Endometriosis is a chronic inflammatory disease caused by cells in the endometrium, the internal tissue of the uterus. One of the most prominent theories about the disease suggests that these cells, instead of being expelled during menstruation, move in the opposite direction and fall into the ovaries or abdominal cavity, where they multiply and bleed again. .
Doctor Daniele Pastore, gynecologist at VITA hospital, explains that the endometrium is the layer that lines the uterus inside, as if it were the uterine “stuffing”, sensitive to changes in the menstrual cycle, and this is where the egg is implanted after fertilized. If there is no fertilization, part of the endometrium is shed during menstruation and what is left grows back. The whole process is repeated with each cycle. The endometrium responds to hormones produced by the ovary in two ways: first by increasing its thickness and later by breaking away from the uterus in the form of menstruation.
“Endometriosis is defined as the presence of endometrial foci in different places of the uterine cavity, most often found in the abdominal cavity – bladder, bowel, fallopian tubes, ligaments and ovaries. In addition, it can also present in form of cysts on the ovaries, called endometriomas “, underlines the gynecologist. The problem usually resolves spontaneously with menopause, due to the drop in the production of female hormones.
According to the doctor, around 200 million women suffer from endometriosis around the world. “Despite a large number, it is estimated that a woman with endometriosis takes about seven years to be diagnosed, often with frequent emergency room visits, several attempts to use medication, numerous absences from work and numerous judgments. The pain is invisible, but real, ”he warns.
Symptoms
According to Dr. Daniele, the main symptoms that lead a woman to see a gynecologist are pain during the menstrual period and difficulty getting pregnant – the local inflammation of endometriosis makes it difficult for the embryo to implant (fix) in the womb. The doctor says it can also cause changes in the architecture of the pelvis (like adhesions in the fallopian tubes) that make it difficult or even prevent pregnancy. “The number and intensity of symptoms are quite variable from one patient to another. The symptoms arise because the endometrial pieces, even outside their usual location, continue to respond to hormone stimuli produced by the ovaries, causing a local inflammatory reaction and bleeding, “the specialist points out.
Dr Daniele warns that you should watch out for the following symptoms:
– Dysmenorrhea: pain during the menstrual period;
– Dyspareunia: pain during sexual intercourse, especially during deep penetration;
– Chronic pelvic pain: pelvic pain lasting more than six months;
– Dyschesia: pain to evacuate, especially during the menstrual period;
– Dysuria: pain when urinating during the menstrual period;
– Difficulty getting pregnant.
Diagnostic
Dr Daniele specifies that the onset of diagnosis is based on the symptoms reported during the consultation and on imaging tests such as transvaginal ultrasound with bowel preparation or magnetic resonance imaging of the pelvis. However, they are not always precise, because if the foci of endometriosis are very small, they may not be identified.
The definitive diagnosis is made by videolaparoscopic surgery – which essentially consists of inserting a microcamera into the abdominal cavity for direct visualization of the pelvis. According to the gynecologist, the advantage of this procedure is that it serves both to confirm the diagnosis proposed in the imaging examinations, and for the treatment, because it allows to eliminate the foci of endometriosis found.
Processing
Therapy is individual, depending on the severity of the symptoms and the patient’s immediate desire to become pregnant. Some cases can be treated conservatively, just with medication, an anti-inflammatory diet, and regular physical activity, but others require videolaparoscopy surgery. The form of treatment is defined after a detailed clinical examination, imaging examinations and according to each case.
About VITA Hospital – The first unit of the VITA network in Paraná was inaugurated in March 1996, in Bairro Alto, and the second in December 2004, in Batel. VITA was the first Brazilian hospital to obtain, in early 2008, Canadian International Accreditation CCASS (Canadian Council for Health Services Accreditation). Health services certification assesses management excellence and, most importantly, the safety of patient care. in addition, VITA is one of the multiplier hospitals of the Brazilian Patient Safety Program (PBSP), which aims to disseminate and create innovative improvements in quality and patient safety. It is also part of the hospital group of the National Association of Private Hospitals – ANAHP. VITA offers a 24-hour service and is a benchmark in the fields of cardiology, general surgery, neurology, bariatric surgery, emergency medicine, urology, intensive care and traumatology-orthopedics. In addition, it has a full sports medicine service, providing assistance to athletes of different modalities; oncology service; Medical center and diagnostic center. To ensure a high level of quality in the services provided to patients, VITA has invested in the extension of infrastructure, treatments with multidisciplinary teams, modernization of equipment, humanization of care, professional qualification and safety of care. . www.hospitalvita.com.br
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