To one of the most painful and dangerousGynecological diseases include retrocervical endometriosis. This disease is characterized by shooting, sharp pains, irradiating in the vagina, rectum, hips, perineum, genitals. Pain syndrome increases with defecation and sexual intercourse. Before and after menstruation, spotting is observed.
Retrocervical endometriosis is a disease accompanied by proliferation in rectovaginal fiber of endometriosis. According to the clinical classification, this disease is divided into 4 stages:
1 - foci of endometriosis are located only in rectovaginal fiber;
2 - the endometriosis tissue germinates into the cervix, the vaginal wall (small cysts are formed at this stage);
3 - the pathological process passes to the sacro-uterine ligaments, serous covers of the rectum;
4 - the proliferation of endometriosis tissue involves the rectal mucosa, rectal-uterine space. For this stage, the formation of adhesions is characteristic.
Retrocervical endometriosis is diagnosed on the basis of clinical data and medical research. It is differentiated from ovarian and rectal cancer.
During vaginal examination of the posterior fornixa knotty, dense knot (sharply painful) is palpated. Its magnitude can be different. When gynecological examination in the mirror are often visible small endometrioid cysts, which look like bluish "eyes". It is from them during menstruation that blood of dark color is allocated. The main method of medical research in the disease of this localization is biopsy.
When the tissues of the rectum are affected,sigmoidoscopy, sight biopsy and irrigoscopy. Patients significantly narrowed the lumen of the intestine. If endometrioid heterotopy has spread to the area of the retrocervical septum, parietography shows a strong thickening, which has an even, clear contour. With sigmoidoscopy, swelling and hyperemia of the mucosa, swelling of the intestinal walls are revealed.
Retrocervical endometriosis is treated with severalways (depending on the stage). The first stage of therapy in this disease is the excision of its focus through the vagina. It is made with a therapeutic and diagnostic purpose. The excised tissues are given for histological examination.
At 1 and 2 stages it is possible to remove endometriosis inlimits of healthy tissue without the use of posterior colpotomy. The wall of the vagina after the operation is sewn with catgut sutures. If the medical institution has a cryosurgical technique before suturing the wall, it is advisable to perform a cryodestruction of the endometriosis bed. This procedure helps to reduce the number of relapses.
With the 3 stage of retrocervical endometriosis,when a posterior colpotomy is required, excision of lesions from the serous covers of the rectum, sacro-uterine ligaments is performed. There may be a need for additional laser and cryo-processing of ligaments.
At 4 stages in young patientsit is advisable to excise a part of the endometriosis focus for histological examination. After that, hormonal therapy is performed with antigonadotropins and gestagenes of the norsteroid series. In the complex treatment of retrocervical endometriosis, sanatorium treatment (iodine-bromine, radon baths), sedative therapy, symptomatic treatment is applied.
Only in time having addressed to the doctor, it is possibleuse completely remedial endometriosis treatment. The patients' testimonies indicate that at the initial stages of the disease it is treated fairly quickly without possible relapses. Among the medicines that are used at the initial stage, there are also combined contraceptive means: "Diane-35", "Logest", "Regulon". One of the most effective is the drug "Jeanine". In endometriosis, its use is due to the presence of a dienogest - progestagen, which has an inhibitory effect on endometrioid heterotopia. This drug causes their regression. To obtain a good result, small doses of the drug are sufficient. The composition of the drug "Jeanine" also includes estradiol, which provides recovery of the menstrual cycle.
