Endometriosis of the pelvic peritoneum. Endometriosis of the pelvic peritoneum what is it Causes of growth of the uterine epithelium

The growth of tissue outside the uterus of a benign nature is called. In this case, the endometrium, that is, the lining of the uterus, is attached to other organs and begins to function actively. This disease is in third place in the list of all diseases of the fair sex and more often affects women in reproductive age.

Causes

To date, the root causes of endometriosis in the female half have not been fully determined, but there are common factors that can provoke this disease.

The main reasons for the development of pathology:

Hormonal failure in the body of a woman;
Decrease in the protective function of the body, since with immunity normally the body is able to fight cells growing beyond the uterine cavity;
“Reverse” menstruation, that is, when a woman’s regular discharge does not come out all, but some enters the abdominal cavity, where the endometrium attaches to other organs and begins to actively function there;
hereditary factor;
Surgical intervention in the uterine cavity or inflammatory processes;
Pathologies associated with abnormal structure of the genital organs;
Obesity;
Decrease in the level of hemoglobin in the blood;
Use of an intrauterine device for a long time.

Most often, endometriosis affects the female half up to 40 years old, as well as girls who have early "critical days" and are accompanied by copious discharge for more than seven days.

Symptoms

Most often, the disease passes without obvious manifestations, that is, a woman, as a rule, does not bother anything. But there are a number of symptoms by which pathology can be recognized.

Symptoms of endometriosis:

Altered vaginal discharge between "critical days" (they may be accompanied by an unpleasant odor, be in the form of pus during inflammation, and also have a brown or red color).
Pain in the lower abdomen, regardless of the "menstruation".
Discomfort and intimacy, as well as during sports.
that have nothing to do with menstruation.
The presence of blood in the urine or feces during menstruation (this occurs when the disease and the rectum).

At the same time, the manifestations of the disease directly depend on the degree of growth of the endometrium outside the uterus, the larger the area of the lesion, the stronger the woman will have various manifestations. Also, endometriosis and infertility are interrelated concepts. 90% of women with the disease have problems conceiving, even when there are no obvious manifestations of the disease.

Forms of the disease

Endometriosis can come in three different forms:

Genital (develops inside the genitals).

This form of the disease occurs most often, but it may not have pronounced symptoms. In this case, the endometrium affects the ovaries, fallopian tubes, cervix and cervical canal.

(endometrium grows outside the internal genital organs).

Here, not only the organs of the peritoneum are affected, but also the pulmonary region and the genitourinary system. If there are internal scars on some organ after surgical operations, then the endometrium is actively attached to them. In rare cases, the disease can affect the organs of vision. In this case, blood may come out of the eyes.

Mixed (development of the disease both inside and outside the internal genital organs).

Also, endometriosis has several stages. At the 1st and 2nd stages, there may not be manifestations, but if left untreated, then the disease acquires. First, small areas are affected, and then the foci of the disease begin to grow. It is also a seemingly benign and harmless disease, if left untreated, of a malignant nature.

Also, foci of endometriosis in the abdominal cavity lead, first of all, to infertility, constant pain in the pelvic region, and also to the adhesive process, if there are scars after a cesarean section or other surgical intervention in this area.

Complications

If treatment is not carried out or the therapy is incorrect, then this can provoke a number of complications. The initial stage of the disease, when only the mucosa is affected, passes into the second, affecting the layers of the myometrium to the middle. Subsequently, the pathology grows to the peritoneal lining of the uterus (3rd form) and affects the entire abdominal cavity (4th stage).

If treatment is not started in a timely manner, then this leads to various consequences.

Possible complications of endometriosis:

The patency of the fallopian tubes is disrupted, which significantly reduces the reproductive function of a woman;
The onset of pregnancy, but ectopic;
Miscarriage;
Adhesions in the pelvis and abdominal cavity;
Anemia due to severe and persistent blood loss;
Education ;
Malignant neoplasms.

Also, the growth of endometriosis affects other organs, which can lead to neurological disorders. And in the case of anemia, a woman feels constant weakness, she is tormented by migraine, heart palpitations and shortness of breath.

Is it possible to conceive with endometriosis?

In general, - rarely compatible concepts. Since the disease itself entails that a woman simply cannot conceive a baby. And even if pregnancy occurs, which is extremely rare, it can end in a miscarriage. But it also cannot be definitely said that endometriosis and infertility are completely incompatible concepts. Pregnancy can occur, although in rare cases. Along with this, not only endometriosis leads to the inability of a woman to conceive a baby, this problem has other root causes.

