Endometriosis Surgery

Endometriosis Surgery

Lining of the uterus is a mysterious disease affecting about 7% of women of childbearing age, nearly 5 million Americans. Although they may suffer from symptoms ranging from large pelvic pain to infertility, and most of these women do not know that they have the lining of the uterus. Doctors to understand (1) clinical, endometrial, (2), correct diagnosis, staging, and (3) Management and sequele has improved dramatically over the past few years. The result was a better and more cost-effective patient care.
Definition
Lining of the uterus is the presence of endometrial tissue (normally found only in the womb) in locations outside the uterus. This fabric reacts to the hormone estrogen and progesterone. The site is usually in the pelvis (the ovaries, fallopian tubes, uterus, or bladder), but the lining of the uterus has also been found in sites outside the pelvis (including the omentum, small intestine, appendix, anterior abdominal wall, and the surgical wound, diaphragm, lung cancer and urinary tract, muscles, bones and nervous systems). This endometrial tissue interacts with the hormonal changes during the menstrual cycle, just as the tissue lining of the uterus inside the uterus reacts during the regular ovulation.
The spread of disease and injury
The prevalence and incidence of inflammation of the lining of the uterus depends on the female population being studied, ranging from 1 to 50%. It has been reported to occur in 10 - 15% of women who had undergone diagnostic laparoscopy, 2 - 5% of women who had undergone tubal sterilization .30 to 40% of women with infertility and a laparoscopy, 14 - 53% of women with pelvic pain.
Pathophysiology
There are many theories that attempt to explain how the evolution of the lining of the uterus. The most popular theory to describe the menstrual backwards through the fallopian tubes, with subsequent implantation and growth of endometrial cells in menstrual blood. Other theories involve metaplasia (normal tissues in the abdominal cavity of their own to change the lining of the womb), cropping directly from the cells lining the uterus in the abdomen during surgery, and the proliferation of cells lining the uterus from inside the uterus to other places through the blood vessels or lymphatic vessels. Each of these can contribute to the lining of the uterus in different patients. Immunity has also changed to play a role.
There seems to be several factors that affect whether a woman will have this condition, and severity of the disease in any particular woman, and her symptoms, and her response to treatment. These include:
* Genetics (mother or sister affected doubles the risk)
* Hormonal state (the highest levels of the hormone estrogen, heavy menses for long periods increases the risk)
* Life style (low body weight and cigarette smoking to reduce risk by reducing the levels of the hormone estrogen)
* The use of contraception (contraceptive by mouth may reduce the development of the disease)
* Date of birth (pregnancy and lactation reduce the risk)
* Anatomical factors (cervical stenosis increases the risk)
* Date of transaction (by medical or surgical treatment reduces the risk)
* Race (caucasions more likely than African-Americans -)
, And possibly exposure to environmental toxins, especially those that estrogenic
Endometrium are believed to cause infertility by distorting anatomy, creating hormonal abnormalities, and change the biochemical environment in the basin, and the impact on the immune system, and interference with sperm function, and (maybe) change the process of embryo implantation.
Clinical presentation
Lining of the uterus and displays in the first place with pelvic pain (about 80% of patients). About 20% of patients presenting with endometriosis are also suffering from infertility, and 5% currently with a "tumor" of the lining of the uterus in one or both ovaries (these are called endometriomas). Anywhere from 1 to 40% of patients who suffer from inflammation of the lining of the uterus will not have any symptoms. Lining of the uterus may occur at any time after puberty, including the age of adolescence.
Degree of pain the patient often does not correlate with the severity of the lining of her uterus. Pain may occur as a result of any or all of the following:
* Uterus transplant secretion irritant (such as histamine)
* Scar tissue (adhesions)
* Endometriomas leaking
* Pressure of other abdominal structures (for example, the intestines, ureters)
* Pressure of the deep endometriotic nodule in the pelvis.
* Invasion of the urinary tract (bladder or ureter)
* Invasion of the digestive tract (small intestine or colon)
Even in patients who suffer from the disease and the minimum is moderate (the Foundation in the first or second), the lining of the uterus is probably associated with infertility. There is a reason the relationship between the greatest impact is certainly moderate and severe disease (established in phase III or IV). Usually these patients have adhesions, deep invasive pests, and endometriomas. Inflammation of the lining of the uterus may also be associated abnormalies structural damage to the fallopian tube. Comprehensive studies do not, however, support an association between endometriosis and increased rates of spontaneous abortion.
Endometrial lesions occur in all parts of the basin. They tend to be more frequent in the back alley de sac and the ovary, and less frequently in the fallopian tube. Lining of the uterus is almost certain that the disease gradually, but the rate of progress and the nature of the lesions varies from patient to patient.
The development of adhesions as a result of the process caused by uterine inflammation for a long time, with more extensive adhesions and dense developing over time. And adhesions in the worst cases, more advanced usually involve the uterus, ovary, colon and lower (near the rectum). Laparoscopic surgical treatment of these cases is always the best, but requires skill and vast experience, and patience on the part of the operating surgeon.