Endometriosis is a condition in which tissue resembling the lining of the uterus grows out of it. The disease can affect the muscular uterine wall (adenomyosis, or internal endometriosis), the neck, ovaries, and other organs. If any anatomical formation, except for the uterus, is involved in the process, the external form of pathology develops.
Bladder endometriosis is a rare disease that can cause severe discomfort in a patient. When abnormal tissue grows, endometriosis of the peritoneum of the bladder, or superficial, occurs on the outer surface of the organ. If the pathology occurs in the mucous membrane or the thickness of the wall of the organ, it is called the deepest form of the disease. Endometriosis of the bladder neck is also isolated, in which the sphincter is involved in the process - a circular muscle, the closure of which ensures the retention of urine.
During menstruation, under the influence of sex hormones, the endometrial tissue thickens and is rejected, leaving through the vagina in the form of bleeding. With its growth outside the uterus, this becomes impossible, which leads to long and severe pain during menstruation and other unpleasant symptoms.
Endometriosis (we have already described this disease in the article earlier) affects 6-10% of women of reproductive age. Of these, only 1-2% show urinary tract involvement, most often it is the bladder that suffers.
The exact reasons are unknown. It is assumed that endometriosis occurs under the influence of the following factors:
- Undergone surgery on the uterus. A cesarean section or hysterectomy (removal of the uterus) can lead to an accidental entry of endometrial cells onto the surface of the bladder.
- An abnormal development of the embryo, in which, even in the prenatal period, the progenitor cells of the endometrial tissue enter the urinary organs.
- Retrograde (reverse) reflux of blood during menstruation. This is possible, for example, with heavy physical exertion during menstruation. The bleeding containing residues of the endometrium, can not penetrate into the vagina, and through the fallopian tubes into the abdominal cavity, and from there implanted in the wall of the bladder.
- Transplant theory. Her supporters suggest that endometrial cells may enter another organ through the blood or lymphatic vessels that are damaged, for example, during intrauterine devices (curettage, abortion).
- Genetic changes. It is believed that endometriosis or the propensity for it can be inherited.
The most common symptoms of endometriosis of the bladder are pain when filling the organ and frequent urination. About 30% of patients do not experience any discomfort. The disease is detected by chance, for example, during examination to identify the causes of infertility.
Usually signs of endometriosis appear or increase during menstruation, these are:
- imperative urge to urinate (feeling urgent need to visit the toilet),
- frequent urination,
- pain when filling the bladder,
- burning or soreness when urinating,
- the appearance of blood in the urine
- pelvic pain
- unilateral back pain.
In some cases, with the common form of the disease, these symptoms are combined with other signs:
- cramping and lower abdominal pain before and during menstruation,
- pain during sexual contact,
- intermenstrual bleeding, which can be very strong,
- severe fatigue, fatigue,
- nausea and loose stools.
Pregnancy with endometriosis of the bladder is possible, since with an isolated course of the pathology does not affect fertility. However, in most cases, it affects not only the bladder, but also the organs of the reproductive system, which creates difficulties for conception.
About endometriosis during pregnancy can be found on this page.
If the disease is not treated, it progresses in about half of the patients. Pathological tissue penetrates deep into the muscle wall and squeezes the internal openings of the ureters, making it difficult for urine to drain from the kidneys. As a result, hydronephrosis and renal failure may develop.
Diagnosis of bladder endometriosis begins with a gynecological examination and urinalysis to detect blood in it.
- Ultrasound. Thus, the doctor will find out where and in what quantity the pathological growths of the endometrium are located.
- MRI Study using a magnetic field and radio waves to obtain detailed images of tissues. It will help determine the smallest characteristics of the pathology.
- Cystoscopy. A thin instrument is inserted into the bladder with a video camera. This makes it possible to see the endometrioid tissue on the mucous membrane and take a biopsy to confirm the diagnosis.
- Laparoscopy. Sometimes, to diagnose a peritoneal lesion covering the bladder, an internal peritoneal sheet is examined through small incisions in the anterior abdominal wall using a special apparatus - a laparoscope.
After confirming the diagnosis, the stage of the disease is determined:
- Stage 1 - minimal. There is only a small amount of pathological tissue on the surface of the organ.
