Endometriosis is the ectopic intrauterine development of mucosa-type, outside the intrauterine cavity. Essentially endometriosis is the development of colonies of cells outside the uterus. These cells should be within the uterus and form what is called a endometrium. The endometrium is a type of epithelial tissue while the rest of the uterus as we know consists of smooth muscle tissue. There have been many theories trying to explain how these cells can be grown in other places outside the uterus, the most prevalent theory at the moment is about a kind of metastasis (a mechanism similar to that obtained in cancerous tumors through the blood vessels). Basically what happens is that cells from inside of the uterus escape through the blood vessels and form colonies in other organs adjacent to, or sometimes located at a distance from the uterus.
The major places that endometriosis develops are the ovaries, the fallopian tubes, the colon, the omentum etc. Endometriosis occurs very often and occurs mainly between the ages of 25 and 48 years. It is most common in countries of the Western world and the white race. Factors predisposing to the existence of endomitiosis gynecological surgery, ysterosalpingografy etc.
The characteristics of outbreaks endometriosis is red masses of cells that grow slowly over time. In the case of endometriosis outbreaks in the ovaries is possible to create smaller or larger cysts with typical chocolate content and has a distinctive image in the pelvic ultrasound.
The main clinical symptoms are pain and dysmenorrhea, which begins around five to seven days before menstrual. Other symptoms are painful defecation, the dysparefnia ie pain during sexual intercourse and the menorrhagia, ie increase of the amount of blood during period.
The diagnosis can be done by laparoscopy, which is a new technique introducing a camera with a cold light through the navel trying to locate in the abdomen and pelvic endometriosis outbreaks. Right now in America and Western Europe laparoscopy is the main way of diagnosing endometriosis cases. Through an ultrasound can only be diagnosed in cases mentioned above as chocolate cysts on one or both ovaries.
There are different stages of the severity of this disease that ranges from a mild stage of superficial lesions in the pelvis, when we have moderate characteristic scarring and adhesions and severe edomitriosis where among other things are chocolate cysts, deposits of endometrial cells in the colon in urinary system and so on. Very rarely there have been endometriosis as far as the lungs.
A key feature we must find is that a large proportion of couples with infertility problems is identifiying during laparoscopy endometriosis outbreaks. These outbreaks may have caused adhesions and pelvic anatomy is completely or partially altered.
Rare complications is the rupture of chocolate cyst which may even cause peritonitis, inflammation.
The treatment of endometriosis could be either surgical, or pharmaceutical by using analgesics or combination of both. We can also GNRH analogues, which are substances that can be found in pill form or given by injection and cause a pharmaceutical menopause, but using these drugs the symptoms get less and unfortunately can not be used, for a period exceeding six months. The reason is that the prolonged use of these drugs can cause malignancy in the ovaries.
Drugs that in some cases can be used are NTANAZOL that is antigonodototropiko. Its use should not exceed the period of 4-6 months. But this medication can cause hair growth, rock voice, dry skin and acne. It is also very important when we use NTANAZOL to inspect liver enzymes at least every two months.
Surgical option in most cases is better in the presence of endometriosis. Laparoscopic surgery can diagnose the disease first and then by various modern techniques, such as using laser, Sun or even diathermy to burn the nests. Also using modern techniques of interventional laparoscopic surgery could do adhesiolysis and try to restore the anatomy of female pelvis.
Endometriosis is a pathology, which as mentioned above, is directly related to infertility. When detected and diagnosed through diagnostic hysteroskopy the treatment should be immediate and a laparoscopic surgery should become invasive in order to offer the patient a chance to raise her chances as much as possible in order to obtain a child. In some cases the reason for endometriosis can cause infertility is unclear. In other cases the reason is because of the adhesions, which often is quite wide, we could say that block the oviduct, not allowing sperm spend time with eggs.
Many women suffering from endometriosis result in in vitro fertilization. Even after surgery or laparoscopy or even surgery for adhesiolysis and destruction of outbreaks of endometriosis, women can conceive naturally or through insemination. Endometriosis is an entity that torments millions of women in our time. Modern obstetrics gynecology has reached a stage that technology can help these women enough to reduce symptoms and eliminate them. And even to achieve the desired effect, having a baby.
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