Endometriosis is a common gynecological disease in women that is formed when active endometrial cells are planted outside the endometrium. Endometrial cells should grow in the uterine cavity, but because the uterine cavity communicates with the pelvic cavity through the fallopian tube, the endometrial cells can enter the pelvic cavity through the fallopian tube to grow ectopic.
1. Planting theory
The menstrual blood is refluxed and the inner membrane is planted. During menstruation, menstrual blood flows downstream from the uterine orifice and vagina, but a small part of menstrual blood or other endometrial fragments mixed with shed endometrial fragments flows from the fallopian tube into the abdominal cavity and is planted on the surface of the pelvic organs to form the uterus. Endometriosis lesions.
2. Metaplastic endometrium
Serosal epithelium, metaplasia intima. During the embryonic development of the human body, the epithelium on the surface of the ovary, the peritoneum, the vaginal septum, and the umbilical are all metaplasia from the epithelium of the body cavity. These tissues can be transformed to form another tissue under the stimulation of gonadal hormones, inflammation, and mechanical factors. Can metamorphose into the endometrium.
3. Benign transfer
Benign metastasis of blood and lymph. This is a relatively rare cause of disease. Endometriosis, which appears in the lungs, meninges, pericardium, limbs, and other distal ends, is caused by the transfer of endometrial debris to a certain organ or tissue through the blood circulation or lymphatic system.
4. Iatrogenic endometrial transplantation
This is a kind of artificial endometrial transplantation to certain parts, which is more common in cesarean section, curettage in early and mid-term pregnancy, lateral episiotomy during childbirth, and artificial abortion.
5. Immune defense function defects
The endometrium, which flows back to the abdominal cavity with menstrual blood, is like a foreign body that activates the immune system in the body, mobilizes a large number of immune cells and body fluids to eliminate it. If the body's immune function is defective, it will develop into endometriosis.
6. Genetic factors
Endometriosis has a certain genetic predisposition and familial clustering, and most people with a family history suffer from this disease.
The treatment plan for endometriosis varies according to the severity of the disease, the age of the patient, and the fertility status. If the condition is serious or manifests as severe dysmenorrhea, or pelvic examination finds a positive endometriosis nodule, medication or surgery must be taken.
Drugs are used to counter or suppress the periodic endocrine stimulation of the ovaries. At first, testosterone-like male hormones were used. Due to the large side effects and the lack of potency, they have been gradually abandoned. Later it gradually developed into pseudopregnancy therapy and pseudomenopausal therapy.
2. Surgical therapy
It is generally believed that chocolate cysts that occur on the ovaries are often larger in size, or endometriotic nodules that occur in other parts of the uterus, with a diameter of more than 2 cm, are not easy to control with drugs and require surgical treatment; or after six Month or even a year of medical treatment, the condition still does not improve, surgical resection should also be considered. If the patient is young and has no children, only the endometriotic lesions are removed during the operation, while the uterus and normal ovarian tissue are preserved, which is called conservative surgery.