- Stage 2 - easy. There are extensive growths of the endometrium without penetration into the deep layers.
- Stage 3 - moderate. Germination of the endometrium through the peritoneum and the formation of nodules in the muscle tissue begins,
- Stage 4 - hard. Endometriosis affects not only the bladder, but also other pelvic organs.
Other possible causes that may be accompanied by similar symptoms:
- acute or chronic cystitis,
- interstitial cystitis
- autoimmune process
- allergic reaction,
Therefore, with persistent pain in the lower abdomen and urinary disorders, you should visit a general practitioner and gynecologist.
This is the best way to get rid of the symptoms. During the operation, all pathological lesions are removed.
There are 2 types of operations for this disease:
- Transurethral surgery. Using a cystoscope inserted through the urethra, the doctor removes the endometrial tissue.
- Partial cystectomy. The operation involves the removal of parts of the organ by laparoscopic or laparotomic.
Laser "evaporation", diathermocoagulation or excision with a scalpel is used to remove foci of endometriosis.
Superficial peritoneal endometriosis can be easily removed without damaging the muscle wall. With an invasive process, a layer-by-layer resection of the bladder muscle wall may be required. For the prevention of damage to the ureters during the intervention in them inject a solution of indigo carmine, which is clearly visible in the abdominal cavity. Endometriosis rarely affects the lower part of the organ (the triangle between the openings of the ureters and the inner opening of the urethra), so the risk of damage to these organs is very small. Post-operative catheterization is usually not required. It is produced only with a large amount of intervention for the discharge of urine, and later for the control X-ray contrast study. A contrast agent is inserted through the catheter into the bladder and an x-ray is taken to ensure that there are no defects.
In some cases, flexible silicone stents are inserted into the ureters during surgery to avoid urinary retention. These tubes can cause discomfort in the lumbar region during the first days after surgery. Subsequently, they are removed by cystoscopy.
If the urinary catheter is installed for several days, the patient can be discharged home. It is recommended to take only a shower and drink plenty of fluids in order to avoid urinary tract infections. To prevent infections, the doctor may prescribe antibiotics.
You can get up, sit and walk from the first day after surgery. However, activity should not cause pain. After discharge, the regime is gradually expanded, but does not allow the occurrence of unpleasant symptoms. In the early days, you may need to take painkillers. During their reception it is better not to drive.
You can return to driving after the patient is able to sit comfortably and without pain in the car seat, buckle up, look in the mirrors.
In the first month, the transfer of heavy objects is limited (no more than 3-5 kg with a weight distribution in both hands).
To reduce the amount of endometrial growths and relieve symptoms, hormonal drugs are prescribed. The following groups of drugs are used:
Nonsteroidal anti-inflammatory drugs
In particular, ibuprofen, prescribed to relieve pain in the pelvic region and spasms during menstruation. They do not affect the processes of implantation of endometrial cells or the progression of the process. However, such medications reduce the production of prostaglandin involved in the perception of pain.
The diagnosis of endometriosis can only be confirmed by biopsy. Therefore, many women with suspicion of this disease initially receive only painkillers without an accurate diagnosis. Under such circumstances, NSAIDs are widely used as first-line therapy.
Since endometriosis of the bladder occurs in women before menopause, many of its treatments are designed to interrupt the normal cyclic production of hormones in the ovaries. For this purpose, various hormone preparations are prescribed.
Analogs of gonadotropin-releasing hormone (GRG)
They effectively relieve pain and reduce the size of foci of endometriosis. These drugs inhibit the production of estrogen in the ovaries by inhibiting the secretion of pituitary gonadotropins. Monthly stop, imitating menopause. Nasal sprays and injections of GRG agonists are used.
Side effects of drugs are associated with a lack of estrogen: hot flashes, vaginal dryness, vaginal bleeding, emotional disturbances, fatigue. For their prevention during treatment with agonists of GRG, small doses of progesterone are given in tablets (the so-called plus therapy).
Combination medications containing estrogen and gestagens are used. They can be assigned continuously, with the result that menstruation does not occur. In rare cases, their use causes weight gain, breast tenderness, nausea, and vaginal bleeding. However, oral contraceptives in women with bladder endometriosis are usually well tolerated.
