Endometriosis after cesarean section and postoperative scar
Gynecologists conducted a study and found that pregnancy, the postpartum period and long breast-feeding is very good for endometriosis. But still sometimes after the birth of a child develops endometriosis, which has not appeared before pregnancy.
Endometriosis refers to the benign diseases that have a tendency to progression and is dependent on hormones with cells of the uterus, the lining, beyond its normal position in the body. There is genital and extragenital endometriosis. Genital detected in 92-94% of all of the facts of cases. He repeatedly became the reason for the childlessness of women, but if it occurs before pregnancy, aggravates the process, there is a threat of miscarriage, placenta previa, abnormal tribal forces, preeclampsia, etc.
There are certain factors that entail endometriosis after cesarean section:
- lengthy labor, too long anhydrous period;
- cesarean section, or postoperative scar endometriosis, adenomyosis;
- loss of blood after childbirth, requiring manual control of the uterus, forceps or the birth of a large baby, all, which causes obstetric injury.
- perineal tears;
- breaks of the cervix;
- ruptures of the vagina;
- placenta previa;
- dense attachment of the placenta.
The types of genital endometriosis
There are only two types: adenomyosis and endometriosis.
Adenomyosis (internal endometriosis of the uterus) is a birth accompanied by the muscular and mucous layers of the uterus create a morphological restructuring of the myometrium and endometrium. But endometrial cells grow into the uterus. There are four degrees of the process:
- endometriosis extends to a small depth;
- endometriotic lesions grow in the center of the thickness of the endometrium;
- the process includes all uterine layers;
- is drawn into the process parietal peritoneum, rectum and bladder.
Adenomyosis of the uterus is expressed by pain, becoming stronger in lesions of adjacent organs, excessive menstruation with clots, spotting occurs, the secretions before menstruation and after, and decrease the ability to conceive.
Endometriosis of the cervix is visually on the vagina shows a small endometrial lesions 2-5 mm. They are red and very visible in the background mucosa pale pink color. During the second phase of the cycle become blue-red and more. And noticeable spotting.
Sometimes takes the form of a pseudo-erosions with hemorrhagic glands. In this case, the growth is in pozadine space. Be felt a strong, extremely painful, tuberculate stationary nodes. Often they’re little, but before menstruation increase. Is the pain in the lower abdomen, extending to the foot, the rectum, and is felt in the process of defecation. There are dark spotting before menstruation and after. During this period, often constipation, flatulence and frequent urination.
Endometriosis in cesarean section
In the process of cesarean section the uterine wall is cut, and after the surgery the skin is left scar. Almost always when such operation in the edges of the wound get small pieces of the endometrium, so there is endometriosis. Usually, it develops after 1-3 years after such a procedure.
This form of endometriosis has three different variations of the flow:
- Endometrial tissue grows in the abdominal region of the uterine scar.
- Affected the seam of the anterior abdominal wall that remains after surgery. It formed a cyst, which becomes larger during menstruation. This pathology has a name, endometriosis of the anterior abdominal wall.
- Endometriosis the uterine cavity, which occurs due to stretch of the endometrium of the postoperative scar.
No woman is immune from the occurrence of endometriosis after cesarean section. It is therefore essential to monitor the state of health and not to neglect symptoms.
Who are prone to endometriosis?
Pathology affects the following women:
- young mothers after caesarean section;
- patients with uterine tumors. Unfortunately, benign tumors do not dissolve completely, even during pregnancy;
- women who once carried out the cleaning of the uterus;
- patients who have been injured mucous layer with a rough survey of the gynecologist.
Symptoms of pathology
The main symptoms of endometriosis uterine scar:
- The first symptom is pain. Expressed pulling sensations in the abdomen. Often the pain is constant throughout the cycle, then subsided, then it becomes stronger, increases and before the onset of menstruation. And also, there may be discomfort during sexual intercourse.
- Huddled cycle with abundant secretions. In the case of destruction of the muscular layer of the uterine cavity, this symptom will be. Menses are delayed and abundant throughout menstruation.
- Spotting a few days before and after menstruation.
- Often there is infertility. When distributing endometriosis occurs the obstruction of the fallopian tubes.
Signs of endometriosis of the anterior abdominal wall:
- The emergence in the area of postoperative scar painful seals.
- Change the color of the abdominal integument is brown or Burgundy-blue color
- The growing nagging pain in the area of the weld seam during menstruation. And there may be small brown allocation in the area of the scar.
- Itching in the joint area, which increases during menstruation.
Endometriosis cause bleeding which can be life-threatening. If foci are located in adipose tissue and the skin, it can develop into cancer. It is therefore necessary for the manifestation of endometriosis symptoms, immediately seek the help of a specialist. Unfortunately, a complete cure will never be possible, but you can overcome its progression.
Endometriosis treatment can be both conservative and surgical. The sequence of therapy is chosen strictly individually.
Surgery for treatment of endometriosis is:
- cauterization of the lesions at hysteroscopy;
- laparoscopically removed separate structures, adhesions cut and koaguliruut abnormal areas. Now is the best option to combat endometriosis. Even the smallest, invisible to the affected areas, viewed through the optics of the device;
- with endometriosis postoperative scar held his knife removal with extensive skin dissection. In some cases, a defeat so great that after its removal resort to plastic surgery.
Endometriosis is a hormonal disease and to get rid of it, only surgically not fully succeed. You always need to use additional therapy, which focuses on the prevention of the progression of pathology. Excellent job with this hormones. They control the production of active substances of the organism, preventing the recurrence. To do this, use:
- oral contraceptives;
- agonists and antagonists of gonadotropin-releasing hormone.
When taking these medications, except oral contraceptives, there is a state of «pseudomenopause», which has its classic symptoms – hot flashes, amenorrhea, etc. the Course lasts from 3 months to half a year. After a course of ovarian function is restored and comes back to normal.
To stop the pain attacks from endometriosis, drink antispasmodic and anti-inflammatory drugs.
Have endometriosis, there are hidden forms and genetic predisposition, so often fails to prevent its occurrence. Prevention of endometriosis includes the usual set to prevent any disease, that is, proper nutrition, healthy sleep, rest, active lifestyle, etc., but, in addition, there are special tips:
- hormones pregnancy inhibits the growth of the disease and it even cleans;
- to avoid interference in the uterus, abortion, curettage, etc.;
- when operations do not touch the endometrium, to the extent possible;
- oral contraceptives will have a greater effect on disease than, for example, uterine spiral;
- prevention of inflammation will be an excellent prevention of violations of hormonal background.
Usually the effect on the appearance of endometriosis have a small number of births, change of lifestyle and various manipulations in the uterus and cesarean section. Timely treatment and prevention will help to achieve stopping the progression of endometriosis.
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