So, endometriosis negatively affects ovulation, can lead to obstruction of the fallopian tubes or adhesions, which in turn makes it difficult for the egg to be released. In addition, a woman with a normal and regular menstrual cycle, but with the presence of a disease, may not ovulate at all. And accordingly, such a woman has no chance of becoming pregnant.

Proper treatment of endometriosis in more than 50% of cases leads to pregnancy within six months or 12 months.

If the therapy was on time and pregnancy came after, then it is this condition that will contribute to the fact that a woman can finally recover from endometriosis. This is because during the period of bearing a baby and feeding him with breast milk, menstruation stops, and the hormonal background changes somewhat. The area affected by endometriosis completely heals during this time and after 10-15 months there are no relapses. At the same time, of course, care must be taken to avoid, if possible, those factors that can provoke the disease.

Diagnostics

This disease is not diagnosed by symptoms, as they are similar to other pathologies in the pelvic region of a woman. To do this, a number of surveys are assigned.

The definition of the disease is carried out by the following methods:

(the vaginal sensor allows you to determine many changes in this area);
Hysteroscopy (helps to examine the surface of the uterus and determine the patency of the fallopian tubes);
Hysterosalpingography (especially relevant for infertility, since it is possible to determine the depth and degree of damage to endometriosis foci);
Laparoscopy (an excellent method of diagnosis, as well as therapy, because during the procedure it is possible to remove foci of pathology and not affect other organs and systems);
General blood test (with the help of a marker, an ailment is determined).

These laboratory tests are prescribed by a specialist after a visual examination and determination of the location of the disease.

Treatment

Treatment may be in the form of surgery or drug therapy. Both of these methods are often used in combination. If the therapy is conservative, then it is aimed at blocking the pathological process of cell proliferation.

Thus, endometriosis of the pelvic peritoneum is treated with oral contraceptives, during which the hormonal levels are corrected. Anti-inflammatory and analgesic drugs are also prescribed, as well as vitamins and immunomodulators, which increase the protective functions of the whole organism. It is possible to use local preparations in the form. But it should be understood that such therapy is designed for a long period, up to six months. But some women may have allergic manifestations to both tablet preparations and suppositories, so conservative therapy in this case is not possible.

As a rule, surgical treatment is carried out after conservative therapy has not brought positive results for six months. In most cases, it is carried out. This method allows you to save the internal genital organs of a woman. It is performed under general anesthesia for half an hour. The recovery process is fast. But if the degree of endometriosis is high and severe, then the woman is recommended to remove the uterus. This often occurs in more advanced forms.

Regarding traditional medicine, it has proven itself well, that is, treatment with leeches. This herbal medicine leads to the restoration of hormonal balance, blood thinning and restoration of the circulatory system. But it should be understood that all this will not lead to the destruction and elimination of endometrial foci, since so far no folk remedy has been able to cope with them.

Prevention

Prevention is especially relevant for women who have already had this disease, as well as for those who have only heard about it.

Preventive measures are as follows:

Avoid sexual intercourse during menstruation;
Engage in timely treatment of any gynecological diseases;
Watch your weight and stick to proper nutrition;
Avoid depression and stress, which can lead to various pathologies in the body;
Avoid interventions in the genital organs, including abortion, which can provoke uterine injuries and the development of various diseases;
Contraceptives should be selected only after consultation with a specialist.

It should be understood that nulliparous women after 30 years are at risk. Frequent climate change is also dangerous, which has a negative effect on the woman's body and on the hormonal background. Therefore, according to statistics, it is the representatives of the weaker sex, whose activities are associated with mental stress, that are susceptible to this disease. As a rule, such women put motherhood on the back burner, as they are busy building a career, and this accordingly reduces their chances of getting pregnant and bearing a baby normally.

Also at risk are women who change sexual partners too often and their sex life is “too active”.

And if the therapy of endometriosis did not bring positive results, then the woman is recommended in vitro fertilization. But it does not always give a positive result. Therefore, at the first symptoms or suspicions of a disease, it is important to undergo appropriate treatment.

Abdominal endometriosis is a benign growth of tissue outside the uterine cavity. Endometrial cells enter the peritoneum, attach to other organs and begin to function.