Substances such as medroxyprogesterone acetate, norethindrone acetate, norgestrel acetate are more potent than birth control pills, and are recommended for those patients who cannot take oral contraceptives or the latter are ineffective. Side effects are more pronounced: breast tenderness, bloating, weight gain, irregular uterine bleeding, depression. The absence of menstruation caused by high doses of progestins can last for several months after the completion of therapy. Therefore, progestins are not assigned to women who want to become pregnant soon after the end of treatment.
This is a synthetic drug that creates a high level of androgens and lowers the level of estrogen, thereby preventing ovulation. In 80% of women taking Danazol, pain relief and reduction of endometriosis foci occur, but 75% of them develop side effects. These include weight gain, edema, acne, breast reduction, oily skin, unwanted facial hair growth, decrease in voice tone, hot flashes, headache, emotional disturbances, decrease in sexual desire.
Almost all of these side effects are reversible, but persist for several months after discontinuation of the drug. Danazol is not recommended for severe heart, kidney or liver diseases.
The most modern group of drugs for the treatment of bladder endometriosis. They block the effect of estrogen on endometrial foci, and also inhibit the synthesis of this sex hormone in the ovaries and adipose tissue. They can be combined with other drugs.
Bladder Endometriosis Treatment
Urinary system diseases are always serious and have unpleasant symptoms. One of these diseases is bladder endometriosis.
This disease occurs only in women, as it is associated with the growth of the uterine lining.
Since this disease tends to affect not only the bladder, but also the neighboring organs of the urogenital system, any warning symptoms should be a reason to visit a doctor.
Endometriosis is a female disease. This pathology is characterized by the movement of the inner lining of the uterus (endometrium).
Endometrial tissue extends into the uterine layer of the muscles or goes beyond the initial location: in the ovaries, cervix, abdominal cavity, intestinal sections, bladder.
In the case when the patient recently underwent surgery in the urogenital system, the uterine mucosa can even shift into the postoperative scar. The symptoms that a woman will experience will depend on where the endometrium is found.
Most often the disease occurs in women of reproductive age - from 23 to 40 years, and occurs in 26% of women. At the age of activation of the menstrual function is found in 10-12% of girls. Very rarely occurs during menopause (3-6%). Endometriosis can be of 2 forms: affecting the genitals (genital) and not affecting the reproductive system (extragenital).
There are 4 main degrees of the disease:
- Single changes in surface tissue, endometrial germination is shallow.
- Multiple foci deep into reaching the middle of the fabric.
- Endometrial germination becomes deeper, single adhesions appear in the abdominal cavity.
- Compaction of adhesions and an increase in the affected areas.
Foci of damage vary in size and shape. There are both rounded foci in a couple of millimeters, and growths of atypical forms, occupying 7-9 centimeters in diameter. They have a dark cherry color, which is uncharacteristic of organ tissues, with whitish scars along the edges. Because of these features, the disease provokes the appearance of adhesions in the pelvis.
Excessive weight can trigger the development of bladder endometriosis in women.
There are many reasons for the development of bladder endometriosis in women:
- hormonal disorders,
- genetic predisposition
- inflammation in the urogenital system,
- poor nutrition,
- water balance disturbances
- metabolic problems,
- weakened immunity
- late pregnancy
- effects of operations (removal of cysts from the ovaries, cesarean section, abortion, treatment of erosion).
The main manifestations indicating the presence of growths of the endometrium are:
- problems with urination, pain accompanying this process,
- the presence of blood in the urine at the end of the act of urination,
- constant or passing pain in the pelvic region (arises or increases before the onset of menstruation),
- heaviness in the lower abdomen,
- "Flaky" inclusions in the urine,
- urinary incontinence,
- weight gain.
In addition to the above signs, the disease is characterized by staining of urine in a red hue before the onset of menstruation.
This color is due to a change in the color of the mucous membrane of the affected bladder. In the general analysis of urine, red blood cells will be detected unchanged.
At the initial stage of development, endometriosis can occur without symptoms. This makes it difficult to determine the presence of the disease.
Bladder ultrasound is one of the diagnostic procedures for detecting endometriosis.
