Endometriosis of the uterus (adenomyosis): symptoms and treatment, taking into account pregnancy. Adenomyosis: symptoms and treatment. What are the dangers of endometriosis foci

The entries "endometriosis" and "adenomyosis" are found in the medical records of our compatriots so often that it is desirable to know the enemy in person.

In the literature, the term "endometrioid disease" is increasingly common. This is one of the most mysterious and insidious gynecological diseases that are difficult to treat.

The main manifestation of the disease are areas of tissue, morphologically and functionally resembling the endometrium, located outside the uterine mucosa.

Let's find out how uterine adenomyosis differs from endometriosis, which is worse for women's health?

What it is

Are endometriosis and adenomyosis the same or not? Pathological endometrium most often grows into the muscular layer of the uterus (myometrium), somewhat less frequently, lesions are detected in the tubes, on the ovaries, and pelvic organs that are not directly related to the reproductive system.

Cases of the formation of endometrioid foci in the lungs and even the eyes are described.

Myometrium lesions account for about 90% of localizations of endometriotic lesions, this form is increasingly distinguished by a separate diagnosis - adenomyosis. All other localizations, including the most exotic ones, are classified as endometriosis.

The clinical symptoms of both diseases are associated with the presence of pathological foci of the endometrium, however, the external manifestations and possible complications of the pathology depend on the localization of the lesion.

Patches of endometrial tissue function in the same way as normal endometrium.

In the first half of the menstrual cycle, when the endometrium is preparing for the possible implantation of the embryo, the pathological tissue also grows.

If fertilization does not occur, the upper layer of the endometrium is torn off, menstruation begins. Fragments of tissue along with blood are removed from the uterine cavity.

At the same time, pathological formations also begin to bleed. If there is an outlet, blood flows out of the lesion, normal menstruation is accompanied by additional bleeding of atypical localization.

If the focus of pathology is closed, internal accumulations of blood are formed, the so-called "chocolate" cysts.

Adenomyosis

When the endometrioid tissue grows into the muscular layer of the uterus, the organ increases in volume. Abundant and painful menstruation indirectly indicates the presence of pathological formations. Pain and spotting dark discharge can occur outside of menstruation.

How adenomyosis classifies lesions of the body and isthmus of the uterus, as well as adjacent areas of the fallopian tubes.

According to the type of endometrioid neoplasms, diffuse, nodular and focal forms are distinguished.

In diffuse form the lesion captures significant areas of the endometrium. Focal formations relatively small, often almost do not disturb the patient. nodular lesions superficially resemble fibroids.

There are four stages in the course of the disease., differing in the severity of the lesion:

Single superficial formations.
Single or few neoplasms affecting the myometrium no more than half the thickness.
Multiple sprouting of endometrioid tissue over more than half the thickness of the myometrium.
Multiple sprouting through the myometrium, extending to the nearest organs.

Adenomyosis - whether it is necessary to treat, "Popular Doctor":

endometriosis

These terms mean germination of the endometrium outside the uterus. The lesion can be localized in any organ, most often the intestines and the genitourinary system suffer.

According to the localization of lesions, genital, extragenital and mixed forms are distinguished.

In the genital form, areas of the pathological endometrium are detected on the genitals. Extragenital lesions are called lesions outside the reproductive system.

Endometrioid lesions of the genital and any other organ system are classified as a mixed form.

Similarly, there are four stages in the development of pathology:

Single superficial lesions that objectively do not have a significant impact on the state of health.
A few sprouting of pathological endometrium in the tissue of the affected organ.
Numerous small endometrioid formations or single deep lesions. Tumors, cysts, adhesions, foci of a chronic inflammatory process are formed.
Endometrioid tissue grows through the wall of the affected organ, a massive lesion is detected. Characterized by the formation of benign and malignant neoplasms.

The exact causes of the growth of the endometrium outside the uterine cavity have not been established.

Endometriosis - symptoms, causes and treatment, the program "About the most important":

Symptomatic differences

Different forms of endometrioid disease are always accompanied by hormonal imbalances, which is displayed on the menstrual cycle. The cycle is either noticeably shortened, or vice versa, there are delays in menstruation.

Abnormal endometrial rejection accompanied by pain, bleeding becomes more profuse and prolonged.

The intensity of pain varies from mild discomfort to unbearable, and the severity of clinical symptoms is not related to the severity of the lesion.