The causes of this disease are not fully established, but it is important to treat the pathology in a timely manner in order to avoid serious consequences. Endometriosis can transform into a malignant tumor.

Depending on the location of the lesion, genital and extragenital endometriosis are distinguished. It is oval, round or other irregular in shape, the foci contain a light or dark liquid.

The causes of the appearance of pathological formations are still under study, but there are common signs that contribute to the development of the disease:

Decreased immune system due to various diseases. If immunity is normal, the body independently fights against pathological cells that penetrate beyond the uterine cavity, blocking their further functioning.
Menstrual irregularities provoke the appearance of pathology. During menstruation, endometrial cells, along with blood secretions, enter the peritoneum. Where they are attached to other tissues and begin to develop.
Hormonal disorders in the body contribute to the development of the disease. The level of progesterone in the blood decreases, the work of the adrenal glands is disturbed, which leads to the appearance of education.
genetic predisposition. Experts have proven that girls whose mothers suffered from this disease are at risk. They are more likely to be diagnosed with this disease than other women.

There are a number of factors that provoke the appearance of the disease:

Mechanical damage to the mucous membrane of the uterine cavity - abortion, the use of an intrauterine device, curettage.
Low level of hemoglobin in the blood.
Excess weight.
Inflammatory processes in the pelvic organs.
Not professional cauterization of erosion, caesarean section.
Liver problems.
Polluted habitat.

More often, women under the age of forty suffer from this disease, girls whose menstruation began very early, during menstruation, abundant discharge is observed, which lasts more than a week.

Sometimes endometriosis passes without pronounced symptoms, a gynecologist can determine it during a routine examination of the patient.

But more often the disease is manifested by signs by which it is possible to determine the disease and prescribe the correct treatment.

The main symptoms of a pathological deviation:

Severe pain in the lower abdomen, the pain intensifies during menstruation. These symptoms are characteristic of many gynecological diseases, which is a reason to seek the advice of a specialist. With endometriosis, discomfort occurs when blood enters the abdominal cavity, which causes irritation and inflammation.
Discomfort during sexual contact appears due to the adhesive process of the pelvic organs. These sensations cause a woman to refuse intimacy, which causes stress for the spouses and even a depressive state, and this exacerbates the problem.
Uterine bleeding that occurs between periods, often combined with heavy menstrual flow.
If endometriosis affects the bladder or rectum, there is blood in the urine and stool during menstruation.
The disease contributes to the formation of speck in the fallopian tubes, which makes it impossible to become pregnant. Therefore, infertility is the main symptom of a pathological deviation.

Exacerbation causes acute pain in the lower abdomen, even without menstruation. This indicates an inflammatory process in the organs where endometrial cells began to function.

All these symptoms should alert the girl, but you do not need to self-medicate. It is important to visit a gynecologist who, after a complete examination, will prescribe treatment.

Depending on the depth of the lesion, four stages of the disease are distinguished:

The first stage is observed when the mucous membrane is affected to the muscular layer of the uterus.
The second, if the layer of myometrium is affected to the middle.
The third stage - the pathology grows to the peritoneal cover of the uterus.
At the fourth, there is a lesion of the abdominal cavity.

In order to prevent the last stages and prevent the spread of pathological cells, it is important to visit a specialist in a timely manner. An experienced doctor will prescribe the right treatment, which will prevent the transition of an acute illness into a chronic form.

Also, timely diagnosis of pathological changes in the body will prevent the development of serious complications.

In violation of the patency of the fallopian tubes, infertility, ectopic pregnancy may develop. If the egg is still fertilized, the disease can cause a miscarriage or premature termination of pregnancy in the early stages.

The growth of endometriosis can disrupt the functioning of other organs, with compression of the nerves, neurological disorders occur.

Excessive bleeding leads to anemia, the general state of health worsens, the woman gets tired quickly, she is worried about headaches, shortness of breath, heart palpitations, and dizziness.

The most dangerous consequence of the disease is the formation of an oncological tumor.

To avoid serious consequences, it is better to consult a doctor at the first symptoms. A complete examination of the patient will help identify the pathology and prescribe complex therapy.

How to identify and treat the disease?

To establish an accurate diagnosis, the patient is recommended to undergo a series of examinations.

