Endometriosis symptoms

1.Endometriosis symptoms according to the different lesion, and there are different symptoms, the most common Endometriosis symptoms is dysmenorrhea, menstrual disorders, sexual pain, infertility grade as follows:
(1) dysmenorrhea and chronic abdominal pain: patients with secondary progressive dysmenorrhea is characterized by intensified following abdominal and anal pain mainly available at menstruation 1 ~ 2 days before the start, after the disappearance of menstrual pain from the lumbosacral Department of Radiation to the abdomen beginning vagina, perineum, anus or thighs, the degree of pain and ectopic foci of the relevant parts, but not directly proportional to the size of lesions, such as uterine sacral ligament ectopic nodules smaller parts may cause the patient intolerable pain, and a larger ovarian endometriotic cyst lesser symptoms or no symptoms. 25% of patients can be without dysmenorrhea, while 20% ~ 30% of patients with endometriosis have chronic pain in the lower abdomen.
(2) menstrual disorders: 15% of patients with endometriosis may have upon the volume increased, extended or menstrual spotting. Yes because of ovarian cyst was damaged parcels or ovarian adhesions caused by ovarian dysfunction caused by menstrual disorders; At the same time, often in patients with uterine fibroids have merged or uterine adenomyoma can also be caused by menorrhagia or extension, such as menstruation. Endometriotic cyst in 9.9% of cases uterine adenomyoma merger, the combined 8.4 percent have uterine fibroids.
(3) Infertility: Endometriosis is often accompanied by infertility patients and has become one of the important causes of infertility. It has been reported in the literature abroad at infertility, 35% ~ 51% for endometriosis and in endometriosis patients with infertility rate is 30% ~ 75%. Endometriosis cause infertility was mainly due to endometriosis cause pelvic adhesions, tubal and ovarian adhesions around the fallopian tubes so that the function and ovarian function obstacle to happen. Tubal adhesion mechanism so that eggs and sperm up the fallopian tubes in infertility transmission barriers happen, although endometriosis lesions to maintain the course of many tubal patency, but Muse is reported that in severe endometriosis in women 7% of infertility caused by fallopian tube obstruction also. The destruction of endometriosis lesions, so that obstacles to happen ovarian function, with or without can cause hyperprolactinemia in anovulatory cycles of luteal phase defect luteinized unruptured follicle syndrome and so on. In addition to also consider endometriosis in patients with abnormal immune function, but also cause infertility reasons, consider pelvic endometriosis in patients with non-specific inflammatory response can activate macrophages and produce various cytokines. Peritoneal macrophages increased, may interfere with phagocytosis of sperm and egg cells in patients with infertility caused by the splitting B lymphocytes in vivo generated anti-endometrial antibodies can interfere with the early delivery and implantation of the fertilized egg. Uterine secretion rectum increases, the increase of prostaglandins and (or) ascites macrophages and T lymphocytes increased, so that sperm - oocyte interaction between, as well as tubal initiative and (or) ovarian dysfunction in patients with infertility due to sexual intercourse because of pain, so that a corresponding reduction in the frequency of sexual intercourse to reduce the chance of conception.
(4) sexual pain: 30% of patients with endometriosis pain often v. sexual intercourse. Many because of mechanical irritation caused. Happened in the uterus Vagina rectum rectum separated from endometriosis, so that surrounding tissue swelling, fibrosis, when having sexual intercourse so that uterine contraction and happened to mention to the increase in pain. The extent of sexual intercourse pain and endometriosis-related sites, such as parts of sacral ligament ectopic nodules, uterine adhesions after the low fixed Dow closed cavity of the degree of pain were exacerbated by sexual intercourse.
(5)gastro-intestinal symptoms: If endometriosis lesions located in the uterus and rectum rectum near at menstrual period because of congestion and edema lesions to stimulate the rectum and can cause anal defecation frequency or pain, but also may present with constipation or diarrhea If violations rectum lesions and lesions larger mesocaval outstanding or may be caused by intestinal stenosis or obstruction. A small number of patients if the lesions violations Tatsu deeper myometrial wall, and because the local intestinal mucosal hyperemia, edema can be cyclical not intestinal mucosal lesions caused by violations
(6) urinary tract symptoms: If endometriosis lesions located in the bladder and ureter, the patient may have cyclical frequency, and hematuri pain,aurinate. Endometriosis lesions in the ureter rare, slow to carry out many of ureteral obstruction because of pelvic endometriosis surrounding tissue caused by pelvic adhesions or large endometrial cyst extrusion, resulting in ureteral scar twist, narrow or obstruction because of ureteral obstruction can form secondary hydronephrosis and renal atrophy oppression.
(7) other parts of endometriosis symptoms: If the other parts of the body happened endometriosis and plant growth, the lesions occurred in a cyclical pain, bleeding and increasing block structures, such as happened in the umbilical lesion abdominal wall wounds and genital lesions when involving lung, pleural or diaphragmatic pleura, the duplicate happened during menstruation Catamenial Pneumothorax Pulmonary involvement may occur in real terms by the former hemoptysis, and dyspnea (or) chest pain. Brain endometriosis is rare, if there may be typical of recurrent headache and neurological deficits phenomenon.
(8) symptoms of acute abdomen: a small number of ovarian endometriosis, menstruation at or before the menstrual period because of increased intraluminal pressure, wall perforation occurred, if the break small spills can be gradually eased much pain; If you break a larger capsule substantial contents spilled into the abdominal cavity causing symptoms of acute abdomen in the field of obstetrics and gynecology for the present new problems worthy of attention.
2. Signs with the lesion, scope and severity vary. Typical pelvic endometriosis performance, uterine adhesions after induced dumping fixed, the uterus may be increased, there is generally no more than 3 months pregnant uterus size. Uterine side or both sides of the attachment area can be touched with the uterine activity is not linked to the cystic mass in the rectum or uterus uterosacral ligament, the posterior wall of the uterus and other parts of the lower reach of irregular size of a grain of rice to the size of the hardware section horsebean single or more than obvious tenderness, and sometimes in the vagina, cervix or surgical scar, the umbilical can be seen, such as Purple-blue nodules, menstrual period becomes more apparent.
In recent years, endometriosis in clinical diagnosis on the rate of increase, and found that it is closely related with infertility. But countries around the scholars also found that because of the disease and the effect of the lack of uniform standards to describe, it is difficult to communicate and compare, so try to formulate a uniform standard to evaluate the patient's condition. Endometriosis classification system has undergone a series of development, has still not perfect. 1979 American Fertility Society (AFS) classification system with a set up for international adoption by 1985, AFS-r again revised.
AFS-r classification system, in accordance with peritoneal disease involving the ovary, fallopian tube, such as depth and caused by dense adhesions and extensive degree to score the total fraction of patients according to severity expressed as a 4. And provides a map depicting anatomical lesions located at the same time provide a record of reproductive tract other than the rare site of lesion location and pathology. This standard has been much used by scholars of the country our country are also adopting this classification system. Therefore, this classification system to be introduced.
This classification system has been widely used, but still not perfect, especially for pelvic pain and infertility judging controversies have hope that there is a better classification system.