Focal adenomyosis of the uterus is a localized disease, the focus of which is in the overgrown endometrium. As a rule, the site of the lesion has clear contours. The focal form of the disease is one of the varieties of endometriosis, which distinguishes the disease from exclusively uterine distribution. Depending on the stage of the lesion and the thickness of the germination of the myometrium, experts distinguish three main degrees of severity of the disease:
- easy;
- medium;
- heavy.
Features of the disease
To understand what it is - focal adenomyosis, let's talk about the features of the pathology. The endometrial layer is located throughout the uterus. It is regularly updated with the menstrual cycle. This helps to prepare the woman's body for possible fertilization and gestation of the embryo. Focal adenomyosis of the uterus occurs, as a rule, in older women who are already 40 years old and have the first symptoms of menopause.
Such women cannote the regular changes in the level of estrogen in the body. At the same time, they experience hot flashes, sweating increases much, and their head begins to spin. If such jumps continue for too long, then against their background, the woman begins to develop adenomyosis of the focal form of the lesion.
This pathology is a type of internal endometriosis, which can be diffuse and affect the entire uterine cavity. Focal adenomyosis is characterized by a specific location of the endometrium in different parts of the uterus.
The main problems in the diagnosis and treatment of the disease are in identifying the stage of the lesion. There are several forms of this disease, two of which are amenable to medical treatment, and the rest are eliminated only through surgery.
Disease progression process
Features of the formation of the lesion in the focal form of adenomyosis look like this:
- formed lesions do not form a capsule;
- they are distinguished by their infiltrative growth and can easily move to nearby tissues;
- endometrioid cells lead to the beginning of the destruction of the affected tissue;
- they, just like malignant cells, rapidly spread throughout the body through the bloodstream and lymph.
Gynecologists report that the internal form of endometriosis of the uterus is a rather dangerous disease, which is very important to treat in a timely manner, otherwise it can lead to serious complications.
In the absence of the correcttreatment, the patient may experience infertility. In addition, the symptoms of endometriosis most often represent a severe pain syndrome, which can adversely affect the general condition of a woman, worsen her well-being and activity.
Main forms of the disease
Specialists distinguish three forms of the described disease:
- Diffuse focal adenomyosis of the uterus - endometrioid cells are localized mainly on the inner surface of the uterus.
- Nodular adenomyosis - cells form nodes that contain blood or exudate. This is due to the fact that the cells in the nodes continue to perform their functions, focusing on the woman's menstrual cycle. With such a disease, single or multiple nodes can form in the uterine cavity.
- Focal adenomyosis. The growth of the endometrium with this form of the disease occurs in certain areas of the uterus, in the walls of the organ there are extensive foci. The size of the lesions in this case can be very different. Focal adenomyosis of the uterus progresses, like other diseases, passing through several stages. The disease is treated by the same methods.
Risk factors
The most common risk factors for adenomyosis are:
- endocrine system problems;
- woman's age;
- heredity;
- socio-economic status.
Uncommon factors:
- late period;
- late birth or birth with complications;
- regular abortions;
- strong irradiation and thermal treatments targeting the pelvic area.
Unfortunately, conservative or combined treatment in rare cases leads to a complete recovery of a woman. Late stages of the disease are a common cause of infertility. But timely treatment helps to achieve a more or less long-term remission, get pregnant and give birth to a child. True, in this case it is important to remember that the risk of spontaneous abortion or the onset of premature birth is high.
Main Stages
Specialists divide focal adenomyosis of the uterine body into the following stages:
- At this stage of development, the depth of growth of endometrial foci in the muscle layers of the uterus reaches 1/3 of the part. With the timely detection of a dangerous formation in the cavity of the named organ, it can be easily and quickly cured without complications.
- The endometrium in the uterus extends to 1/2 part, so the gynecologist prescribes to the patient a course of hormonal medications, as well as the passage of appropriate physiotherapy procedures.
- In this case, the endometrium is widely distributed in several areas of the uterus, localized in the outer walls of its muscle layer, leading to more serious complications and problems in the patient's body.
- What is stage 4 diffuse focal adenomyosis? In this case, the endometrium begins to actively affect tissues located outside the uterine cavity. Neoplasms begin to form on neighboring organs. As a rule, the doctor prescribespatient required surgery.
