Adenomyosis Uterine

Adenomyosis Uterine

The occurrence of a new menstrual pain periodically in the contract of 40 and can be attributed to inflammation of the lining of the uterus, uterine fibroids, partial or narrowing of cervical adenomyosis. Even now most likely cause of this painful menstrual cramps at this time is adenomyosis. This is sometimes called the International lining of the uterus or the lining of the uterus of the Interior.
Since this is the problem is most likely that your doctor will want to rule in or rule out with tests diagnositic, let us focus on adenomyosis.
What is adenomyosis?
Adenomyosis know the existence of endometrial glands and tissues supporting the muscles of the uterus where it usually will not happen. When that is subject to the growth of thyroid tissue during the menstrual cycle, and subsequent rupture, could be the old tissue and blood can not get out of the muscles, and the flow out of the cervical part of the normal menstruation. This global blood and tissues of the uterus cause pain in the form of menstrual cramps. It also produces abnormal uterine bleeding and some of the blood in the end avoid muscle and results in selecting a location for long periods. For a picture of what looks like a simplified adenomyosis, see pictures () in one location gynecologist.
Adenomyosis occurs more often in the decade of 40's, perimenopausally. Samples in a hysterectomy, can be found on adenomyosis be from 15% to 25% of the time (1, 2). Change in the glandular cells lining the uterus in adenomyosis are often incomplete in the second half of the menstrual cycle (phase luteal), and as a result, adenomyosis may not be very responsive to repression by progesterone. About 50% of adenomyosis are the symptoms although it does not run deeper into the muscles of the uterus, it tends to be more likely to produce symptoms (3, 4). It is also often associated with fibroids (5), and is often associated with other conditions, such as ovarian cysts, and depression and even cancer gynecology (6) that can cause pain in the pelvis.
How is the diagnosis of adenomyosis?
Until recent years, it was said that adenomyosis was diagnosed only by a pathologist examines the sample hysterectomy. Now magnetic resonance imaging (MRI) can accurately diagnose adenomyosis, despite the fact that many doctors feel this is too expensive to use the test routinely. Patterns of adenomyosis as recognized by the before and seems to be magnetic resonance imaging are either scattered in all parts of the uterus (about 66%) or focal lesions (33%) that do not occur only in places and one or two (7). If treatment is not a hysterectomy is being considered in adenomyosis, then MRI should be used to diagnose the disease and if coordination is shown, then surgical amputation of the lining of the uterus without doing a hysterectomy may be considered.
You can use a special ultrasound Doppler color flow can also be used for the diagnosis of adenomyosis (8). Sometimes it has difficulty to distinguish smaller fibroids (smooth muscle) of adenomyosis but are able to capture about 80% of the existing lesions. In-depth discussion on the pre-ultrasound diagnosis of surgical adenomyosis, see (and Presurgical diagnosis of diffuse Adenomyosis by Helen Bickerstaff, MB, BChir.
Uterus and take samples of uterine needle has also been used for the diagnosis of adenomyosis (9), but there seems to be within the clinical process because they miss a lot of areas in the muscle lining of the uterine glands, uterus, where they can find. When used in conjunction with ultrasound, and they may be able to pick areas that are positive (10). The most important concept in diagnosis is to keep in mind that since adenomyosis produce symptoms of pain and / or abnormal bleeding, only 50% of the time (11), just an imaging study found no evidence of adenomyosis, does not mean that the focus is causing the pain. This may be physiological adenomyosis is a condition found in women after pelvic pain but not necessarily the cause of pain, a total of (12).
Caesarean section does not link the issue of in vitro or adenomyosis?
There is some evidence that women who have had Caesarean sections may be at risk was slightly higher (about 2 to 1) for adenomyosis 13). Theoretical basis for this would be when construction operations are performed inside the uterus, and this may allow the lining of the uterus to the bottom of the workbook muscles of the uterus. This is known to occur in the incisions in the abdomen with a caesarean section in the lining of the uterus, which is sometimes mentioned in the cracks and must be eradicated (14).
Another factor that had been proposed as a possible associated factor, causing the adenomyosis is tubal ligation. Under this theory, the natural flow of the cells lining the uterus back in those allocated to the development of women lining of the uterus is blocked due to the process of connecting pipes faloppian. This would increase the pressure in the uterus and the strength of some of these cells to the bottom of the uterine muscles and consequently the development of adenomyosis. There is some support for this concept that women who have adenomyosis may be more frequent a tubal ligation (15).
In one study, there were also a higher incidence of adenomyosis in a woman who had termination of pregnancy (16). Presumably, most of these have been implemented by extending the suction and C, and again we have the concept of the uterus may result in organs in the lining of the uterus that grows deep in the muscles. It is important to remember that there is no pregnancy is also considered a risk factor (17).
What are the treatments for adenomyosis is hysterectomy?
Factors can be released Gonadotropin (for example, Lupron ®) can be used for the treatment of adenomyosis, but the problem is that adenomyosis seems to recur after stopping treatment. It can be used, however, to reduce the amount of adenomyosis and then the rest of the areas can be resected if, for example, a woman wants to get pregnant (18). The device can progesterone contraceptive intrauterine pregnancy can also be used to improve the irregular bleeding and avoid hysterectomy (19).
The question of whether endometrial ablation may be a treatment for adenomyosis, or perhaps even that it could make matters worse? This was seen in one study and found that endometrial ablation was nearly the same success rate improving heavy menstrual periods (approximately 60%) and whether or not adenomyosis was present (20). Thus, if the bleeding is severe, rather than menstrual cramps is one of the major symptoms of adenomyosis, and endometrial ablation should be considered a treatment.
Hysteroscopic endometrial ablation and can sometimes remove the adenomyosis superficial, but in order to remove most of the areas of coordination adenomyosis, which is more in-depth, either laparoscopic or open amputation amputation of myometrial myometrial there is a need to get rid of the symptoms (21).
Hysterectomy is a very successful for the treatment of adenomyosis?
One might think that a hysterectomy would cure the pain in 100% of women with adenomyosis undergoing this surgery, but in fact, studies that do not appear specifically in the treatment of pain rate for women with adenomyosis undergoing hysterectomy. Generally, when the uterus is the pelvic pain in origin, hysterectomy significantly improves pain in 75-80% of cases (22, 23).
Conservative surgery for adenomyosis is about 50% effective (24), so it is still likely that a hysterectomy is more successful in treating this disease, although we do not know with certainty what is the success rate of hysterectomy. Are likely to be a hysterectomy at least 80% or more effective. For all types of chronic pelvic pain, and non-surgical treatment and can be good, although the rate of recovery is not as high as hysterectomy (25).