Some patients experience intermenstrual bleeding, spotting dark discharge a few days before or a few days after menstruation.

Pain during intercourse, bowel movements, or urination. Some patients experience fever, nausea or vomiting during menstruation.

Main difference clinical manifestations associated with the localization of pain and bleeding. With adenomyosis, the uterus is painful, in cases where the pathological process spreads to neighboring organs, the pain becomes diffuse.

Other forms of endometrioid disease are manifested by pain in the area of localization of the focus of pathology.

If fragments of endometrioid tissue can be brought out, there are periodic spotting and bleeding in the corresponding area. Soreness and bleeding are naturally associated with cyclic changes in the hormonal background.

In advanced and severe cases of adenomyosis and endometriosis manifestations of anemia join the main gynecological symptoms. Both pathologies often cause secondary infertility.

Differential Diagnosis

If endometrioid disease is suspected, in addition to a standard gynecological examination ultrasound is performed with a transvaginal probe, if necessary - ultrasound of the abdominal organs.

Additionally, the patient may be assigned:

hysteroscopy;
hysterosalpingography;
colonoscopy;
CT or MRI;
blood test for specific tumor markers CA-125 and CA-199.

The main diagnostic feature for differentiating endometriosis and adenomyosis is the localization of the pathological endometrium.

If lesions are found on the body of the uterus, in adjacent sections of the tubes or isthmus, diagnosed with adenomyosis.

When identifying areas of endometrioid tissue on other organs endometriosis is diagnosed.

Treatment

Since the nature of both pathologies is the same, treatment is carried out by similar methods.: conservative, surgical or combined.

Treatment tactics are selected individually, taking into account the localization of the pathology, the severity of the lesions, the age of the patient and her plans for future motherhood.

The main role in the medical treatment of endometrioid pathologies belongs to hormonal drugs. Additionally, the patient may be prescribed anti-inflammatory, analgesic, immunomodulatory drugs.

Surgical treatment of endometriosis and adenomyosis can be performed laparoscopically. Removal of cysts and other endometrioid neoplasms, dissection of adhesions is performed.

In severe lesions, the volume of surgical intervention can vary up to the complete removal of the uterus in the last stages of adenomyosis.

Both pathologies, especially with an aggressive course, greatly complicate life and call into question the possibility of conceiving and giving birth to a child.

It is impossible to say which of the diseases is worse.. Each individual clinical case and its outcome is very individual.

It is important to remember that a responsible attitude to one's own health is one of the key conditions for its preservation. With early diagnosis and appropriate treatment the development of the disease can be stopped.

According to statistics, one out of ten diseases identified by a gynecologist is the result of the germination of the endometrium deep into the muscular layer of the uterus or any other organ. These pathologies are called adenomyosis and endometriosis. Are there any differences between them and how is the treatment carried out?

Let's first understand the meanings of these words and the nature of the course of diseases.

Adenomyosis

This is one of the most common female diseases.

Adenomyosis is a disease of the uterus caused by penetration into the muscle tissue of the endometrium. This penetration leads not only to an increase in the volume of the uterus, but also to severe bleeding, which causes severe pain both during menstruation and outside it.

There are three main forms of the disease:

focal;
diffuse;
nodal.

It is noteworthy that in one patient two or even three forms of manifestation of the disease can be observed simultaneously. The diffuse form is expressed by the defeat of large areas of the uterus. Focal, on the contrary, captures small areas and practically does not cause inconvenience. The nodular manifestation of adenomyosis is very similar to myoma in its structure, small nodes are formed.

There are four stages in the development of the disease.

The first is superficial penetration of the endometrium.
The second is that the endometrium has stuck deep enough, but the damage is not local. The defeat of the thickness of the muscular layer of the uterus does not exceed 50%.
The third is a deep penetration of the endometrium by more than 50%.
The fourth is complete damage when the endometrium is located at the entire depth of the layer.

Adenomyosis belongs to the category of chronic diseases and requires high-quality therapeutic measures. It is very important to detect pathology in the early stages of development - this will greatly facilitate treatment, and also help to avoid serious manifestations of the disease.

The reasons

To date, it is still not known what can cause the onset of the disease. However, a clear relationship was found between the germination of the endometrium and the amount of female hormones - their number is overestimated. Hereditary predisposition is seen in almost every case.

The impetus for the development of pathology can be:

stress;
depression;
overwork;
nervous breakdowns.

