자궁내막증 증상Disease Encyclopedia
Endometriosis
Endometriosis is a condition in which endometrial tissue (uterine glands and stroma) exists outside the uterus, causing disease. Ectopic endometrial cells located outside the uterus have receptors for various sex hormones. Depending on the menstrual cycle, local bleeding and inflammatory reactions occur in the lesion, which eventually leads to fibrosis and adhesion, resulting in pain and infertility.
Several causes have been suggested to cause endometriosis. Among them, the most influential hypothesis is that retrograde menstruation occurs through the fallopian tubes during menstruation, and as a result, endometrial cells contained in menstrual blood move into the pelvis, causing this disease.
Pelvic pain seen in endometriosis is characterized by dysmenorrhea that begins before menstruation and continues throughout the menstrual period. You may have back pain and abdominal pain even during normal times, and you may have severe pain during intercourse. Non-specific symptoms may include perimenstrual bowel movements, diarrhea, difficulty urinating, or widespread pelvic pain. Infertility may also occur.
Endometriosis can be suspected based on symptoms and physical examination. To confirm the diagnosis, the lesion must be observed directly with the naked eye or a histological examination of the tissue lesion must be performed. On examination, the uterus is displaced toward the rectum and is fixed. Tender nodules on the uterosacral ligaments or posterior vaginal fornix may be palpated.
Imaging tests such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) can help in diagnosis. A blood test is CA –125. It is not appropriate as a screening test, but is helpful as a follow-up test.
[Endometriosis]
Before treating endometriosis, it must be confirmed by laparoscopy. Treatment methods can be divided into medical and surgical treatments.
① Medical treatment
Medical treatment includes administering painkillers, oral contraceptives, progesterone, danazol, and gonadotropin-releasing hormone.
② Surgical treatment
Surgical treatments include removing only the endometriosis lesion through laparoscopy or laparotomy to preserve pregnancy and fertility. There are also radical surgeries (hysterectomy and bilateral salpingo-oophorectomy). If infertility is a problem, assisted reproductive techniques may need to be performed.
Treatment methods may vary depending on the patient’s situation, so a treatment policy tailored to each individual must be established after consultation with a specialist.
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