Main causes of occurrence
Researchers have not yet fully understood the diffuse focal form of adenomyosis and have not identified all the causes that provoke its occurrence. At the same time, doctors note that such a lesion is most often detected in patients in whose hormonal background serious and prolonged disruptions occur. Such women are in a special risk zone, therefore, they must carefully monitor their he alth and, when the first signs of damage appear, immediately seek help from a specialist.
The main factors that lead to the appearance of focal adenomyosis of the uterus include: frequent pregnancies, certain surgical interventions, the installation of a spiral, frequent curettage or abortion.
In addition, the following factors can be attributed to provocative factors:
- Susceptibility to disease at the genetic level. In this case, a woman may experience not only focal adenomyosis, but also other forms of endometriosis.
- Problems with the amount of hormones in the body: too much estrogen or not enough progesterone.
- Regular stress, worries, emotional outbursts, wrong rhythm of life, excessive loads of both mental and physical nature.
- Reinforced sports.
- The presence of bad habits, as well as uncontrolled intake of drugs that were not prescribed by the attending specialist, and not followingdosage.
Theories of emergence
Doctors rely on the following theories to explain the causes of the appearance and development of internal endometriosis of the uterus:
- Very rarely, a disease of this form is detected in young girls (before puberty). It is believed that under the influence of intrauterine disorders, endometriosis foci actively move to nearby tissues, which begin to progress immediately after puberty.
- During menstruation, a certain amount of blood containing endometrial cells is thrown into the peritoneal cavity. This process is otherwise called retrograde menstruation. But far from all women, endometrioid components can normally take root in the peritoneum. To do this, such elements need to provide certain conditions, which will consist in violations of the hormonal and immune systems.
- Many diseases associated with the reproductive system have to be treated through surgery. Adenomyosis often appears after an operation that provokes the destruction of the inner layer of the uterus. As a result of such exposure, endometrioid cells receive all the necessary conditions for penetration into the myometrium and deeper layers of the organ.
Internal endometriosis can also appear as a result of exposure to negative factors from outside. A woman should always remember that if timely treatment of the inflammatory process in the uterus and other genital organs is not started, then as a result this can affect not only reproductive function,but also lead to more serious complications. Infection, regular stress and anxiety can increase the risk of occurrence and progression of adenomyosis of the uterus by reducing the protection of cellular immunity.
Main symptoms
The main symptom of adenomyosis in the uterine organ is severe pain in the pelvis, as well as the onset of heavy bleeding. During the development of the disease, the woman feels tired and unwell. By the way, most often its first two stages are asymptomatic, so it is very important to visit a doctor regularly to diagnose a he alth condition.
The main symptoms of pathology directly depend on menstruation. Experts have found that the foci of the disease menstruate at the same time with a correctly located endometrium. The inability to remove endometrial cells from the focus leads to the onset of the inflammatory process.
Doctors identify the following signs of focal adenomyosis:
- Pain. It was found that the pain syndrome in the focal form of the lesion is characterized by its cyclicity. Most often, it becomes stronger before and during critical days. Pain is localized predominantly in the lower abdomen, and in the sacrum, irradiation to the lower extremities may occur. In some cases, the pain is so severe that the woman has to call an ambulance and undergo an examination in the gynecological department.
- Heavy bleeding during menstruation. Most often, the patient notes a large amount of blood discharge. At the same time, they canobserved as smearing before and after menstruation. In some cases, strong periods indicate the presence of uterine fibroids, which often occurs with adenomyosis. Internal endometriosis and uterine fibroids appear as a result of problems with the hormonal system.
- Excessive bleeding in the absence of menstruation. A symptom such as severe bleeding may indicate an active process of disease development. At the same time, they provoke the development of anemia and severe blood loss.
- Infertility or miscarriage. Due to problems with hormone production, anovulation often occurs with internal endometriosis. Degenerative processes do not allow a fertilized egg to normally reach the organ and gain a foothold in its cavity. With adenomyosis, inflammation of the uterus can begin in a woman's body, which will disrupt the natural contractility of the named organ and lead to miscarriage at an early stage of embryo development.
The main symptoms of adenomyosis can be identified during a gynecological examination in the clinic. In this case, the specialist will reveal the soreness of the body of the uterus and the rate of growth of the lesion. Also, the doctor will determine various changes regarding the shape and consistency of the uterine body. Most often, during internal endometriosis, the organ takes on a spherical shape, and its density increases.