Symptoms

In the initial stages, adenomyosis can proceed completely without a trace. Obvious signs of the disease appear extremely rarely, and in most cases they do not exist at all.

What are the signs of adenomyosis?

Lower abdominal pain. It is especially pronounced during menstruation, physical activity and sexual intercourse.
Profuse bleeding during menstruation.
Presence of blood clots.
Before and after the cycle, spotting is observed.
Enlargement of the uterus.
Due to heavy bleeding, patients experience anemia, and this in turn causes weakness, dizziness, and fatigue.
There is a logical system of disruption of the whole organism, which worsens the quality of life and the possibilities of a woman.

endometriosis

The pathology is more complex. Adenomyosis is often referred to as internal endometriosis.

As in the previous case, the pathology is the germination of the endometrium outside the uterine mucosa. Any organ or system can be affected. Most often it comes to the gastrointestinal tract and the genitourinary system. There are three forms of pathology.

Genital - damage to the genital organs and canals.
Extragenital - any other organs, canals, and even postoperative scars are affected.
Combined - foci of the disease are found both inside the uterus and in other organs.

There are four stages in the development of endometriosis.

The first - there is one or more small foci of the disease that do not have a significant effect on the body.
The second - several foci of pathology were found. The endometrium has already begun to spread deep into the tissues of the organs.
The third - suggests the presence of a large number of small lesions or several deep ones. Serious problems are observed in the body, cysts, tumors, and inflammations are formed.
Fourth - the complete penetration of the endometrium deep into the organs is massive. Benign and malignant formations are observed.

The reasons

In general, the causes are identical to adenomyosis, but there are certain prerequisites for a more extensive spread of pathology. One of them is a violation of the immune system. Under normal conditions, the body does not allow the endometrium to take root outside the uterus.

Many researchers suggest that endometrial cells penetrate into other organs due to the ingress of menstrual blood deep into the body. The second version is that they move through the lymphatic system. This theory suggests the development of the disease due to changes in the internal structure of the body (surgery, tumors, inflammation).

The influence of hormones on the development of the disease is still dominant. Therefore, hormonal changes can be a reason for endometriosis.

In general, there are only theories. There is currently no conclusive evidence to support any of the assumptions.

Symptoms

The symptoms of the disease are almost identical. The difference lies in the larger area and localization of the pathology. The same symptoms with endometriosis appear much brighter, and pain and bleeding can shift to almost any part of the body.

As a result, an approximate list of symptoms looks like this.

Profuse bleeding during menstruation.
Bleeding of the uterus and canals.
Inflammation, an increase in volume in the affected area and the possible presence of benign and malignant formations.
Bleeding of the affected organ or surface.
appearance of temperature.
Pain during defecation and urination.
Pain at the site of localization during physical exertion and menstruation.
Lengthening the cycle of menstruation.

Similarities and differences

Two pathologies are of a similar nature - in both cases they are caused by the spread and germination of the endometrium outside the zone of its normal location. Many symptoms overlap, and it is possible to establish the disease only after a long and close analysis of the situation.

But there are some special manifestations. Endometriosis can cause female problems, infertility. Endometriosis is a more complex disease, it is much more difficult to treat, and the list of symptoms is much wider. For example, there are cases of the development of this disease even in the lungs, causing them to bleed during menstruation. Endometriosis can occur even in men, but is very rare.

Due to its specificity, the disease spreads to many internal organs. The attending physician can not immediately determine the cause of inflammation, and the disease continues to progress. Therefore, it is much more difficult to diagnose.

Diagnostics

There are a lot of difficulties in diagnosing diseases. Most of the symptoms overlap with other diseases, which makes it difficult for even an experienced specialist to identify.

The absence of clear symptoms, especially in the initial stages of the disease, leads to the fact that the disease is detected after a long time. In such cases, treatment is not only longer, but also more stringent. One of the few possible ways is surgery. The reason for this turn of events may also be an inattentive attitude to minor deviations attributed to the weather, overwork, and age.

How is the diagnosis done? A set of analyzes and additional studies is being carried out. No device is able to clearly show endometriosis or adenomyosis. But studies can rule out a number of similar diseases. Thus, it is possible to calculate this insidious disease - by excluding other diseases. Otherwise it is impossible to do it. It is possible to determine the growth of the endometrium only on the removed uterus or organ, with a careful examination of the tissue under a microscope.