The appearance of any problems with the bladder is a reason for prompt treatment to the doctor. The complex of diagnostic procedures for the detection of endometriosis includes:
- history taking - analysis of heredity, past diseases, infections, injuries of the urogenital system, residual postpartum injuries, abortion effects,
- the study of menstrual function - the duration, frequency, profusion of menstruation,
- cystoscopy - study of the urethra with an endoscope, carried out using anesthesia,
- collection of general blood and urine tests.
- ultrasound (ultrasound).
A woman may be assigned magnetic resonance imaging (MRI). But it is used only in cases that are unclear and difficult to diagnose - when it is difficult to distinguish other diseases of the urinary system from endometriosis. As soon as the patient is diagnosed with endometriosis of the bladder, it is important to immediately begin treatment to prevent the development of complications.
Disease therapy is performed in one of two ways:
Conservative treatment involves taking drugs that affect hormones (oral contraceptives).The doctor will ask whether the patient plans to become pregnant and takes into account the perception of drugs by her body.
To improve the condition of the bladder and cope with the manifestations of the disease, contraceptives are taken by courses for 3-4 months. Remember that you can not violate the regimen, otherwise the treatment will be ineffective.
Additionally prescribed drugs aimed at restoring immunity.
If there is no improvement in the patient's condition, the question of the operation will be raised. When the condition of the disease is neglected and the medications cannot stop the inflammatory process, the affected parts of the bladder will be removed.
The most dangerous in surgical intervention is the possibility of introducing pathological endometrial cells into other organs of the urogenital system. But doctors carefully monitor this during the operation.
In the postoperative period, the patient is prescribed hormonal drugs for the speedy healing of tissues.
You should not engage in a plane - you can harm health.
Therapy with herbs and other methods of traditional medicine must be approved by the attending physician. Self-medication can harm health and aggravate the course of the disease. If everything is in order and folk remedies can be used for the patient, then effectively managing the manifestations of the disease will help:
- tinctures and decoctions of herbs that increase immunity (chamomile flowers, mountaineer, nettle leaves),
- decoction based on the red brush.
The recipe for red brush decoction is as follows. You need a dry root of the plant. It is crushed, poured into a saucepan and mixed with half a liter of boiling water.
The mixture must be boiled over medium heat for 15–20 minutes. Next, the pot should be wrapped with a blanket or a towel and insist 30 minutes.
Daily use half a glass of broth 2-3 times before meals. During the period of menstruation should take a break.
Prevention and prognosis
Endometriosis of the bladder in women can be easily prevented by such preventive measures:
- Maintain a healthy and active lifestyle.
- Do not abuse alcohol, stop smoking.
- Get rid of excess weight.
- Eat well in order to establish a metabolism.
- Twice a year to be examined by a gynecologist and a urologist.
- Avoid abortions and do not bring the urinary system diseases to operations.
Timely diagnosis and timely treatment can completely cure the disease. If you do not stop the development of the disease, the enlarged endometrium can develop into a malignant tumor of the bladder and lead to infertility. The prognosis for patients who are planning a pregnancy in the event of recovery is favorable - conceiving and carrying the child will not hurt anything.
This article focuses on the causes, symptoms, clinical picture, diagnosis and treatment of diseases such as bladder endometriosis. However, as practice shows, “bare” information about the disease is not easily understood by the reader. That is why you will familiarize yourself with such concepts as endometrium and endometriosis, and then study the information about bladder endometriosis.
Structure and function of the endometrium
Endometrium is the inner layer of the uterus lining its cavity. endometrial function - fixation of the egg for subsequent fertilization and growth of the fetus. Endometrial tissue is very rich in estrogen and progesterone receptors, for this reason, a monthly update of the endometrium occurs. Endometrium consists of two layers:
- External - endometrial or glandular layer, undergoes cyclical detachment during the period of menstrual discharge and re-grows in the first phase of the menstrual cycle.
- The inner or basal layer, which is responsible for the formation of a new layer of glandular endometrium.
Information about the structure and functioning of the endometrium is important for further understanding the mechanism of a disease such as endometriosis.
Normally, the endometrium lines the inner surface of the uterus and is no longer found anywhere in the body.
