Endometrial pathology

The pathology of the endometrium is more common today. Specialists attribute this trend to an increase in the number of women suffering from obesity, endocrine disorders and a decrease in 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 all gynecological diseases reveal hyperplastic processes in the endometrium. Such conditions include fibro-endometrial, glandular fibrous, glandular polyps, adenomatosis. Hyperplasia (glandular-cystic, diffuse or focal, glandular) is becoming more common.

Most experts agree that the cause of the processes is a hormonal failure in the body of a woman. Endometrium is the 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. Hyperestrogenia 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 with hyperplastic processes are blood contact discharge, uterine bleeding (mostly acyclic). Bleeding in the reproductive age is manifested by prolonged and abundant menstruation (by the type of menometroragia) in the pre-menopausal period - acyclically, in postmenopause - bleeding secretions of different intensity.

Diagnosis of endometrial hyperplasia is performed by transvaginal ultrasound in pelvic organs, gysteroscopy (diagnostic, with separate curettage, histological study of the material obtained).

One of the most important gynecological tasks today is the 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 techniques for surgical intervention, including modern minimally invasive, with relatively fast recovery times.

The operative method includes resection (ablation) of the endometrium.

The aim of this surgical intervention is to eliminate the 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 means scraping, 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 histological examination can not be taken.

Excision (resection) of the thickness of the endometrium is carried out only by electrosurgical method. In this case, 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.