An examination by a gynecologist in some cases also does not guarantee a definition, but the doctor may notice deviations. So it turns out that the disease is detected at an early stage. After a complete examination, the doctor diagnoses the disease and prescribes a treatment that will quickly improve the functioning of the body.

What does the treatment look like?

Since the exact cause of the diseases remains unknown, in most cases the doctor seeks to relieve the patient of the symptoms and influence the intensity of menstruation. This can be done by many methods, but the task of the doctor is to select the ideal option.

Taking painkillers before and during the cycle will relieve pain.
Contraceptives reduce the intensity of menstruation and reduce inflammation.
Hormonal preparations are used to create the necessary balance. They are the main treatment.
Anti-inflammatory drugs are prescribed to reduce inflammation.

In some severe cases, surgery is indispensable, but they are tried to be avoided. The complexity of the procedure depends on the degree of spread and the desire of the woman to have a child in the future. Cauterization of damaged areas is carried out, and then complete or partial removal of the ovaries, removal of the uterus can be carried out. The efficiency of operations is very high, but the consequences for the body are very severe.

Another way out can be a spiral. However, its action cannot be described as a treatment - after its removal, the disease may return.

Treatment of diseases is possible only with the implementation of a complex effect.

Complications

The appearance of anemia has already been mentioned, but is it the most dangerous? No. A number of consequences are irreversible changes. Violation of the reproductive function can be a real grief for a family who wants to have a child. Such exposure occurs without any symptoms of disease. If you have not been able to get pregnant for a long time, the doctor will look for signs of endometriosis and adenomyosis.

Fibroids and endometriosis are closely related. The same goes for adenomyosis. Fibroids and endometriosis share many of the same symptoms, but often the two conditions develop at the same time, with one causing the other over time. However, the relationship is not reliably confirmed due to problems with determining the causes of ailments. It is likely that fibroids and endometriosis simply create favorable conditions for each other to develop. It remains obvious that a tumor appears and grows with hormonal disorders and a weakened immune system.

If the treatment does not bring results, then sooner or later the removal of the uterus and ovaries will be recommended, which in itself is a heavy blow to the body.

Finally

According to medical data, middle-aged and elderly women are more likely to suffer from such diseases. Environmental problems, bad habits, rejection of a healthy lifestyle and a balanced diet every year rejuvenate these pathologies. Both of them are dangerous to health and can cause a strong deterioration in the well-being and worldview of a woman, depriving her of the opportunity to achieve the goal of giving birth to a child. By the way, the birth of a child under the age of 30-35 is one of the best preventive measures.

To get timely treatment, it is not enough just to monitor your health, you also need to undergo regular examinations by a gynecologist and take the necessary tests. There is nothing better than early detection and treatment.

Faced with an incomprehensible diagnosis, women are often at a loss: what is the difference between adenomyosis and endometriosis? What do these consonant pathologies have in common, which one is worse for the female body and how to treat them? To clarify, we will consider both diseases and conduct a comparative analysis.

The inside of the uterus is lined with a special tissue called the endometrium. Endometrial cells are sensitive to the menstrual cycle. They grow, thicken, and once a month they are destroyed and removed from the body with blood.

They say about the disease when the endometrium, growing through the wall of the uterus, affects neighboring tissues, or is carried with the bloodstream to other organs and systems. At the same time, the cells continue to live in their usual rhythm: grow and bleed regularly, which provokes the appearance of chocolate-colored cysts.

The exact cause of endometriosis is not known., there are only theories about predisposing factors:

failure in the production and ratio of sex hormones;
surgical interventions that contribute to the germination of the endometrium into the body of the uterus and throw it into the abdominal cavity (abortion, caesarean section);
genetic predisposition.

Attention! An important role is played by a decrease in immunity, excessive physical and psycho-emotional stress.

The development of endometriosis takes place in 4 stages:

The presence of several shallow foci that do not manifest themselves clinically and do not threaten the normal functioning of the body.
Germination of the endometrium deep into the affected organ. It is during this period that symptoms may appear.
Multiple foci of varying degrees of damage. There are deviations in the work of the pelvic organs, tumor-like formations, cysts are detected.
The capture of other organs by the endometrium takes on a massive character, the tissue is affected to the full depth. In large numbers, benign tumors and their degeneration are noted.

At the initial stage, endometriosis develops asymptomatically.. Often, the first signs of a woman are noticed only with the formation of cysts, an increase in the size of the affected organ and its bleeding in accordance with the menstrual cycle, pain in the places of focal growth. Perhaps the appearance of inflammation, an increase in the temperature of local and general, anemia develops.