First, the doctor listens to the woman's complaints, learns about all the symptoms, genetic heredity, prescribes a series of examinations:

Ultrasound examination using a vaginal probe will help detect changes in the pelvic organs.
Hysteroscopy is used to examine the surface of the uterus, the patency of the fallopian tubes.
Hysterosalpingography is a diagnostic method when, with the help of a special substance, it is possible to determine the depth of germination of foci, the condition of the fallopian tubes. Especially effective method for women who have infertility.
Laparoscopy is an effective way not only for diagnosis, but also for the parallel treatment of the disease. With minimal surgical intervention, it is possible to remove foci of pathology without harming other organs.
Blood analysis.

The method of research is determined by the doctor, it all depends on the localization of the foci of the endometrium.

In the treatment of acute illness, drug therapy or surgery is prescribed. Often a combination treatment is used.

Conservative therapy is used to block the growth of pathological cells.

For this, appoint:

oral contraception.
Anti-inflammatory drugs.
Painkillers.
Candles, vitamins, immunomodulators.

Drug therapy is prescribed for girls at the first stage of the disease, when it is necessary to restore the ability to become pregnant. Contraceptive contraception is able to normalize the level of hormones, block the entry of monthly blood into the abdominal cavity.

This method requires long-term use of hormonal drugs and constant monitoring by a gynecologist. If there is a negative reaction to the tablets, it is important to inform your doctor.

If after six months, drug treatment does not work, the patient is recommended surgery. The method of removing pathological foci of the endometrium is chosen by the doctor. It all depends on the location, the severity of the disease, the age of the woman and her desire to have children in the future.

The spread of the endometrium of the uterus beyond this organ can occur both in the reproductive system and beyond - in the intestines, bladder, on the pelvic peritoneum, in the lungs, and even in the eyes. Endometrial cells in any part of the female body are subject to the cyclic action of female hormones, and bleed during menstruation.

If there is no exit of blood from damaged vessels, it accumulates, forming cysts, nodes, plaques and other formations. This disease is very common among women of reproductive age who have gynecological problems. Among those who are being treated for infertility and undergoing a detailed examination (in particular, laparoscopy and laparotomy), from 6 to 44% of women have a similar diagnosis.

Extragenital endometriosis, which includes endometriosis of the pelvic peritoneum, is from 6 to 8% of all recorded cases of the disease. Regardless of the location, endometriosis is not a local, but a general disease that causes endocrine and nervous system disorders in a woman.

Etiology of the disease

The distribution of endometrial cells is based on their distribution through the blood and lymph flow to other organs and tissues.

This is facilitated by medical manipulations inside the uterus:

Diagnostic curettage;
Abortion;
C-section;
Manual examination of her cavity after childbirth.

Among other factors in the development of the disease, experts call injuries to the inner surface of the abdominal cavity, combined with reduced immunity. It can be inflammation, mechanical damage, surgery. In addition, genetic predisposition plays an important role.

There is an assumption that endometrial cells during menstruation, for some reason, are not excreted through the cervical canal, but are thrown into the abdominal cavity through the fallopian tubes. Normally, this situation is stopped by immune cells (macrophages), but if there are problems with the endocrine and immune systems, this protection may not work. Peritoneal cells (mesotheliocytes) begin to interact with endometrial cells, forming foci of the disease.

Clinical picture of peritoneal endometriosis

There are two forms of peritoneal endometriosis:

Heterotopia is diagnosed exclusively in the peritoneum of the small pelvis;
In addition to the peritoneum, endometriosis affects the uterus, ovaries, fallopian tubes, and intestines.

The severity of the disease depends on the following factors:

The area of foci of peritoneal endometriosis (from extensive to minimal);
The presence of adhesions, their severity (from single to complete obliteration);
The depth of the peritoneal lesion (1-3 cm).

A small form of the disease does not manifest itself for a long time, it proceeds latently.

With the spread of foci of the disease into the deeper layers of fiber before and after menstruation, the following symptoms appear:

Debilitating pelvic pain, pain in the lower abdomen of a pulling or aching nature;
Pain during sexual contact and during physical exertion;
Violation of the functioning of the abdominal organs - problems with urination, defecation, bending of the uterus due to adhesions in the peritoneum;
Absence of normal ovulation due to the adhesive process, and, as a result, infertility.

Diagnosis of peritoneal endometritis

Most often, endometritis of the abdominal cavity is detected during laparoscopy. Morphological manifestations of peritoneal endometritis:

Vesicles of a whitish hue without pigment;
Hemorrhagic vesicles - small cysts filled with thick tar-like contents;
Superficial and deep foci of the endometrium (heterotopia) of blue, purple, black;
Knots, tubercles, spots, painted in yellow-brown color.

