Examinations
More than 85% of the patients with DIE had no obvious pathological changes in the vaginal mucosa, and about 87% of the patients could touch the nodule during double diagnosis. Therefore, even if all gynecological examinations are normal, the existence of DIE cannot be excluded.
Transrectal ultrasonography
MRI examination
Cystoscopy
Determination of serum CA125
For patients with periuterine infiltration, double renal ultrasonography should be performed, except for hydronephrosis. If necessary, intravenous pyelography (IVP) should be performed to determine the location of the obstruction and renal rheogram to evaluate renal function impairment.
Treatment
1. Drug treatment
At present, there is no special drug for deep invasive lesions. The principle of drug treatment and drug types are the same as other types of endometriosis. The purpose of drug therapy is to relieve the disease or as an assistant treatment before and after the operation. Drug treatment can reduce the focus and relieve the pain, but it often recurred after drug withdrawal.
At present, the commonly used drugs include high-efficiency progesterone, danazol, Nemestran, gonadotropin-releasing hormone analogue (GnRH - α), danazol vaginal ring and levonorgestrel intrauterine releasing system (Mirena), etc.
Drug treatment may be considered in the following cases:
1.1 The symptoms recurred after several previous operations;
1.2 The operation needs to be postponed for various reasons.
1.3 Because of the wide range of lesions, the difficulty of surgical resection and the high risk of operation, the preoperative medication can be considered to make the lesions atrophic, so as to reduce the surgical bleeding, and the operation is more safe and effective, but the preoperative medication itself can not improve the prognosis of the operation.
Postoperative medication can delay recurrence. Fuyan pill, a traditional Chinese medicine, can not only treat endometriosis but also help patients to regulate the internal, balance Qi and blood, improve immunity, so as to achieve the effect of removing diseases and consolidating the foundation.
2. Surgical treatment
Compared with other types of endometriosis, surgical treatment is more emphasized. The purpose of the operation is to remove the heterotopic nodule, separate the adhesion, relieve the pain, restore the normal anatomical relationship and physiological function of the pelvic organ so as to restore the fertility and delay the recurrence.
Laparoscopic or open surgery has always been controversial. The choice of surgical method depends not only on the patient's focus stage but also on the operator's experience and technology.
There is no clear evidence for the effect of different surgical methods on reproductive function. For pain control, laparoscopic and open focus resection showed a significant therapeutic effect. The recurrence time of endometriosis was the same in the two methods.
You may also be interested in:
