Endometriosis: Pathogenesis, Symptoms & Diagnosis
Endometriosis means that endometrial glands and stroma are present outside the uterus. Usually these are present in the pelvis, but they can be found in various places such as large intestine, small intestine, diaphragm, thoracic cavity. Endometriosis is not a malignancy, but ectopic endometrial tissues can cause excessive menstruation, abdominal pain, and even infertility. Endometriosis is estrogen dependent.
Pathogenesis of Endometriosis
Endometriosis is known to be caused by the growth of ectopic endometrial cells elsewhere and causing an inflammatory reaction. Pathogenesis is known to play a role in a variety of causes, including ectopic endometrial tissue, altered immunity, asymmetric cell proliferation and apoptosis, defective endocrine function, and genetic factors.
One hypothesis that endometriosis occurs is the hypothesis that endometrial cells flow into the abdominal cavity through the fallopian tubes during menstruation (sampon's theory of retrograde menstruation).
Another hypothesis is that mesothelium, stem cells, mullerian rests, bone marrow stem cells and embryonic vestiges are metaplasia of endometrial tissue due to some action in the peritoneal cavity, resulting in endometriosis.
Although retrograde menstruation is most commonly observed in patients with most endometriosis, the sampon's theory of retrograde menstruation is most prevalent, but patients with endometriosis before the onset of menstruation are thought to be the cause of coelomic metaplasia .
When the environment of this endometriosis is established, it is known that the inflammatory reaction causes symptoms. Pelvic pain associated with endometriosis is known to result from neurological abnormalities due to increased mediators associated with inflammation and pain.
In addition, if endometriosis is severe, infertility can be caused by endometriosis due to adhesion of the pelvis, resulting in anatomical abnormalities are known to cause infertility.
Clinical manifestations of endometriosis
Endometriosis usually manifests itself in women of childbearing age, often requiring excessive menstruation, dyspareunia and pelvic pain. There are also many cases that I want due to infertility and ovary hump. Endometriosis is the most prevalent in women aged 25 to 35 and has been reported to occur in 2-5% of women before or after menopause.
If endometriosis is severe, the adhesion of the pelvic cavity may become worse and the bowel or bladder function may be lowered. This may cause diarrhea, constipation, abdominal pain, bowel obstruction, frequent urination, urgent urination. Abnormal uterine bleeding may also occur.
Diagnosis of endometriosis
Diagnosis of endometriosis should be preceded by symptoms, history taking, and physical examination. As mentioned above, symptoms of dysmenorrhea and dyspareunia are the main symptoms.
Endometriosis is a disease that can be confirmed by biopsy of lesions through surgery.
Suspicious findings of endometriosis may increase CA125 in the laboratory. However, CA125 may be elevated in other diseases, such as ovarian cancer and endometrial cancer, and is therefore not appropriate as a screening tool.
Imaging findings include ultrasound, ultrasonographic findings such as hypoechoic, vascular, and solid mass, irregular boundaries, and often spicualtion. CT and MRI are also helpful for diagnosis, and MRI is about 95% accurate in diagnosing thoracic endometriosis.
Pathogenesis of Endometriosis
Endometriosis is known to be caused by the growth of ectopic endometrial cells elsewhere and causing an inflammatory reaction. Pathogenesis is known to play a role in a variety of causes, including ectopic endometrial tissue, altered immunity, asymmetric cell proliferation and apoptosis, defective endocrine function, and genetic factors.
One hypothesis that endometriosis occurs is the hypothesis that endometrial cells flow into the abdominal cavity through the fallopian tubes during menstruation (sampon's theory of retrograde menstruation).
Another hypothesis is that mesothelium, stem cells, mullerian rests, bone marrow stem cells and embryonic vestiges are metaplasia of endometrial tissue due to some action in the peritoneal cavity, resulting in endometriosis.
Although retrograde menstruation is most commonly observed in patients with most endometriosis, the sampon's theory of retrograde menstruation is most prevalent, but patients with endometriosis before the onset of menstruation are thought to be the cause of coelomic metaplasia .
When the environment of this endometriosis is established, it is known that the inflammatory reaction causes symptoms. Pelvic pain associated with endometriosis is known to result from neurological abnormalities due to increased mediators associated with inflammation and pain.
In addition, if endometriosis is severe, infertility can be caused by endometriosis due to adhesion of the pelvis, resulting in anatomical abnormalities are known to cause infertility.
Clinical manifestations of endometriosis
Endometriosis usually manifests itself in women of childbearing age, often requiring excessive menstruation, dyspareunia and pelvic pain. There are also many cases that I want due to infertility and ovary hump. Endometriosis is the most prevalent in women aged 25 to 35 and has been reported to occur in 2-5% of women before or after menopause.
If endometriosis is severe, the adhesion of the pelvic cavity may become worse and the bowel or bladder function may be lowered. This may cause diarrhea, constipation, abdominal pain, bowel obstruction, frequent urination, urgent urination. Abnormal uterine bleeding may also occur.
Diagnosis of endometriosis
Diagnosis of endometriosis should be preceded by symptoms, history taking, and physical examination. As mentioned above, symptoms of dysmenorrhea and dyspareunia are the main symptoms.
Endometriosis is a disease that can be confirmed by biopsy of lesions through surgery.
Suspicious findings of endometriosis may increase CA125 in the laboratory. However, CA125 may be elevated in other diseases, such as ovarian cancer and endometrial cancer, and is therefore not appropriate as a screening tool.
Imaging findings include ultrasound, ultrasonographic findings such as hypoechoic, vascular, and solid mass, irregular boundaries, and often spicualtion. CT and MRI are also helpful for diagnosis, and MRI is about 95% accurate in diagnosing thoracic endometriosis.