Fortunately, endometriosis, in its full manifestation, does not develop so often. Usually its “lightened” form is found - adenomyosis.

Adenomyosis: causes and stages of development

The essence of the development of adenomyosis and endometriosis is the same. The disease is based on the pathological growth of the endometrium, but unlike the disease described above, adenomyosis does not go beyond the uterus. Cells penetrate into the muscle layer of the organ at all levels, forming a focal, diffuse or nodular lesion.

There are 4 stages of the course of the disease:

superficial localization;
penetration into the body of the uterus to the middle of the muscle layer;
damage to the wall throughout its thickness;
full germination, exit under the outer shell.

The main culprits of the changes are hormonal disorders and the hereditary factor. Among the concomitant causes are long-term depressive states, debilitating physical exertion, and serious illnesses. That is, factors that weaken the immune system.

Reference! It is believed that it is a well-functioning immune system that does not allow endometrial cells that accidentally enter the abdominal cavity to grow.

Adenomyosis can be suspected by the following manifestations:

change in the size of the uterus in accordance with the menstrual cycle;
prolonged and intense bleeding, the appearance of clots;
spotting before and after menstruation for several days;
severe pain on “critical days”, which is not eliminated by conventional analgesics for a long time;
development of anemia due to massive blood loss, deterioration in general well-being.

Both diseases develop slowly, gradually increasing symptoms. At the initial stage, the pathology proceeds without pronounced signs, which complicates its timely detection.

Similarities and differences

Having gained an idea of the essence of the changes, we will compare the pathologies, determine their similarities and differences. What is the difference between adenomyosis and endometriosis, the table will clearly demonstrate.

Despite the obvious differences between adenomyosis and endometriosis, this is just a different form of the same pathology. They have one cause of occurrence, disrupt the normal rhythm of the menstrual cycle, and in the long term lead to infertility. In the initial stages, both diseases are amenable to hormone therapy. But successful treatment does not mean the impossibility of recurrence., since the basis of pathological changes is an internal failure.

Methods of treatment

In solving the problem, drug therapy and surgery are used. The choice of method depends on the degree prevalence, intensity of symptoms, age, desired outcomes (for example, the birth of a child).

The basis of therapy is hormonal drugs. They restore and maintain the desired balance, normalize the duration of the menstrual cycle and the intensity of bleeding. Non-hormonal anti-inflammatory therapy eliminates pain and general malaise. In addition, doctors prescribe:

painkillers;
antispasmodics;
immunomodulators;
sedatives.

More radical methods include: cauterization of areas of the overgrown endometrium, laparoscopic removal of cysts and formations, complete removal of the uterus and ovaries.

Therapeutic procedures include the setting of a hormonal spiral, but this is only a deterrent. After the coil is removed, the disease usually returns.

Adenomyosis and endometriosis are complex diseases that require a woman to constantly monitor her health. Unspecified causes of occurrence do not allow the development of a narrowly focused diagnosis and an effective treatment system. And, of course, the presence of adenomyosis does not exclude the development of endometriosis later.

Endometriosis is the appearance of uterine lining tissue in atypical places. Adenomyosis is considered as a special case of endometriosis. Treatment can be surgical or conservative.

What is the difference between adenomyosis and endometriosis and how to treat

For those who are faced with such incomprehensible diagnoses as adenomyosis and endometriosis, it can be difficult to figure out what the difference is. These medical terms characterize similar conditions, that is, they have much in common. The fundamental difference is only the localization of the pathological focus, and the clinical symptoms, principles of diagnosis and approaches to treatment are similar. Questions regarding endometriosis and adenomyosis will be safely resolved by an obstetrician-gynecologist.

Adenomyosis and endometriosis are almost the same disease. Both pathological processes are distinguished by the formation of foci of the endometrium (the inner lining of the uterus) in atypical foci. Adenomyosis affects the deeper layers of the uterus. With endometriosis - any organ of the female body, from the reproductive system to the camera of the eye. Endometrial cells with blood or lymph flow can penetrate into the most distant parts of the body from the primary focus.

It must be understood that adenomyosis and endometriosis are a benign tumor process, although it is characterized by the growth of the pathological focus into still healthy tissues. Endometriosis is distinguished from a malignant tumor node by the absence of atypical (cancerous) cells and the dependence of clinical symptoms on menstrual function.

