Pathology of the endometrium
The pathology of the endometrium is more common today. Experts associate this trend with an increase in the number of obese, endocrine disorders and a decrease in women's immunity. In most cases, the pathology of the endometrium is accompanied by imbalance in the hormonal system, metabolic processes. Of great importance is the increase in the number of somatic diseases of chronic course.
Today, approximately 30-40% of allgynecological diseases revealed hyperplastic processes in the endometrium. These conditions include fibro-endometrial, glandular fibrous, glandular polyps, adenomatosis. Hyperplasia (glandular-cystic, diffuse or focal, glandular) is becoming more common.
Most experts agree thatthe cause of the processes is a hormonal failure in the body of a woman. Endometrium is a target for sex hormones, due to the presence of special receptors in it. The disorder of the hormonal background of a woman leads to changes in the differentiation and growth of cellular elements. As a result, the pathology of the endometrium of the neoplastic or hyperplastic nature develops. Hyperestrogensia plays a special role in the formation of processes. In many ways, the increase in the level of estrogen is affected by a metabolic disorder that accompanies various therapeutic diseases.
The most common complaints of patients withHyperplastic processes are blood contact discharge, uterine bleeding (mostly acyclic). Bleeding in the reproductive age is manifested by prolonged and profuse menstruation (by the type of menometroragia) in the pre-menopausal period - acyclically, in postmenopause - bloody discharge of different intensity.
Diagnosis of endometrial hyperplasia is carried outtransvaginal ultrasound in the pelvic organs, gysteroscopy (diagnostic, with separate curettage, histological study of the material obtained).
One of the most important gynecological taskstoday there is treatment of hyperplastic processes. The pathology of the endometrium involves the use of conservative therapies. These include hormonal treatment with estrogen-progestogen drugs, progestogen medications. In addition, there are methods of surgical intervention, including modern minimally invasive, with relatively fast recovery times.
The operative method includes resection (ablation) of the endometrium.
The purpose of this surgical interventionis the elimination of clinical manifestations of the existing hyperplastic processes. In addition, this method is used as a prophylaxis for endometrial cancer, to increase the chances of conception in women of childbearing age.
Under the ablation (ablation) of the endometrium is meantscraping, removal, destruction of the uterine cavity. Until today, gynecologists have not come to one opinion what to consider a resection. There is also no clarity about when to apply the definition of "ablation".
The destruction of the entire endometrium (ablation) can be performed electrosurgical and laser. In this case, tissue for carrying out a histological examination can not be taken.
Dissection (resection) of the thickness of the endometriumis performed only by electrosurgical method. At the same time, the cutting loop cuts out all the uterine mucosa in the form of shavings. In carrying out this surgical intervention, it is then possible to take the excised tissue for histological examination.
Typically, the operation is performed under epidural analgesia or general intravenous anesthesia. With simultaneous laparoscopy, endotracheal anesthesia is used.
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