Endometriosis and its types
Endometriosis is a disease of the female reproductive system in which the growth of endometrial tissue occurs outside its physiological localization, i.e.
it is found outside the uterus. Monthly cyclical fluctuations of female sex hormones lead to the formation of symptoms and a complete clinical picture of endometriosis.
There are two types of endometriosis: genital and extragenital.
A type of endometriosis in which the formation and proliferation of endometrial tissue outside the female genital organs occurs. It is the extragenital variant that refers to endometriosis of the bladder in women. In addition to the bladder, endometrial tissue can be found in any organ, which forms a certain symptom complex of the disease.
Damage to the bladder by endometrial tissue
In gynecological practice, endometriosis of the bladder is quite rare, and the clinical picture of the disease does not have any specificity.
That complicates early diagnosis, and treatment often begins only with the appearance of marked symptoms in a patient.
With endometriosis of the bladder, the endometrium grows in the cavity or wall of the bladder, which further forms the symptoms characteristic of many diseases of the urological profile.
Causes of Bladder Pain in Women
Endometriosis of the bladder causes symptoms characteristic of many urological diseases, however, the complexity of the symptoms suggests endometriosis and conduct a diagnostic study for accurate diagnosis. With the defeat of the bladder endometrial tissue in a sick woman the following symptoms are formed:
- Dysuria is a violation of the mechanism and process of urination.
- Pain and discomfort in the pelvic area and pubis - is characteristic during periods of menstruation. Pain is a nagging character of average intensity. Determining the location of pain is difficult.
- Hematuria - the appearance of blood (red blood cells) in the urine.
- Significant turbidity of urine - visually looks like flakes in the urine.
- Pain during urination.
Abdominal pain, the appearance of blood in the urine and dysuric phenomena that are aggravated during menstruation are the main signs of bladder endometriosis.
It is worth noting that the symptoms are formed gradually, and the identification of their sick woman can be quite late, which is why it is worth listening to any changes in the body.
If you find one or more of the above symptoms, do not delay with the consultation and medical treatment to a gynecologist. Timely diagnosis of endometriosis of the bladder and adequate treatment will quickly and effectively cope with the disease.
To establish a clinical diagnosis of endometriosis of the bladder, the obstetrician-gynecologist performs a full diagnostic complex of research. Such a complex includes consultation and examination in a gynecological chair in mirrors, collection of information (obstetric and gynecological history) about life and this disease, taking into account all complaints and checking specific symptoms.
Next, the specialist assigns a number of instrumental studies:
- Hysteroscopy - intravaginal examination of the uterine cavity with the use of special optical technology.
- Cystoscopy is similar to the previous study, but the bladder is examined.
- Ultrasound examination of the pelvic organs.
- Computer and magnetic resonance tomography. In cases where the differential diagnosis is difficult.
Cystoscopy allows to identify foci of endometriosis on the inner surface of the bladder
Instrumental studies are necessarily complemented by laboratory data, which takes into account the general analysis of blood and urine, as well as the level of female sex hormones.
After conducting a comprehensive study, the doctor establishes a clinical diagnosis - endometriosis of the bladder - and determines the plan and treatment regimen.
It is performed in advanced cases when extragenital endometriosis is in the 3rd and 4th stages, i.e. affected most of the organ or invasion of endometrial tissue occurred throughout the entire thickness of the organ. Also, surgical treatment is carried out when establishing persistent infertility in women.
Surgical treatment consists in resection (removal) of the affected part of the bladder, followed by closure. Currently, the operation is performed laparoscopically and is considered to be minimally invasive, which allows achieving a good postoperative period and a high level of the patient’s further quality of life.
It is possible to completely remove all foci of endometriosis only with the help of surgery.
In general, bladder endometriosis responds well to treatment, especially with the use of surgical techniques. In the early stages, hormone therapy is carried out with several long courses, which helps to control the disease well. However, the radical treatment today remains precisely surgical treatment, which allows you to completely get rid of the disease.
Carefully treat your body and protect your health!
All about Bladder Endometriosis
About 80% of women in their lives faced diseases of the urinary system (cystitis, for example, is known to most people by hearsay). Endometriosis of the bladder, the symptoms and treatment of which every girl should know is a rather rare but insidious disease from the same sphere.