Endometriosis and adenomyosis should not be considered only as a local process; at any location of the pathological focus, significant neurohumoral changes are noted.

It is common among women of all countries and continents. The most frequently recorded damage to the organs of the reproductive sphere, and only in 6-8% of cases - extragenital endometriosis. It is this benign tumor disease that causes female infertility.

Causes of endometriosis and adenomyosis

To date, there is no consensus among experts on the origin and mechanisms of development of endometriosis. There are several theories outlining the alleged causes of the formation of endometriosis (adenomyosis) in a woman's body. Among the possible provoking factors, the most significant are the following:

a variety of surgical interventions with a violation of the integrity of the uterus (caesarean section, enucleation of the myomatous node, curettage), as a result of which endometrial cells penetrate into deeper layers;
hereditary factor (often the disease is transmitted from generation to generation);
hormonal disorders;
repetitive stress, nervous fatigue;
pathology of the immune system (congenital and acquired immunodeficiency).

The assumption of a possible etiology of endometriosis (adenomyosis), unfortunately, does not allow us to develop an effective strategy for its prevention.

Clinical symptoms

The main difference between adenomyosis and endometriosis is the prevalence of the pathological process. Growing foci of the uterine mucosa do not go beyond this organ, so some gynecologists consider adenomyosis as a special case of endometriosis.

Adenomyosis

With adenomyosis, the mucosa grows inward - into the muscular and outer membranes. Numerous cystic cavities are formed in the thickness of the uterine wall, which are filled with bloody contents. There are 4 degrees of adenomyosis:

1st - germination only to the muscle layer;
2nd - to the middle of the depth of muscle tissue;
3rd - defeat of the entire wall to the outer shell;
4th - damage to the inner sheet of the peritoneum covering the uterus.

The clinic of adenomyosis increases gradually, the severity of individual signs is determined by the degree of germination of the pathological tissue.

Adenomyosis is characterized by the following symptoms:

pain in the lower abdomen, which is poorly relieved by analgesics and can be quite significant;
increase in the duration of menstruation;
a few days before the actual bleeding and a few days after its completion;
infertility (primary and secondary), which becomes the reason for contacting a specialist.

Clinical signs of endometriosis increase during menstrual bleeding and subside during other phases of the cycle.

endometriosis

According to objective and subjective signs, endometriosis does not differ significantly from adenomyosis. All of the above points are observed during the formation of heterotopic foci in other organs. Only some variants of endometriosis have distinctive features.

Gynecologists distinguish endometriosis of the following localization.

In the case of long-term endometriosis, posthemorrhagic anemia (anemia) develops. The woman becomes pale, complains of weakness, lack of air, increased fatigue. Treatment of anemia is directly related to the treatment of the underlying disease.

When the foci of endometriosis are located on the surface of the external genital organs, a woman notes a strong pain syndrome. Unpleasant sensations are aggravated with significant physical exertion, and urination, sexual contact.

With changes in the internal organs (ovaries, peritoneum), an adhesive process develops, which gradually covers larger areas. A woman feels almost constant discomfort (pelvic pain syndrome). As a consequence of these two pathological processes (adhesions and endometriosis), female infertility occurs.

General principles of diagnosis and treatment

Only a doctor can help to understand how endometriosis differs from other diseases of the reproductive sphere, and what treatment is needed for a particular patient. Instrumental diagnostic methods are necessarily preceded by a bimanual internal obstetric examination.

To clarify the diagnosis, the following methods can be used:

X-ray hysterosalpingography;
hydrosonography;
hormonal panel;
smear cytology.

And they have similar external signs, so a morphological study is mandatory. Only it will allow to diagnose (or exclude) a malignant neoplasm at an early stage.

Therapy of endometriosis is divided into conservative and operative.

Among the variety of gynecological pathologies, it is necessary to know what is the difference between the main endometrioid diseases that affect reproductive function and reduce the comfort of a woman's life. Adenomyosis and endometriosis do not differ in the nature of the disease (in each case, the basis of the disease is the errant endometrium), but the important difference will be in the symptoms, complications and treatments that will be required for each type of pathology.

Endometrioid disease of the uterus primarily affects menstrual and reproductive function, and the treatment used involves the preservation of a young woman's ability to bear children. Endometriosis of other localizations implies the presence of specific manifestations, and diagnosis and treatment are carried out using special examination methods. Adenomyosis differs only in that it is the most common variant of endometrioid disease, occurring in the vast majority of cases (more than 90%), while endometriosis of other organs is a rather rare pathology.