Diagnostic lesion measures
To determine diffuse focal adenomyosis 13 and 15 mm, it is imperative to undergo an ultrasound examination, which will help determine the specific signs of the disease. A transvaginal scan will help identifyaccurate diagnosis of the disease. If timely treatment of focal adenomyosis of the uterus is not started, then as a result, as already mentioned, the patient may experience infertility or she will have to undergo partial or even complete removal of the named organ.
Most often, the diagnosis of such a disease is carried out using ultrasound. To identify focal adenomyosis and possible uterine cancer, a biopsy and analysis for CA-125 is performed. All this allows you to well consider the signs of pathology of both the organ itself and neighboring tissues. It is best to conduct such an examination before menstruation. The doctor will be able to accurately identify the nature of the disease, its shape, the size of the uterine body, the thickness of the walls and structures of the myometrium. In order to take a biopsy, the doctor prescribes a hysteroscopy.
Basic ways to treat a lesion
It is important to remember that only the first two stages of adenomyosis can be treated. But for those who fell ill with such a lesion, unfortunately, a full recovery, as a rule, does not occur. This can be explained by the fact that the focal form of adenomyosis in the uterine cavity often reappears, for this reason it is important for the patient to carefully monitor the hormonal system.
All types of adenomyosis are treated with two common methods. In the first case, the specialist prescribes the use of drugs against adenomyosis. If such therapy does not improve the condition of a person, then experts prescribe surgical intervention. All methods for removing endometriosis of the internal form will differ from each other depending on the severity andgermination of the lesion, as well as the state of the female reproductive system.
The most common method of removing a lesion is uterine artery embolization. Other procedures to remove the affected area, including curettage, are quite dangerous and can lead to infertility.
To begin the proper treatment of uterine disease, the specialist will rely on the following factors:
- woman's age;
- presence or absence of children, desire to give birth in the future;
- lack of childbirth;
- development stage of the lesion;
- the main symptoms of the lesion and their manifestation.
If a woman has any problems with the functioning of the kidneys, liver, blood vessels, or diabetes mellitus is present, then he prescribes a course of taking hormonal drugs. Whether to carry out the removal of adenomyosis of the uterus, the attending physician will decide after a diagnostic examination. He will study the woman's history, identify the presence of asthma or obesity. And the goal of treating the disease will be to introduce a woman into a drug-induced menopause.
Internal endometriosis should be treated with hormonal agents, but it is important to remember that they often provoke adverse reactions. During treatment, a woman must follow a special diet, exclude all harmful foods from her diet. The menu should include as many foods enriched with proteins and vitamins as possible. Additionally, the doctor prescribes immunotherapy and physiotherapy. With a focal form of uterine adenomyosis, a woman often develops neurotic diseases against the background, in which it is very importanthelp of a psychotherapist.
Medication treatment
Treatment with drugs can be carried out in conjunction with non-traditional. These include hirudotherapy, or treatment with leeches, homeopathy and medication. Such a set of procedures always brings a positive effect.
But doctors forbid patients to self-medicate and purchase medicines without a prescription, as this is extremely dangerous for the he alth and condition of the woman herself. At the same time, with the right choice, homeopathic medicines will help enhance the effect of taking other medicines.
Many women have tried leeches on themselves. It helps to accelerate blood flow and eliminate the process of inflammation inside the organ.
Modern treatments
Medicine has developed new ways to treat focal adenomyosis of the uterus:
- Electrocoagulation. In this case, an electric discharge acts on pathological formations in the body, which destroys focal formations in a mild form.
- Embolization. This method of treatment is based on blocking the blood flow, which comes to all formations. Due to the lack of oxygen, the formations begin to quickly collapse.
- Ablation helps to destroy the lining of the uterus.
All the described methods of treatment have their own merits, with the help of them many patients were able to eliminate adenomyosis without dangerous he alth consequences.
In addition, doctors advise to lead an active lifestyle,eat a he althy diet, exercise regularly and have a he althy sex life. With regular problems in the menstrual cycle, it is important to immediately go to the doctor and conduct a comprehensive examination for the timely diagnosis of the pathology.