Surgery

The only radical remedy that allows you to get rid of foci of endometriosis is laparoscopy. This procedure has many positive properties:

She is low-taumatic;
The woman does not lose the ability to bear children;
During laparoscopy, the doctor has the opportunity to objectively assess the condition of the internal organs;
The very next day, in the absence of complications, you can leave the hospital;
Traces of the operation heal quickly, they are 3 small punctures in the anterior wall of the peritoneum.

During laparoscopy, the doctor grabs the endometriosis focus with a clamp and cuts it off with special scissors. The defects of the peritoneum remaining after this heal quickly. To prevent the disease from spreading further, the tissues excised during laparoscopy are removed through the operating channel in a special container.

In addition to surgery, it is possible to carry out cryodestruction, laser coagulation, excision of nodes with an electric knife, argon coagulator, and an ultrasonic scalpel.

Conservative treatment

In addition to removing the foci of the disease, the goal of specialists involved in the treatment of endometriosis is:

Prevention of recurrence of the disease;
Protection against complications, consequences of adhesive disease;
Therapy of pain syndrome;
Treatment of posthemorrhagic anemia;
Relief of psychoneurological manifestations.
Hormone therapy lasts from 2 months to six months.

It includes the following groups of drugs:

Estrogen-gestagens - Microgynon, Diane-35, Ovidon, Rigevidon, Anovlar, side effect - increased risk of thrombosis;
Progestins that effectively relieve pain - Norkulot, Depostat, Duphaston, Orgametril, a side effect - weight gain, swelling of the limbs, tension in the mammary glands, breakthrough uterine bleeding;
Gonadotropin-releasing hormone agonists that cause temporary amenorrhea - Suprefect-depot, Zoladex, Decapeptyl-depot, a side effect - hot flashes similar to menopausal syndrome;
Androgens - Testosterone, Sustanon-250;
Anabolic steroids - Retabolil, Methylandrostenediol;
Antiestrogens - Tamoxifen, Toremifene.

These drugs require strict control of contraindications, side effects.

Other groups of drugs for symptomatic treatment:

Immunomodulators - Levamisole, Cycloferon, Timogen;
Antioxidants - ascorbic acid, vitamin E, pycnogenol;
NSAIDs for pain relief, treatment of inflammatory processes - Brufen, Indomethacin;
Antispasmodics - Analgin, No-shpa;
Tranquilizers to eliminate neurological manifestations - seduxen, Elenium, Phenazepam, Rudotel, Tazepam;
Iron preparations for the treatment of hemorrhagic anemia (Ferroplex, Fenyuls).

With the exact selection of drugs and the implementation of the doctor's recommendations, the disease is effectively treated.

Prognosis of the development of the disease

Relapses of the disease occur in 20% of women of reproductive age with a similar diagnosis. In premenopause, the prognosis is more favorable because the production of estrogen by the ovaries gradually decreases. After radical surgery, peritoneal endometritis does not recur, the ability to bear children is restored.

Endometriosis of the abdominal cavity is a pathological proliferation of endometrial cells outside the uterus, their ingrowth into the soft tissues of neighboring internal organs located in the small pelvis. The process of cell germination in the abdominal cavity is benign, but without timely treatment, in the presence of concomitant diseases, the possibility of degeneration of endometriosis foci into a malignant tumor is not ruled out.

Why endometrial cells grow into the abdominal cavity - scientists still have not been able to find out. However, there are a number of factors that can significantly increase the risk of endometriosis in the peritoneum:

depressed immune system - weak immunity is observed in women who have had severe infectious or viral diseases, which is why the body cannot cope with the growing cells of the endometrium;
failure of the menstrual cycle, leading to incorrect and untimely maturation and an increase in the thickness of the epithelial uterine layer;
injuries of the cervix and the organ itself - cases of medical abortion, the passage of a curettage procedure for therapeutic or diagnostic purposes, other types of surgical interventions;

chronic inflammation of the pelvic organs;
lack of hemoglobin - this pathological condition is observed in diseases of the circulatory system, anemia, malnutrition;
excess weight, obesity;
liver disease;
poor environmental situation in the region of residence;
hormonal imbalance is a common cause of the development of the disease;
heredity.