Terminology

The appearance of endometrial cells, which normally should be only inside the uterus, in any atypical places is the main pathological factor that forms the disease. In fact, the detection of a lost endometrium anywhere in the female body with the formation of typical symptoms and complications is an endometrioid disease. In this case, the word "endometriosis" (endometriosis - endometrial disease) indicates the anatomical essence of the problem: the formation of an endometrial focus outside the usual location. Adenomyosis is one of the most common forms of endometrioid disease. when endometrial cells penetrate the muscular wall of the uterus.

The difference between these terms is significant: with a correctly formed diagnosis, the doctor will be able to prescribe effective treatment and avoid unreasonable removal of the uterus in a young woman who wants to have a baby.

Differences between internal and external endometriosis

Endometrioid disease, according to the location of the foci in the area of \u200b\u200bthe female reproductive organs, is divided into internal and. It is important to know the anatomical features of these variants, because this largely determines the future treatment and possibilities for preserving the uterus.

Internal endometriosis is adenomyosis. The penetration of endometrial cells into the muscular structures of the body and the isthmus of the uterus become the main factor for the disease.

The following types of adenomyosis are possible:

diffuse;
nodal;
focal.

Sometimes there are mixed forms, when against the background of many small diffuse foci a node is formed in the form of a cystic cavity.

External endometriosis is the formation of pathological heterotopias outside the uterus, but within the female genital organs, limited by the small pelvis. The main condition for the use of this term is the absence of damage to the nearby excretory organs (bladder and rectum). Small foci of endometriosis, scattered throughout the peritoneum of the small pelvis, belong to the external forms of the disease.

Differences between genital and extragenital forms of the disease

The spread of heterotopias beyond the small pelvis becomes the reason for the formation of extragenital forms of pathology. Usually, problems with internal organs are rare. But it is these forms of endometrioid disease that are the most severe variants of endometriosis, and treatment is a complex and ineffective exercise.

When identifying any types of female diseases associated with endometriosis, it is necessary to follow the doctor's recommendations for examination in order to find out the causes, make an accurate diagnosis and determine the prognosis for reproductive function. Only then can treatment begin.

Algorithm for diagnosis and treatment

At the first stage of the examination, the doctor will find out complaints and features of the course of the disease. You need to accurately answer the following questions:

how pronounced is the pain syndrome (where it hurts, how much, whether the pain changes depending on menstruation);
how the menstrual cycle has changed (abundant or scanty, spotting before and after menstruation, contact bleeding);
it turns out to get pregnant or not, whether there were cases of spontaneous miscarriages;
whether there are problems with urination and emptying the rectum (blood in the urine or stool during or after menstruation);
how much behavior and emotions have changed (irritability, depression, insomnia, emotional instability).

After a routine gynecological examination, you will need to perform the following studies:

transvaginal ultrasound scanning;
colposcopy;
general clinical blood and urine tests;
assessment of the level of tumor markers CA-125, CA-199.

Based on the results of the initial examination, the doctor will have grounds for a presumptive diagnosis. If all the symptoms point to adenomyosis, then the doctor will prescribe a hysteroscopy with the obligatory taking of an endometrial biopsy. A visual examination should be carried out in the 1st phase of the cycle, almost immediately after the end of menstruation, in order to see the endometrioid passages on the walls of the uterus. This is usually enough to make a correct diagnosis and start treatment.

If the doctor assumes the presence of endometriosis of other localizations, then the following studies will be required:

x-ray of the lumbosacral spine;
laparoscopy;
examination of the intestine (sigmoidoscopy, irrigoscopy);
urography, cystoscopy;
Magnetic resonance imaging.

With the results of all examinations, the gynecologist will refer you for a consultation to narrow specialists (urologist, proctologist, neuropathologist, surgeon). It is important to accurately determine the localization of endometrioid heterotopias in order to carry out effective treatment.

Endometrioid disease, as the cause of pain and infertility, disrupts the usual rhythm of a woman's life. Growing like a snowball, problems and the inability to fulfill a dream create the basis for social and psychological disorders. Treatment of endometriosis of the uterus should be started as early as possible to eliminate the risk of serious complications and irreversible changes in the reproductive organs. Adenomyosis is not at all an obstacle to successful conception, and timely treatment of extragenital endometriosis will ensure the elimination of pain and return the woman to the joy of life.