Definition of Endometriosis
Endometriosis is an inflammatory disease of the uterus is benign, and is defined by the presence of extra uterine endometrial tissue that depends on the hormone estrogen. This often occurs among women in the general population, with an estimated prevalence of approximately 6-10%. The most frequent symptoms of endometriosis include infertility, dyspareunia, and chronic pelvic pain, and usually occur in the pelvic peritoneum, rectovaginal septum or ovaries. Although the clinical findings and symptoms may be able to provide a statement that a woman has endometriosis, a definitive diagnosis us pathological can only be made after the surgery is done.
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| Wide excision of Endometriosis Surgery |
Various theories of pathogenesis have historically been used to explain how endometriosis growing. These include retrograde menstruation causes reflux implantation of endometrial tissue, the development of endometrial tissue coelomic mesothelial cells that undergo metaplasia and lymphatic or hematogenous spread of endometrial cells. Although research has been attempted, the exact mechanisms responsible for the development of endometriosis are still not fully explained.
Endometriosis is not merely a local disease, but rather a chronic multifaceted process. As a result, the management of this disease is to overcome a challenge. Although medical treatment, surgery and traditional infertility continues to be applied in women with endometriosis, more recent research has focused on the use of therapies that target disease at the molecular level.
Symptoms of Endometriosis / Symptoms of Inflammatory Uterus Diseases
Painful
The most common Symptoms of associated with endometriosis is pain. It is believed that the results of endometriosis-related pain of the effects of inflammatory cytokines in the peritoneal cavity, bleeding from endometriosis implants, invasion and pelvic nerve irritation base. Women with endometriosis may suffer from dyspareunia, dysmenorrheal or pelvic pain cyclic / noncyclical. Medical and surgical treatments can be used to control the pain associated with endometriosis. Estrogen-progestogen contraceptives (combined oral contraceptives - COCs), used cyclically or continuously, commonly prescribed as first-line treatment for women with mild endometriosis pain, although its mechanism of action is not fully understood. It has been proposed that by inducing a state of pseudo pregnancy, COC cause endometrial decasualization and subsequent atrophy.
Infertility
Although a causal relationship cannot be confirmed for sure, endometriosis can be associated with infertility (infertility). Endometriosis was found in 20-40% of infertile women, and alleged that several mechanisms contribute to the decline in fertility in women. Ovum transport may be disrupted as a result of the distorted pelvic anatomy. There is also the theory that chronic inflammation resulting from endometriosis can affect egg acceptance by the uterus, ovary folliculogenesis and function of the fallopian tubes. Advanced endometriosis can affect fertility significantly. Medical therapy and surgical strategies have been used in the treatment of endometriosis infertility. Other treatments, such as intrauterine insemination (Intrauterine insemination - IUI) and IVF, has also been used in infertile women with endometriosis.
Although conventional treatment methods will continue to be used in dealing with endometriosis, most likely there will be therapy in the coming years. Innovative strategies that target disease at the molecular level have been developed and studied, which in turn, can be used for treatment or therapy combined with long or even replace it. Interest in endometriosis research continues, also the possibility that the optimal management of endometrioma operations will be further investigated. Given that endometriosis is common among women of reproductive age, it is very important that the quality of research continues to be done so that this disease may be better understood and treated optimally.
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