If a woman among blood relatives had cases of peritoneal endometriosis, the risks of the onset of the disease increase significantly, especially in the presence of provoking factors. The probability of pathological proliferation of epithelial cells increases in girls with an early onset of menstruation. This refers to situations when a teenager's period began earlier than 14-15 years.

The etiology of the disease is due to the fact that during menstruation, for unknown reasons, the cells of the uterine layer of the endometrium do not penetrate the cervical canal, but seep into the peritoneum through the passages of the fallopian tubes. In a normal state of health, the immune system itself copes with pathogenic cells, producing antibodies to them - macrophages. But with weak immunity, this process is too slow, or absent altogether. Then peritoneal endometriosis begins to develop. Endometriosis of the pelvic peritoneum is more often diagnosed in women aged 35 to 40 years.

Symptoms

Endometriosis of the pelvic peritoneum in the early stages of development may not have a pronounced symptomatic picture. The symptoms of the disease appear gradually. Their nature and intensity depend on the tissue of which particular organ the endometrial cells germinate.

Common signs of pathology include:

severe pain in the lower abdomen;

increased pain during menstruation, heavy periods;

constant feeling of discomfort in the abdomen, bloating;

discomfort in the groin during sexual intercourse;

bleeding not associated with menstruation.

If the tissues of the bladder, cervical canal, endometriosis of the anterior abdominal wall (see photo) or rectum are damaged, the woman has a violation of the stool, frequent constipation is replaced by prolonged diarrhea, blood clots are present in the feces and urine. Over time, endometrial cells affect more and more tissues, which leads to blockage of the fallopian tubes and the inability to conceive a child.

The disease negatively affects the emotional background. Knowing that every sexual intercourse will cause abdominal pain, a woman deliberately refuses to have sex. Each arrival of menstruation causes a feeling of panic, abundant discharge, which occurs in the middle of the cycle, depresses a woman, and interferes with an active life.

Diagnostics

Soft tissue damage from endometriosis is a serious disease that, if left untreated, can lead to serious consequences. The specificity of endometriosis lies in the fact that it very quickly passes into the chronic stage, and even the surgical treatment performed will not guarantee a complete recovery.

A woman should immediately consult a doctor as soon as she discovered that, in addition to menstruation, she had discharge, and bleeding during menstruation became profuse, her stomach often began to hurt. The diagnosis of abdominal endometriosis is made after the doctor conducts a gynecological examination of a woman on a chair, makes a thorough history, and analyzes complaints.

To clarify the primary diagnosis, determine the degree of development of the disease and the presence of complications, a medical examination is carried out, including the following methods:

Ultrasound of the pelvic organs- performed transvaginally. The introduction of a special sensor into the vagina makes it possible to obtain an accurate image of the state of the cervix and uterine cavity.
Hysteroscopy- is carried out to analyze the state of the uterine fundus, the degree of patency of the fallopian tubes is analyzed.
Laparoscopy Minimally invasive surgery is performed for both therapeutic and diagnostic purposes. This method of examination is used for suspected complications from the pelvic organs.

To assess the general health of a woman, a general and detailed blood test is done. If there are blood clots in the urine or feces, they are tested in the laboratory. Based on the data obtained during the medical examination, the doctor selects a treatment method.

Treatment of abdominal endometriosis

In the early stages of the development of the pathological process, when pathogenic cells have not yet had time to fully grow into the soft tissues of the abdominal organs, conservative treatment is prescribed. It consists in taking medications aimed at normalizing the hormonal background of the reproductive system, stopping the signs of endometriosis and stopping the further spread of the pathological process.

In a severe stage, when the disease has become chronic and provoked a number of complications, there is no point in drug therapy. A positive result can be achieved only through surgical intervention.

Medical treatment

To stop the process of pathological proliferation of endometrial cells, hormonal drugs are prescribed. As a rule, women are prescribed oral contraceptives, the long-term use of which contributes to the normalization of hormonal levels and inhibition of the production of a large amount of the female hormone estrogen.

