Obstetrics and gynecology. Endometriosis (most important)

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Obstetrics and gynecology. Endometriosis (most important)

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52. Endometriosis

Causes of endometriosis. There is no single theory that fully explains the cause of this disease. Types of endometriosis: genital and extragenital. Genital endometriosis is divided into internal and external. With endometriosis of any localization, endometrioid growths are glandular formations that look like small round, oval-shaped foci that are separate or merge with other tissues, the cavities of which contain a thick dark or clear liquid.

Internal endometriosis

Occurs when the body of the uterus is affected, has a diffuse and nodular form. The uterine angles and the posterior wall of the uterus at the bottom are most often affected. It is accompanied by prolonged, painful and profuse menstruation, leading to anemia in patients. A characteristic sign is an increase in the uterus before menstruation and a decrease after it ends.

External endometriosis

Endometriosis of the cervix. Damage to the cervix is the only localization of endometriosis that is not accompanied by pain. Upon examination, bluish areas in the form of eyes are found in the mirrors. Clinically, the disease manifests itself as bloody spotting a few days before and after menstruation.

Endometriosis of the ovary. It appears in the form of pinpoint bluish formations on the surface of the ovary. More often, cystic cavities are formed, filled with chocolate-colored contents. Hemorrhages into the cyst walls and microperforations cause perifocal inflammation, leading to extensive adhesions with surrounding tissues.

Tubal endometriosis. Dense nodules of various sizes form in the thickness of the pipes.

Vaginal endometriosis. On palpation, a dense, sharply painful infiltrate without clear boundaries is determined. There are pains in the lower abdomen, in the perineum, in the lower back, and spotting before and after menstruation.

Retrocervical endometriosis

In the posterior fornix, a bumpy, sharply painful, mobility-limited formation is palpated. When viewed in the mirrors, cyanotic areas in the form of eyes are found. Retrocervical endometriosis is characterized by severe pain.

Extragenital endometriosis

Endometriosis of the scar develops most often after gynecological operations on the uterus

Diagnostics. When making a diagnosis, the clinical data of the disease are taken into account, and special examination methods are also used.

Endometriosis treatment. An integrated approach to the treatment of this pathology, based on a combination of medical and surgical methods, is considered optimal. For the purpose of drug treatment, hormonal drugs are used, leading to the shutdown of menstrual function for the duration of treatment. Symptomatic therapy consists of prescribing painkillers and hemostatic agents.

Author: Ivanov A.I.

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