endometriosis

Endometriosis is the presence of endometrial glands and stroma in tissue outside of the uterus. Endometriosis is most commonly seen in the pelvis. DG organs in the abdomen and pelvis outside the body can be seen in different regions. In women of reproductive age it is considered to be found approximately 10%. or malignant type of cancer is not a disease.

Endometriosis seen bodies:

Endometriosis most commonly in the ovaries (ovarian) is observed. in other organs in the pelvis outside the ovaries, pelvic peritoneum in Douglas pit, broad common in ligaments. Most colon and rectum are seen outside the pelvic organs. Apart from all the digestive tract, appendix, lung, pleura, but it can occur in any organ such as the brain. Surgical scar area can be seen in epizyotu my scars.

Endometriosis is common in women of reproductive age. The most common among 25-35 years old, is rare after the age of 45. After the period of the previous girls entering puberty or menopause it is very rare, because the development of endometriosis in the ovaries (ovarian) is closely associated with the production of estrogen and progesterone hormones. After hormone replacement therapy during menopause women can be seen in the area.

Symptoms:

- Chronic pelvic pain (most common symptom)

- Abdominal pain, back pain, backache

- Number of be painful (dysmenorrhea)

- Infertility (infertility)

- Painful sexual intercourse (dyspareunia)

- Pain in the Limbs

Depending on which organ the more rarely settled ...

- Kabızklık or diarrhea

- Rectal pain hit

- Bloody stool

- To be bleeding from the anus

- The blood in the urine

- Each time that nosebleeds

- Be on time during menstrual bleeding and bruising parts of the body

- Katemenial pneumothorax (pneumothorax siklis menstrual cycle)

- Katemenial seizures (convulsions menstrual period is due to CNS involvement)

- Endometriosis patients for various reasons difficult to become pregnant. In pregnant patients with low risk it is higher than usual.

Endometriosis in the ovaries (ovaries) called endometrioma or chocolate cysts are cysts may occur due to the settlement. These cysts usually does alone, there often with endometriosis in the pelvic tissues.

How does endometriosis?

The exact cause of endometriosis is unknown, but some theories have been put forward to explain how it developed. These:

- Retrograde menstruation: the backward tube consisting of menstrual bleeding in the uterus and from there into progress towards the abdomen. The lung theory can not explain endometriosis in organs such as the brain.

- Vascular or lymphatic metastasis: the endometrium of the uterus that is moved to the innermost layer of blood vessels and lymph vessels elsewhere in the body and through it to settle in the region.

- Coelomic metaplasia theory: some turn into endometrial tissue under the influence of factors in some of the cells in the abdomen.

Risk factors include:

Endometriosis is more common in women who have the following risk factors.

- Infertility (infertility)

- Nulliparity

- Your mother and sister in women with endometriosis

- Menstruating at frequent intervals, but with prolonged bleeding women

- Early menarche

- Red, kımız haired women

- Utero DES exposure

- Tall, lean women (overweight is less common in women)

- Who fed red meat and high in fat

Generally, factors that reduce the frequency and duration of menstruation reduces the risk of endometriosis. For example, use of birth control pills, pregnancy, menstruation conditions are conditions that reduce the risk of endometriosis.

Diagnosis:

The definitive diagnosis of endometriosis is found to be, and what stage but laparoscopy or made by examining biopsies of suspicious areas seen during open surgery. Continuous groin pain, the pain and infertility in older units beginning in those who suffer from endometriosis is suspected. However, no complaint can not be the person with endometriosis. Endometriosis in the abdomen during surgery are small (3-5 mm), blue, red, pink is seen as spots. endometriosis in the operation phase of the light is determined to be moderate or severe, it is made scoring.

Kanda is a tumor marker CA-125 levels may rise in the diagnosis of endometriosis, but there is no pathognomonic feature can only be suspected of supporting the diagnosis.

Endometriosis can not be seen on ultrasound but if endometrioma cysts in the ovaries can be seen with ultrasound.

Infertility in endometriosis:

Connected ovarian endometriosis and adhesions formed in the tube can cause infertility. Also some substances secreted from endometriosis and sperm fertilized the egg, the uterus can interfere into the settlement. Endometrizo can lead to anovulation. Endometriosis, infertility does not occur in all patients, and some self-help treatment for pregnant women to various vulnerability can stay while others pregnancy, they need vaccination or IVF treatment. Chance of pregnancy in patients with advanced stage endometriosis and advanced age is lower. abortion in pregnant patients with endometriosis (low) risk is higher than normal.

Endometriosis accompanying diseases:

Endometriosis patients with an increased risk of clear-cell and endometrioid ovarian c (source). SLE, melanoma, non-hodking research showing an increased risk of lymphomas available (source).

Treatment:

There is no definitive treatment for endometriosis permanent. The aim of the treatment applied to relieve pain and to eliminate infertility. For this purpose, medical and surgical treatments can be applied. Drug therapy is useful in reducing the pain, but does not increase the pregnancy rates. Surgical treatments (laparoscopy) are useful to increase the pregnancy rate and in reducing pain as well. In the treatment of endometrioma cyst laparoscopic cystectomy is the most effect method. During menopause, estrogen levels in the body to regress to decrease endometriosis.

Medical treatment of endometriosis based on the principle that an estrogen-dependent disease. Drug therapy progestins (medroxyprogesterone acetate), antiprogestins (gestrinone, danazol), GnRH analogues (leuprolide, goserelin, buserelin), combined oral contraceptives (birth control pills), mifepristone, aromatase inhibitors (letrazole, anastrozole) can be used.

In cases of severe endometriosis, endometrioma cyst surgery is the treatment approach should be preferred in patients. The laparoscopic approach is the gold standard treatment. endometriosis and adhesions in abdominal surgery subversion burned and cut away as much as possible. This is very effective in reducing pain, but after a while complaints can begin again. To ensure the reduction of postoperative pain and the recurrence is usually given medication.

Non-steroidal painkillers antiinftamatu in reducing pain is quite effective, but the loss of endometrioma focus and do not provide these medicines complaints start again interrupted.

Infertility (infertility) treatment (ovulation treatment, vaccination or test-tube baby VB) applies if the child prompt.

hormones due to menopause in patients with a history of endometriosis, estrogen alone therapy should not be given if needed replacement therapy, the absolute progesterone should be added.