What does it give? When the concentration of estrogen decreases, there is no ovulation. The organs of the reproductive system stop preparing every month for the possible fertilization of the egg, the endometrium stops growing. Hormone therapy includes the use of certain drug groups to alleviate the general condition of a woman:

Antigestagens- drugs quickly reduce the pain symptoms of the disease. The drugs of this group trigger the process of atrophy of the uterine layer of the endometrium, preventing further growth of pathogenic cells. Despite the effectiveness of this therapy, it is resorted to only if the woman has contraindications for surgery, and the disease is developing rapidly. The disadvantage of this treatment is that hormonal agents from the antigestagen group often cause side symptoms - weight gain, hot flashes, acne.
Agonists- drugs of this group slow down the process of producing hormones of the female reproductive system. These drugs should be taken in a short course, as long-term use creates an artificial menopause. Not recommended for patients planning pregnancy.
Preparations of the estrogen-gestagen group- are prescribed for an intense symptomatic picture, when the endometrial cells have grown deep into the tissues of the pelvic organs, the woman has severe pain in the pelvic region.
Progestogens cause atrophy of the endometrium. Effective for symptomatic therapy. Medicines relieve severe pain in a short time. The disadvantage of treatment is the high risk of complications such as rapid weight gain, extensive swelling of soft tissues. Hormonal preparations from the progestogen group are taken for a long course of 6 to 12 months.

In addition to hormonal treatment, symptomatic therapy is carried out. Painkillers and non-steroidal anti-inflammatory drugs are prescribed to relieve attacks of abdominal pain.

To restore the protective functions of the immune system, immunomodulators are prescribed. It is allowed to use traditional medicine methods - taking decoctions from medicinal herbs (chamomile, St. John's wort, celandine). Decoctions are also used for douching. The alternative method of treatment helps to normalize the functioning of the organs of the reproductive system and reduce the intensity of pain.

Doctors take 6 months for conservative treatment, ultrasound is periodically performed to monitor the condition of the endometrium. If after six months there is no positive dynamics, an operation is prescribed.

Surgery

The operation for the treatment of endometriosis is carried out in two ways - laparoscopy and classical surgery. Depending on the severity of the clinical case, during the operation, the uterus and appendages are either partially or completely removed.

Preference is given laparoscopy. This method of operation is characterized by minimal traumatism, the rehabilitation period is short. Complications after laparoscopy are rare. Due to the absence of a cavity incision, a woman does not need to stay in the hospital for a long time. Discharge from the hospital is carried out the next day.

During laparoscopy, the doctor makes several punctures in the abdominal cavity, through which surgical instruments and an endoscope are inserted, through which the doctor receives an image from the peritoneum on the screen.

The foci of endometriosis themselves are removed by cauterization. The following methods are used for this:

cryodestruction - the destruction of pathogenic cells with liquid nitrogen;

electrocoagulation - exposure to high-frequency current;

laser vaporization - a method of evaporating pathogenic tissues with a laser;

radiocoagulation - exposure to foci with radio waves.

During laparoscopy, the removed tissues of endometriosis foci are sent to the laboratory for histological examination, which determines the nature of the formations. Such an examination is carried out for the reason that there is a risk of degeneration of foci into malignant neoplasms.

After the operation, a woman needs to undergo a course of hormonal therapy in order to restore the functioning of the organs of the reproductive system, normalize the menstrual cycle, and prevent the re-growth of endometrial cells.

Possible Complications

Ascites is dropsy in the abdominal cavity that occurs due to inflammation of tissues damaged by endometriosis cells.

Ascites is manifested by an increase in the volume of the abdomen, severe pain, signs of intoxication of the body. The disease is treated only by surgical intervention. If the operation is not carried out in a timely manner, the dropsy filled with fluid will burst, which will lead to peritonitis.

Despite the fact that during the surgical treatment of abdominal endometriosis, the foci of the disease are removed, there is still a risk of a recurrence of the disease. The recurrence of lesions occurs if the cause of endometriosis has not been cured.

Another complication after surgery is endometriosis of the postoperative scar. The pathology develops gradually, it can manifest itself in a few years. With the development of this disease, endometrial cells begin to grow rapidly outside the uterine cavity and grow into the postoperative scar. Symptoms and treatment are identical to the general clinic of endometriosis.

A woman experiences severe pain in the abdomen, the cycle of menstruation is disturbed. The therapy is conservative, if the disease was diagnosed in the early stages, or an operation is prescribed when medications do not help, the pathology is running and there are complications.

Pregnancy and pathology

It is possible to become pregnant with abdominal endometriosis in the early stages of the development of the pathological process, when there are still no extensive adhesions that block the passages of the fallopian tubes. If a laparoscopy was performed, it is recommended to become pregnant immediately after the completion of restorative hormonal therapy. Under the influence of a natural change in the hormonal background, there is a possibility that the pathological process will stop.