The main feature of it is the occurrence of epithelial and stromal cells in various organs of the female body. New formations correspond to the endometrium, so most of the changes in them depend on the phase of the menstrual cycle. At the site of localization, the disease can be in the genitals or extragenital in nature.
The latter group includes endometriosis of the bladder.
Causes of Bladder Endometriosis
The bladder is located in the pelvis of a woman and plays a leading role in the process of removing urine from the body. Any violations of the function of this body adversely affect human life. Since the bladder in women is adjacent to the internal and external genital organs, it can be involved in the pathological problems of the female genital sphere.
Endometrium is a uterine mucosa, the cells of which, under certain conditions, can enhance their growth and seize neighboring organs. The bladder is located in the immediate vicinity of the uterus, and therefore, extragenital endometriosis affects it in the first place.
Most often the disease occurs in women from 18 to 45 years. Experts associate a similar age-related selectivity of the pathology with the hormonal factor. Outside this framework, endometriosis of the bladder can be detected in up to 5% of patients.
Twenty to thirty years ago, the disease was rarely diagnosed, but given the general background of a weakened immune system and environmental degradation, the number of patients with endometriosis of the bladder is rapidly increasing.
According to the degree of damage to surrounding tissues, the disease can be divided into several types:
- pathological tissue formations of a single character, located on the surface of the walls of the bladder,
- one or several small lesions with the growth of connective tissue deep into the bladder wall,
- formation of adhesions in the lumen of the bubble,
- the defeat of 100% of the bladder wall and pronounced adhesions.
Endometriosis of the bladder in a woman can take up an area from a few millimeters to 7–9 cm. Quite often, experts note the development of a tumor-like formation in the lumen of the bladder in this pathology, which reduces it. In addition, the formation of scars leads to the development of adhesions in the pelvis.
The medical literature discusses several theories of the occurrence of this pathology. The greatest number of adherents have three main causes of endometriosis:
- implant theory
- embryonic origin of endometriosis,
- metaplastic theory of bladder disease.
However, a large number of specialists in urology do not disregard the hereditary origin of the disease, since in 20% of cases bladder endometriosis is diagnosed at a fairly young age and in the complete absence of any manifestations on the part of the female genital organs.
The main symptoms of bladder disease in women
There are several main symptoms characteristic of any localization of the pathological process. First of all, doctors note the long and constantly progressing course of the disease. A relative regression of endometriosis of the bladder is possible only after the onset of menopause, when the female sex hormones no longer affect all organs and systems.
One of the main symptoms of the disease is pain. It usually appears or increases 2–3 days before menstruation and disappears at the end of menstruation. In severe endometriosis, the pain syndrome can persist for a long time and is stopped with great difficulty.
The bladder with a similar pathology may increase in size, often putting pressure on the organs located near it. An increase and decrease in the affected bladder can also be directly related to the woman's menstrual cycle.
For endometriosis, the symptoms of the urinary tract system will be sufficiently characteristic:
- blood in the urine or turbid urine mixed with flakes,
- severe pain in the pelvic area, which may be permanent or occur only during urination,
- nocturnal or chronic incontinence,
- swelling of the face, trunk and lower extremities.
Methods for the diagnosis of endometriosis of the bladder
If you experience these symptoms, the woman should seek the advice of specialists. In diagnosing pathology, an important role is played by the study of the patient's life history. First of all, it is necessary to exclude the hereditary nature of the disease, possible injuries and past diseases. It is also important to pay attention to the problems of the patient's genital sphere.
Of great importance is:
- the state of the reproductive system in women
- duration and frequency of menstruation,
- the presence of inflammatory diseases of the genital organs,
- the number of births, abortions,
- transferred gynecological operations.
Laboratory diagnostics will determine the presence of bleeding and inflammation in the bladder, and a general analysis of urine will give a comparative description of the state of the urinary system in general.
Of instrumental methods for the diagnosis of endometriosis of the bladder, cystoscopy has become the most common.
This procedure is carried out with the help of a cystoscope, which is inserted through the urethra into the bladder of a woman, to determine the nature and extent of its damage.
