endometriosis. Reusable scraping of the uterus can lead to endometriozone only because of trauma, but also due to retrograde dropping of blood into the fallopian tubes or abdominal cavity. Rough palpation of the uterus during surgery, difficulty in outflowing menstrual blood for one reason or another (atresia of the cervical canal, retroflexia of the uterus) also lead to the onset of endometriosis, including extragenital.
Clinical picture.
The main sign of internal endometriosis is the violation of menstruation, which acquire the character of hyperpolymenorrhea. Sometimes there is a brown discharge at the end of menstruation or a few days after it. Part of the symptom is dysmenorrhea (painful menstruation). Pain occurs a few days before menstruation, during menstruation increases and subsides after it ends. Sometimes pain can be extremely strong, accompanied by loss of consciousness, nausea, vomiting. During menstruation, the organs affected by endometriosis may increase.
Endometriosis of the ovaries causes endometrioid ("chocolate") cysts, aching pain in the lower abdomen and in the cross.
Retrocervical endometriosis is also accompanied by pain in the lower abdomen and lower back, they are associated with the menstrual cycle. The pain syndrome is strengthened by the act of defecation, the escape of gases.
Endometriosis of the cervix is ​​clinically manifested by the presence of spotting spotting before and after menstruation.
Extragenital endometriosis is most often postoperative scars and navel. It develops, as a rule, after gynecological operations. In places of localization of the endometriotic process, cyanotic formations of various sizes are found, from which blood can be released during menstruation.
At many women at detailed inspection reveals allocation of a colostrum from nipples.
In 35-40% of women with endometriosis, infertility is diagnosed. But, here we are not talking about infertility as such, but about reducing fertility - the opportunity to become pregnant.
The choice of method of treatment depends on the age of the patient, the location of endometrioid sprouting and the severity of clinical symptoms. The modern pathogenetic concept of treatment of genital endometriosis is based on combined treatment with the use of medical and surgical methods.