In this article, we will consider the signs of endometriosis of the body of the uterus. What is it?
Endometriosis was first mentioned in the mid-nineteenth century. Nowadays, scientists are closely studying the causes of the development of this insidious pathology. A disease such as diffuse endometriosis of the body of the uterus is often congenital and is 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 magnitude. 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, there are several forms of development of uterine endometriosis:
- Diffuse type. This form of pathology is also called internal endometriosis of the body of the uterus. It should be noted,that this is the most common form of the disease. It is very often found among women who fail to conceive a child. Myometrial tissues in this type of disease are affected only at the cellular level. They are distributed evenly in the uterus, and therefore the possibility of their focal removal is excluded.
- 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 body of the uterus is not characteristic, but the appearance 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 are likely to insist on surgical intervention. It should be noted that such formations cannot be treated with medication.
- Development of endometriosis of the external type. This species is also called genital. Against its background, pathological formations occur on all reproductive organs with the exception of the body of the uterus. In most examples, they can affect the fallopian tubes with the ovaries. This pathology also often becomes the main cause of infertility in many women.
Against the background of the development of diffuse endometriosis in the uterus, the muscle tissues of the peritoneum are affected. The tissues of the pelvis, ligaments and excretory organs may also be affected. This type of disease does not have an individual form, but occurs as a result of the development of certain pathologies. It entails negative consequences and requiresspecial treatment. It is important to note that scientists have recently managed to find out that any form of endometriosis of the uterine body can metastasize, therefore it is very important to identify the disease in a timely manner at its initial stage of development. Metastases disappear on their own due to timely treatment.
Diffuse endometriosis: common signs and stages
The diffuse form is able to affect the tissues of the uterus in a consistent and uniform manner. The lesions form deep into the body, after which they begin to grow. The main problem in the treatment of this pathology is the absence of characteristic signs, since the uterus is completely affected. The diffuse type of endometriosis of the body of the uterus has its own stages of development.
- At the initial stage, endometrial cells infect the uterus to a depth of one centimeter. In this case, patients do not feel any soreness or discomfort. At this stage of development, bleeding may increase during menstrual cycles, which can cause anxiety and anxiety.
- At 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 swelling occurs, often leading to the omission of the organ. There may be a discharge with small streaks of blood, which occurs between periods.
- 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, it goes to the area of the vagina and affects the walls of the abdominal cavity with the ovaries.
The main problem of doctors with diffuse endometriosis of the uterine body (ICD N80) is that they cannot remove the lesions.
What could 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 he alth:
- The appearance of pain in the pelvic area.
- Monitoring premenstrual and menstrual pain.
- Having excessive bleeding during menstruation.
- Presence of spotting between periods.
- The presence of discomfort on the background of intimate relationships.
- Missing a planned pregnancy.
Often, the symptomatology of the diffuse form of endometriosis of the body of the uterus manifests itself as a complication against the background of the inflammatory process. It can also be the result of an unsuccessful gynecological intervention. Influences the formation of pathology, in addition, the unhe althy state of the immune and endocrine systems.
Diffuse endometriosis and its degree of development
The course of this disease is divided into the following four degrees according to the scale of cell distribution.
- Endometriosis of the body of the uterus of the 1st degree. This is a pathological process that affects the upper layer of the myometrium.
- Endometriosis of the body of the uterus 2 degrees. A process that affects half of the myometrium.
- Pathology,affecting myometrium completely.
- The process of the spread of pathology to areas of neighboring organs, for example, to the intestines, and, in addition, to the urogenital area.
Focal type
Focal endometriosis of the body of the uterus is referred to as a separate form of the disease. At the same time, pathological neoplasms are formed unevenly, affecting not the entire surface of the uterus. Against this background, small foci can form, which are located at a certain depth. This 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 tissue area increases in size. Such areas are constantly developing, causing soreness with little bleeding.
Diffuse endometriosis and its symptoms
Doctors identify the following symptoms of endometriosis of the body of the uterus:
- This type of disease can affect the entire uterine cavity. The distribution of nodules in this case occurs in a chaotic manner, they very quickly grow into the area of \u200b\u200bneighboring internal organs. Thus, the affected area quickly increases in size, after which it swells.
- In the event that the neoplasm appears on the cervix, then endometriosis can only be noticed 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 dark brownshade.
- Often, damage to the fallopian tubes can also occur. In this case, adhesions with nodules clog the passage, and, in addition, prevent the desired pregnancy from occurring. Such formations are primarily subject to mandatory removal, since they cannot disappear on their own. After the operation, women in most cases are infertile.
Echo signs of endometriosis of the body of the uterus
The first diagnostic method used by a doctor if this pathology is suspected is an ultrasound scan. Echo signs can be very informative for the initial detection of the disease and diagnosis. The technique is simple and safe, and ultrasound criteria are understandable and objective, which allowed ultrasound to become a mandatory method for preliminary diagnosis of the disease.
It is quite simple to detect echoscopically endometriosis of the body of the uterus.
