Adenomyosis

[Outlined -- adenomyosis (adenomyosis), also known as internal endometriosis. to the uterine endometrium penetrated the outer muscle, is endometriosis in a special type, can be "external" or mainly pelvic endometriosis also exist. Endometriosis can have two forms of invasive uterine muscle layer, diffuse and localized. The former endometriotic penetrated the entire uterine muscle wall, in different parts of their range and depth of invasion may be different; only the latter endometriotic aggression and certain muscle wall, similar to uterine fibroids, but with the surrounding normal tissues did not boundaries (pseudocapsule). 【Secondary diagnosis -- a steadily increasing sexual dysmenorrhea, in the middle-age childbearing women should consider adenomyosis. If accompanied by menorrhagia, menstrual too long, the uterus increases, it should consider adenomyosis. Uterine lipiodol contrast can be seen in one or a few into the muscle wall to form diverticula-film, but its positive rate was only 20%. Final diagnosis largely depends also on the uterus and histopathological examination. [Treatment] adenomyosis fertility patients no longer required to hysterectomy as well as ovarian reservations. If the merging of pelvic endometriosis were also possible excision of ovarian function and retained so that patients, to natural menopause. Require fertility, hormone therapy can be 6-12 months, withholding deduction hope to be in the short term pregnancy. In the case of surgical exploration found that the removal should be considered gland retained uterine fibroids. [Pathological changes -- lesion showed staggered rough strip with muscle fibers and fiber belt, a dark red or bleeding which appeared Area, few olypoid endometrial to serosal layer prominent, Visibility tissues endometrial glands and stroma. [Clinical manifestations of secondary dysmenorrhea -- in older women, that is nearly 40 years old, dysmenorrhea gradually worsened, often spastic, as well as day-to-day work can persist. Dysmenorrhea is due to the menstrual ectopic endometrial edema, hemorrhage, stimulate muscle wall spastic contraction. Increased menstrual flow, menstrual extension, a few have a bit before and after menstrual bleeding, uterine volume is increased, endometrial uterine cavity area, and intramural endometriosis affect uterine muscle fiber contraction about it. Double clinics often found uterine growth consistency, tenderness, However, the uterine size or even smaller than normal with normal may have adenomyosis exist. 【Prognosis -- endometriosis lesions slow growth, often occur during pregnancy degeneration, postmenopausal stop the development, it generally better prognosis. If the scope is too wide disease, or intestinal involvement, there may be obstruction of the serious complications. Endometriosis little complicated pregnancy, pregnancy is also prone to miscarriage, premature or tubal pregnancy. Endometriosis of the results of surgical treatment than ideal. Younger patients and may again resume reproductive function. Endometriosis vicious small probability.