Adenomyosis is a diffuse or limited lesion in which the endometrial glands and strata invade the uterine muscle layer. It is a common gynecological disease. Adenomyosis used to occur mainly in women over 40, but in recent years it has gradually become younger.
Although adenomyosis is a disease that occurs inside the uterus, it will inevitably have some effects on other organs.
Let me introduce the position of the uterus in the body. The front of the uterus is the bladder, and the back is the intestine. The lesions of adenomyosis also grow in different parts of the uterus. Some will be on the front wall, and some will be on the back wall.
That is to say, adenomyosis lesions grow in different parts of the body and affect organs in different parts of the body.
Affect the bladder
If the adenomyosis lesion grows in the anterior wall of the uterus, it will affect the bladder, and there will be frequent and urgent urination during menstruation. Especially at night, some patients have to go to the toilet several times.
Affect the intestine and rectum
If the adenomyosis lesion grows in the back wall of the uterus, it will affect the intestines and rectum. In this way, the patient will have anal swelling during menstruation, and they want to go to the toilet to defecate, but it can't be discharged after going there. Some patients will even have an increase in the number of defecation. If the adenomyosis lesion grows more severely in the rear, there will be an intestinal obstruction and no defecation.
Affect the ureter
The focus of adenomyosis still grows left and right, which will affect the ureter. If the ureter is involved, there will be hydronephrosis and ureteral dilation.
For patients with adenomyosis, the most prominent clinical manifestation of the damage to the body is dysmenorrhea, which tends to worsen gradually. It is difficult for general painkillers to achieve therapeutic effects.
In severe cases, some patients will have nausea and vomiting and cannot work, affecting work and study. This situation is relatively complex, and some patients will have infertility.
According to the situation, patients with adenomyosis must go to the hospital for active treatment. If the patient has not given birth, treating and preparing for pregnancy as soon as possible is recommended. Otherwise, in the later stage, adenomyosis will cause uterine changes and abdominal pain, affecting fertility, and must be actively treated.
Adenomyosis should be treated according to the patient's age, clinical symptoms, uterine size, fertility requirements, etc., including expected therapy, drug treatment, surgical treatment, interventional treatment, assisted reproductive medicine, etc.
1. Expected treatment: patients with mild illness, no symptoms, and no fertility requirements at present can not receive special treatment temporarily but can have regular re-examinations and observation of disease changes. Pregnancy and delivery can increase the level of progesterone in the body and relieve dysmenorrhea, anemia, and other conditions;
During lactation, patients will not menstruate, and the level of progesterone in the body is still high, which can inhibit the effect of estrogen. Therefore, the symptoms of adenomyosis in this part of the population can be relieved after pregnancy.
2. Drug treatment: If the symptoms are mild, Fuyan Pill can be taken to relieve pain; young patients with fertility requirements and near menopause can try gonadotropin-releasing hormone agonists (GnRH-a) for treatment, which can relieve symptoms and shrink the uterus; patients can also use danazol capsules and progtaenozone capsules Other drugs can alleviate symptoms by inhibiting ovarian function.
3. Surgical treatment: For young patients with fertility requirements, lesion resection or hysterectomy can be performed; for patients with no fertility requirements and increased menstruation, endometrial removal can be performed; for patients with severe symptoms, no fertility requirements or ineffective drug treatment, total hysterectomy can be achieved. Doctor Whether to retain the ovaries will be determined according to the lesion and age of the patient's ovaries.
4. Interventional treatment: including uterine artery embolization, high-intensity focused ultrasound ablation treatment, microwave ablation, etc., which can be used to treat focal lesions, but it cannot be cured, so the indications should be strictly mastered.
5. Assisted reproductive treatment: Patients with adenomyosis and infertility can consider taking assisted reproductive treatment if the natural pregnancy fails. In vitro fertilization or embryo transfer is generally recommended.
It is recommended that patients with adenomyosis go to the gynecology department of a regular hospital to clarify the condition through blood routine, hormone examination, ultrasound examination, pathological examination, etc., and then treat it under the guidance of a doctor.
You may also be interested in: