Endometriosis: etiology, pathogenesis, diagnostics, modern aspects of treatment

Authors

  • N. V. Avramenko

DOI:

https://doi.org/10.14739/2310-1237.2014.2.28543

Keywords:

Endometriosis, Etiology, Pathologic Processes, Diagnostics, Treatment

Abstract

Aim. To analyze the data of the current scientific literature on the etiology, pathogenesis, diagnosis, clinic and modern therapy of genital endometriosis, which is one of the most urgent problems of modern gynecological practice.

Methods and results. The main role in the process of growth and development of endometriosis is currently attributed to changes in the function of the immune system, possibly genetically determined. Currently, it is proved that endometriosis develops immune processes against endometrial tissue. There is every reason to believe that endometrium in its unusual places can acquire antigenic properties that stimulates the body's immune system reaction. Hyperandrogenism, early menarche, heavy and prolonged menstruation, disorders of the outflow of menstrual blood, adverse environment, obesity, smoking, stress are considered as the risk factors for the development of endometriosis. Revised diagnosis is possible with laparoscopic visualization (ideally with confirming histological research). A presumptive diagnosis is based on typical clinical symptoms and signs. Laboratory methods of diagnosis: magnetic resonance imaging and ultrasound. The main methods of treatment of endometriosis are surgical, medication, combined.

Conclusion. Endometriosis remains unresolved scientific and clinical problem characterized by the paradoxical aspects of the pathogenesis and clinical contrasts of course without found explanation yet.

References

Tanko, O. P., et al. (2013) Adaptaciya mirovykh praktik lecheniya e`ndometrioza v ukrainskom sociume [Adaptation practices in the treatment of endometriosis in the Ukrainian society]. Zdorov'e zhenshchiny, 7, 27–31. [in Ukrainian].

Unanyan, A. L., et al. (2013) Aktivnyj i neaktivnyj adenomioz: voprosy patogeneza i patogeneticheskoj terapii [Active and inactive adenomyosis: issues of pathogenesis and pathogenetic therapy]. Zhurnal akusherstva i zhenskikh boleznej, 4, 10–13. [in Russian].

Baranov, V. S. (2013) E`ndometrioz kak problema sistemnoj genetiki [Endometriosis as a problem of genetics system]. Zhurnal akusherstva i zhenskikh boleznej, 62(1), 71–78. [in Russian].

Volkov, N. I. (2010) E`ndometrioz kak prichina besplodiya [Endometriosis as a cause of infertility] Besplodnyj brak. Sovremennye podkhody k diagnostike i lecheniyu (Eds.) G.T. Sukhikh, T.A. Nazarenko. Moscow: GEOTAR-Media. [in Russian].

Veropotvelyan, P. N., Veropotvelyan, N. P.m & Sagan' A. S.(2013) E`ndometrioz u pacientok stradayushchikh besplodiem i ego lechenie [Endometriosis in patients suffering from infertility and its treatment]. Zdorov'e zhenshchiny, 9, 157–161. [in Ukrainian].

Manuhin, I. B., Tumilovich, L. G., & Gevorkyan, M. A. (2013) Ginekologicheskaya e`ndokrinologiya. Klinicheskaya lekciya [Gynecological endocrinology. Clinical lecture]. Manukhin, I. B., Tumilovich, L. G., Gevorkyan, M. A. Rukovodstvo dlya vrachej [A guide for physicians]. Moscow: GEOTAR-Media. [in Russian].

Denisova, V. M. (2013) E`ffektivnost' agonista gonadotropin-rilizing gormona v terapii e`ndometrioza [Efficacy agonist of gonadotropin-releasing hormone in the treatment of endometriosis]. Zhurnal akusherstva i zhenskikh, 62(5), P. 29–34. [in Russian].

(2011) Diahnostyka i likuvannia endometriozu. Kerivnytstvo Korolivskoho koledzhu akusherstva i hinekolohii Velykobrytanii [Diagnosis and treatment of endometriosis. The leadership of the Royal College of obstetrics and gynecology UK]. Zhinochyi likar, 5, 32–42. [in Ukrainian].

Dyadyk, E. A., Pokolodnaya, Yu. I., Chajka, V. K. (2013) Naruzhnyj genital'nyj e`ndometrioz: vozmozhnosti rannej diagnostiki [External genital endometriosis: the possibility of early detection]. Ukrainskyi medychnyi almanakh, 16(3), 30–31. [in Ukrainian].

Zaharenko, N. F., Kosej, N. V., Kolomiec, L. M. (2012) E`ndometrioz: poisk farmakoterapevticheskogo kompromissa [Endometriosis: the search for pharmacological compromise]. Reproduktivnaya e`ndokrinologiya, 2, 52–56. [in Ukrainian].

Kovaleva, L. A. (2013) Osobennosti terapii e`ndometrioza (klinicheskaya lekciya) [Endometriosis therapy features (clinical lecture)]. Ginekologiya, 15(4), 19–22. [in Russian].

Krasil'nikov, R. G. & Abdullaev R. Ya. (2013) Transvaginal'noe ul'trazvukovoe issledovanie i magnitorezonansnaya tomografiya v diagnostike giperplasticheskikh processov e`ndometriya [Transvaginal ultrasound and magnetic resonance imaging in the diagnosis of endometrial hyperplastic processes]. Mezhdunarodnyj medicinskij zhurnal, 19(1), 113–117. [in Ukrainian].

Tan'ko, O. P., Samojlova, M. V., Gajvoronskaya, S. I., Vygovskaya, L. A. (2012) Mazhornaya i minornaya sostavlyayushchie v terapii e`ndometrioza [Major and minor components in the treatment of endometriosis]. Zdorov'e zhenshchiny, 1, 50–55. [in Ukrainian].

Malanchuk, L. M., et al. (2012) Mozhlyvosti fitoterapii v suchasnykh metodakh likuvannia ta profilaktyky retsydyvu henitalnoho endometriozu [The possibilities of herbal medicine in modern methods of treatment and prevention of recurrence of genital endometriosis]. Reproduktivnaya endokrinologiya, 6, 24–29. [in Ukrainian].

Molchanova, O. V. (2013) Henitalnyi endometrioz yak «khvoroba tsyvilizatsii»: do pytanniia symptomatyky patolohii [Genital endometriosis as a disease of civilization: the symptoms of pathology]. Aktualni pytannia pediatrii, akusherstva ta hinekolohii, 1, 158–159. [in Ukrainian].

Orazov, M. R., Chajka, A. V., Nosenko, E. N. (2013) Dienogez v lechenii khronicheskoj tazovoj boli pri adenomioze [Dienogez in the treatment of chronic pelvic pain in adenomyosis]. Medyko-sotsialni problemy simi, 18(3), 49–54. [in Ukrainian].

Pirogova, V. I & Kozlovskyi, I. V. (2013) Do pytannia medykamentoznoho suprovodu diahnostuchnoho protsesu pry henitalnomu endometriozi [To the issue of medical support of the diagnostic process when genital endometriosis]. Zdorov'e zhenshchiny, 6, 110–112. [in Ukrainian].

Krasilnikova, A. K., Malyshkina, A. I., Sotnikova, N. Yu., & Antsiferova, Yu. S. (2013) Prognozirovanie e`ffektivnosti khirurgicheskogo lecheniya besplodiya u zhenshchin s malymi formami naruzhnogo genital'nogo e`ndometrioza [Prediction of the Efficiency of Surgilcal trea tment for infertility in women with minor Forms of external genital enometriosis]. Akusherstvo i ginekologiya, 7, 36–39. [in Ukrainian].

Roshchina, G. F. (2012) Korrekciya klinicheskikh proyavlenij e`ndometrioza i narushenij menstrual'nogo cikla [Correction of clinical manifestations of endometriosis and menstrual disorders]. Reproduktivnaya endokrinologiya, 2, 58–65. [in Ukrainian].

Tatarchuk, T. F., Zakharenko, N. F., Turchenko, T. N. Novye podhody k problemnym voprosam le4enija genital'nogo jendometrioza [New approaches to problem questions of the treatment of genital endometriosis] Reproduktivnaya endokrinologiya, 3, 36–45. [in Ukrainian].

Tikhomirov A.L E`ndometrioz – sugubo khirurgicheskaya patologiya? [Endometriosis – especially surgical pathology?]. Ginekologiya, 15(2), 78–81. [in Russian].

Unanian, A. L., Sidorova, I. S., Kogan, E. A. (2013) Naruzhnyj e`ndometrioz: voprosy posleoperacionnoj terapii [External endometriosis: Problems of postoperative therapy]. Rossijskij vestnik akushera-ginekologa, 13(3), 56–59 [in Russian].

Срegura, S. B. (2013) Е`ndometrioz – zagadka veka: seriya master-klassov v universal'noj klinike «Oberіg» v pomosch' ukrainskim ginekologam [Endometriosis – the mystery of the century: a series of master classes in the universal clinic «Oberig» to help Ukrainian gynecologists]. Zdorov'e zhenschiny, 1, 32–35. [in Ukrainian].

Срegura, S. B. (2013) Е`ndometrioz – «znakomyj neznakomec». Vybor taktiki vedeniya zhenshchin s dannoj patologiej [Endometriosis is a «familiar stranger». The choice of tactics of treatment of women with this pathology] Medicinskie aspekty zdorov'ya zhenshchiny, 9, 25–37. [in Ukrainian].

Prilepskaya, V. N., Ivanova, E. V., Tagieva, A. V., & Letunovskaya, A. B. (2012) Е`ndometrioz: ot trudnostej diagnostiki k novym vozmozhnostyam terapii / [Endometriosis: from diagnostic challenges into new possibilities of therapy]. Ginekologiya, 14(4), 4–8. [in Russian].

Manukhin, I. B., et al. (2013) Е`ffektivnost' lecheniya khronicheskoj tazovoj boli u pacientok s naruzhnym genital'nym e`ndometriozomv zavisimosti ot urovnya metabolitov e`strogenov [The effectiveness of treatment of chronic pelvic pain in patients with external genital endometriosis depending on the level of metabolites of estrogen]. Ginekologiya, 15(4), 16–18. [in Russian].

Polak, G., Barczyński, B., Kwaśniewski, W., Bednarek, W., Wertel, I., Derewianka-Polak, M., et al. (2013). Low-Density Lipoproteins Oxidation and Endometriosis. Mediators Inflamm, 2013, 167–78.

Fleming, R., Kelsey, T. W., Anderson, R. A., Wallace, W. H., & Nelson, S. M. (2012) Interpreting human follicular recruitment and antimüllerian hormone concentrations throughout life. Fertility and Sterility, 98(5), 1097–1102. doi: 10.1016/j.fertnstert.2012.07.1114.

Cockerham, A. Z.(2012) Adenomyosis: a challenge in clinical ginecology. J. Midwifery Womens Health., 57(3), 212–220. doi: 10.1111/j.1542-2011.2011.00117.x.

Kitawaki, J., Kusuki, I., Yamanaka, K., & Suganuma, I. (2011). Maintenance therapy with dienogest following gonadotropin-releasing hormone agonist treatment for endometriosis-associated pelvic pain. European Journal of Obstetrics & Gynecology and Reproductive Biology, 157(2), 212–216. doi: 10.1016/j.ejogrb.2011.03.012.

How to Cite

1.
Avramenko NV. Endometriosis: etiology, pathogenesis, diagnostics, modern aspects of treatment. Pathologia [Internet]. 2014Oct.1 [cited 2024Mar.29];(2). Available from: http://pat.zsmu.edu.ua/article/view/28543

Issue

Section

Review