Ultrasound signs of adenomyosis
The doctor draws attention to:
- thickness of the walls of the uterus;
- change in the myometrium (the muscular layer of the uterus);
- how the thickness of the inner shedding layer has changed;
- change in the basal layer of the endometrium;
- small or large inclusions in any layers of the body 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 even contours or foci with blurry outlines are formed;
- there is a large number of cystic cavities and small inclusions (diameter no more than 6 mm);
- thicknessuterine wall changed;
- the inner cavity of the uterus 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 with the help of various medications. For this, the patient is prescribed hormone therapy. Hormonal preparations help to cope with the foci in which inflammatory processes occur, which should be selected individually for each woman.
As part of the artificial method of treatment, women stop their menstrual cycles for six months. Against the background of such a process, the body can independently fight endometrial cells. Hormonal treatment is accompanied by various drugs, the effect of which is aimed at strengthening the immune system, and in addition, to increase the resistance of the whole organism as a whole.
In the event that women do not monitor their he alth and do not undergo regular preventive examinations with a doctor, diffuse endometriosis is often diagnosed in them already at the last stage. In such situations, the complete removal of the body of the uterus is prescribed.
The simultaneous formation of uterine fibroids in combination with endometriosis usually occurs against the background of sharp hormonal surges or disruptions in the postpartum period, against the background of abortion or inflammation, traumatic injuries or miscarriages, etc.
Usually treatment is based on operational measures. A specific technique is selected in accordance with the form of myoma neoplasm,the patient's condition, 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 long-term use of such drugs, even against the background of a slight lesion of the body of the uterus. But thanks to this treatment, it is possible to completely restore the functioning 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 hormonal therapy.
- Change and disruption of the hormonal background can lead to the emergence of disease-causing cells in the uterus. It is drugs that are based on hormones that help stabilize any disturbances 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 the event that the patient is given an artificial interruption of the monthly cycle, then the body gets the opportunity to independently cope with the pathological foci that have appeared. Endometrial cells during the entire treatment are in a state of complete rest.
- The average interruption of menstruation by artificial method is six months. Only on the basis of the testimony of a doctor can hebe extended. But this process can negatively affect the activity of the reproductive organs, in connection with this, in the future there may be a problem with the onset of pregnancy.
Treatment of focal form
The focal form of diffuse endometriosis in most cases is treated exclusively with the help of the surgical method. Formed foci must be completely removed. Only after a comprehensive diagnosis, the doctor will be able to make a decision regarding the appointment of hormone therapy for the patient. Diagnostics in this case is directed to the complete weakening of the foci, which are subsequently to be removed.
Pathological foci can also appear on the ovaries, and therefore doctors can operate on them as well. Unfortunately, the 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.
Features of therapy
It should be noted that, as a rule, exclusively active forms of diffuse endometriosis of the uterine body, which manifest themselves as severe bleeding, and, in addition, pain, are subject to treatment. Many experts believe that the treatment of an inactive disease can contribute to its further spread. In this regard, suchpatients should just be observed.
Treatment of endometriosis of the body of the uterus involves hormonal adjustment. In this case, suppression of the production of female hormones - estrogens - is especially required. It is also very important to treat inflammatory areas that are near the immediate foci of endometriosis. Equally important in the framework 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 endometriosis foci are cauterized for patients. In the presence of adenomyosis or in cases of a combination of this disease with fibroids, supravaginal amputation of the uterus is recommended. This type of surgery is often performed on women who are in the postmenopausal period.
How to treat endometriosis of the body of the uterus, now we know.
Prevention of diffuse endometriosis
Preventive measures against the background of the risk of developing diffuse endometriosis in women, which are carried out in medical centers, as a rule, include a number of the following procedures:
- Carrying out a thorough examination of girls in their teens, and in addition, young women who have severe pain during menstruation.
- In cases of abortion or in the backgroundany other surgical interventions that involve penetration into the uterus, it is necessary to observe patients in order to timely identify, and, in addition, eliminate possible pathologies in them.
- Treatment of inflammatory pathologies of the genital area.
- Regular testing.
Complications due to 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 great problems in order to conceive a child and bear it 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 blockage of the fallopian tubes, which occurs against the background of diffuse endometriosis, that largely prevents conception. Even if a zygote is formed, it does not germinate along with implantation in 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 is generally small. Previous research has found that endometriosis in some way may contribute to an increased risk of cancer in women. Thus, in some albeit rare cases, the development of endometriosis is possible.associated adenocarcinoma in women with a complicated medical history.
In conclusion, we note that diffuse endometriosis of the uterus is a gynecological disease that often occurs in women who are in the reproductive period. The allocation of this particular form of pathology into a separate nosological category was due to the presence of a specific feature in it. Its peculiarity lies in the fact that the cells of the endometrium, which is the inner layer of the uterus, can grow directly into its muscle layer, completely replacing it.
Thus, this pathology is very common and can deprive a woman of the opportunity to become a mother in the future. Therefore, in order to prevent its occurrence, abortions should never be done and any inflammatory processes that occur in the genital area should always be treated on time. It is important to remember that any surgical intervention in the area of the uterus can also cause this disease. In addition, you should regularly check with a gynecologist.
