Endometriosis is one of the most widespread and dangerous diseases in modern gynecology. Untimely detection of this pathology, associated with the complexity of the diagnostic process, threatens the patient with the development of many serious complications, such as infertility and oncological pathology. That is why every practicing gynecologist must know about the methods of treating endometriosis, depending on where the pathological focus is located. Pathology develops mainly in patients of reproductive age, and gynecologists encounter it in their practice quite often.
An integrated approach to the treatment of endometriosis: conservative and surgical methods
The treatment of endometriosis has several main goals: stabilization of the hormonal background, elimination of the symptoms of the pathology and surgical removal of the pathological focus. To achieve these goals and prevent the development of complications of the endometrioid process, an integrated approach to the treatment of endometriosis is currently used: conservative and surgical methods of treatment are used. The combination of hormonal therapy, surgery and symptomatic drug therapy allows you to achieve the maximum effect and save the patient from such a serious gynecological problem.
Treatment of endometriosis:
- what surgical interventions are performed for endometriosis;
- hormonal therapy in a complex treatment regimen for endometriosis;
- methods of symptomatic treatment of manifestations of endometriosis.
Hormonal therapy in a complex treatment regimen for endometriosis
The leading role in the combined treatment of endometriosis is given to surgical interventions, the choice of which depends on the localization and prevalence of the pathological process:
- Surgical treatment of endometriosis of the cervix includes methods such as electrocoagulation, radiocoagulation, laser vaporization and cryodestruction;
- in case of endocervical endometriosis, the optimal method of treatment is radiocoagulation of pathological foci, laser vaporization or conization of the cervix;
- in case of vaginal endometriosis, excision of endometriotic lesions is recommended;
- ovarian, fallopian tube and pelvic peritoneal endometriosis are treated by coagulation or laser vaporization at laparoscopy;
- As a surgical treatment for adenomyosis, organ-preserving endoscopic techniques are used, in some cases a hysterectomy is necessary.
Hormonal therapy in a complex treatment regimen for endometriosis
Hormone therapy is currently recommended for almost all forms of endometriosis, which can be explained by the participation of the hormonal factor in the process of this pathology. Stabilization of the hormonal background helps prevent relapses of the disease and achieve the maximum effect from the complex treatment of endometriosis. To date, it is recommended to use the following groups of hormonal drugs:
- combined synthetic estrogen-progestin preparations;
- progestins are drugs that do not contain an estrogen component;
- antiprogestogens;
- antigonadotropins;
- gonadotropin-releasing hormone agonists;
- Antiestrogen;
- anabolic steroids;
- androgens.
The selection of a hormonal therapy regimen is carried out taking into account all contraindications, side effects and individual characteristics in each individual case of endometriosis.
Methods of symptomatic treatment of manifestations of endometriosis
Symptomatic treatment of endometriosis involves the use of various groups of medications in order to eliminate the manifestations of endometrioid pathology. Immunomodulators are prescribed to normalize immune status disorders, which are one of the triggers for the development of endometriosis. To eliminate the pain syndrome, which is the leading one in endometrioid pathology, patients are prescribed analgesic, antispasmodic and non-steroidal anti-inflammatory drugs. Sedatives and tranquilizers are recommended to eliminate the neurological manifestations and consequences of endometriosis that has arisen in the patient. Iron preparations are recommended for the treatment of posthemorrhagic anemia, which often accompanies endometriosis. Physiotherapeutic methods of treatment complement the basic scheme of complex therapy of endometriosis.
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