endometriosis definition

Endometriosis refers to the presence of endometrial tissue with growth function in other parts of the uterine cavity than the endometrium and the myometrium of the uterus. It is an estrogen-dependent chronic inflammatory disease.

1. Pathological characteristics

Ectopic endometrium can invade the pelvic peritoneum, ovaries, fallopian tubes and other parts, forming purple-blue nodules or cysts. The lesions undergo periodic bleeding under the influence of hormones, leading to local fibrous tissue proliferation and adhesion. Typical pathological manifestations are glandular, interstitial and hemosiderin deposition.

2. Pathogenesis

It is mainly related to theories such as countercurrent menstrual blood implantation, body cavity metaplasia, and lymphovascular metastasis. Genetic susceptibility, immune abnormalities, and inflammatory microenvironment are jointly involved in disease progression. Abnormal expression of estrogen receptors promotes intimal cell proliferation and angiogenesis.

3. Clinical manifestations

Progressive dysmenorrhea, chronic pelvic pain, dyspareunia and infertility are common. Ovarian endometriosis cysts can cause masses in the adnexal area, and deep infiltrating lesions may cause painful defecation or hematuria. Some patients are accompanied by abnormal menstruation or intestinal and bladder irritation symptoms.

4. Diagnostic criteria

It needs to be combined with medical history, gynecological examination, imaging and serum CA125 testing. Laparoscopy is the gold standard for diagnosis, and pelvic purple-blue lesions, adhesions or chocolate cysts can be seen. Pathological examination reveals endometrial glands and stroma to confirm the diagnosis.

5. Disease classification

According to the distribution of lesions, it is divided into peritoneal type, ovarian type and deep infiltrating type. The American Society for Reproductive Medicine’s staging is divided into stages I-IV based on the scope of the lesions and the degree of adhesion. Special types include abdominal wall incisional endometriosis, pulmonary endometriosis, etc.

Patients are advised to avoid strenuous exercise during menstruation and reduce high-fat diet intake. Regular gynecological examinations can help with early detection. When pain symptoms are obvious, you can try hot compresses to relieve them. After diagnosis, drug or surgical treatment needs to be carried out according to the doctor's advice. Long-term management needs to pay attention to fertility needs and recurrence prevention.