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Endometriosis 子宮內膜異位症
Endometriosis 子宮內膜異位症
2023/12/26
Foreword
Endometriosis happens when endometrial tissue is discovered outside the uterine cavity.
Etiology
If endometrial tissue is discovered at the ovary, it is so-called endometrioma or chocolate cyst.If the endometriosis occurs in the myometrium, it is called adenomyosis. Even though the etiology of endometriosis is still unclear, hypotheses include:
- Menstruation blood reflux: menstrual blood containing endometrial cells refluxes through ovarian tube into abdominal cavity.
- transported by vascular and lymphatic systems: menstrual blood containing endometrial cells passes through orifices of uterine vascular and lymphatic vessels. It is transported to other parts of the body such as lung, umbilicus, and lymph nodes.
- auto-immune deficiency: endometrial tissue can be degraded by phagocytosis of leukocyte and lymphocyte. However, there are a few women who could not absorb excessive endometrial tissue; so those cells would be attached to ovary, ovarian tube, urinary bladder, colon, and Douglas pouch.
Examinations
- Palpation: colon and vagina digital examination or abdominal palpation
- Ultrasonography: to detect the location of pelvic cyst
- Blood examination: to examine the level of CA-125 tumor marker
- Laparoscopic examination: the only means to confirm diagnosis
Symptoms
- Dysmenorrhea: one to two weeks before menstrual period, most women often feel backache, diarrhea, dizziness, severe abdominal pain, and dropping feeling of lower abdomen.
- Infertility: there are 30%-50% of women are infertile because they have endometriosis.
- Dyspareunia: there are 25%-40% of women suffering from painful sexual intercourse.
- hypermenorrhea or vaginal spotting before menstrual cycle: there are about 20% to 30% abnormal vaginal bleeding incurred by hormonal dysfunction.
- Surgical scar tissue with periodical pain: when there is endometriosis incurred by surgical scar, patients would suffer from pain caused by menstrual period.
- periodical hemoptysis and epistaxis: endometriosis invading nasal mucosa and lung.
- others: there are also non-specific symptoms such as hematuria, dysuria, and anal pain caused by defecation.
Treatments
- Hormone therapy like progesterone, oral contraceptives, and androgen
- Surgical treatments including laparoscopic or laparotomy surgery
- Combined medical and surgical treatment
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電話:(04) 22052121 分機 14145
HE-60024-E
電話:(04) 22052121 分機 14145
HE-60024-E
中國醫藥大學附設醫院暨體系院所