The manipulation itself is quite painful, so it is performed under general anesthesia in the hospital.
If it is not possible to make a clear differential diagnosis of endometriosis with other lesions of the bladder, ultrasound and magnetic resonance imaging can be used.
Bladder pathology treatment
Treatment of the disease should be complex, differentiated and take into account the following factors:
- the age of the patient
- psychological personality traits and the attitude of the patient to possible future pregnancies,
- localization of the pathological process, its prevalence and severity of the course,
- the presence of an inflammatory component, various adhesive manifestations of endometriosis,
- endometrial hyperplastic processes and the threat of malignancy.
Endometriosis of the bladder can be treated by conservative and surgical means. At the end of the main therapy, the patient is shown a rehabilitation period aimed at eliminating residual disorders, restoring work ability and other types of social activity.
Medications for the treatment of disease in women
In conservative treatment of bladder endometriosis, the main role is assigned to the use of progestins. The preparations “Linestrenol” and “Norkolut” became widespread in the late 80s and did not lose their relevance today.
Foreign sources offer for the treatment of endometriosis a synthetic drug "Danazol". This medicine is used on 400 - 800 mg per day for 6 months, and in severe cases, therapy can last up to a year.
A good drug for the treatment of endometriosis of the bladder is Gestrinone. With its high biological activity, this medicine has a pronounced therapeutic effect even in small doses.
Many authors have noted a fairly high effect from the use of these drugs. Рецидив болезни составлял не более 18%, однако в значительном количестве случаев можно говорить лишь о ремиссии эндометриоза мочевого пузыря.
Достаточно хорошие результаты дает использование в лечении этой тяжелей болезни рефлексотерапии и применение лечебных пиявок. Various types of physiotherapy in combination with spa treatment can also enhance the effect of the recovery period.
We recommend reading the article on drugs for the treatment of endometriosis in women. From it you will learn about the features of the disease, the goals of drug therapy, the means used.
Any disease is easier to prevent than to cure. This well-known truth is fully applicable to endometriosis of the bladder.
Women are recommended twice a year to conduct preventive examinations by a gynecologist and an endocrinologist, and when identifying hormonal and other disorders, not to delay treatment.
With this, patients will be able to improve their quality of life and avoid major problems with their health in the future.
Why does endometriosis of the bladder develop, how to treat
Painful sensations in the bladder area do not always indicate the development of urological problems. Sometimes endometriosis can cause pain. This disease usually affects the internal genitals of women (uterus, ovaries), so even qualified urologists can not always determine the pathology at an early stage.
What are the causes of endometriosis?
Endometriosis is an abnormal growth of cells that usually line the inside of the uterus on the walls of the bladder. The main cause of pathology is considered to be retrograde menstruation: a process in which menstrual blood does not flow through the vagina, but enters the other organs in the peritoneal cavity.
Endometriosis of the bladder indicates that cells that had previously washed the inside of the uterus accumulated on its walls for more than one month. In the end, there was an infiltration, and the area of the urinary organ became dependent on the hormonal background and the menstrual cycle of the woman.
More rarely, endometrial foci on the organs of the urinary system grow as a result of abnormal immunity. In particular, women suffering from allergies, asthma, cancer are more prone to endometriosis than those who do not have any abnormalities in the immune system.
It is impossible to determine the pathology on your own, but the following symptoms should alert:
- Decreased bladder capacity (manifested as more frequent urination),
- When menstrual pain occurs, similar sensations appear in the bladder.
- During menstruation, hematuria appears (blood in the urine is more often noticed by those who use tampons, not pads),
- Pain extending to the upper front of the legs.
Such signs should be a reason for going to the gynecologist and urologist. If the problem is ignored, the endometrial cells will continue to grow and can completely block the urethra.
How is endometriosis diagnosed?
It is very difficult to identify the disease at the earliest stages, because the pathology is very rare and not all urologists (with the development of implicit symptoms in a patient) immediately suspect it. Even on a clear ultrasound image, it is not always possible to notice the pathological thickening of the walls of the bladder.
Timely diagnosis is complicated by the fact that endometriotic foci can grow both outside and inside the body. If you suspect bladder endometriosis, the urologist prescribes cystoscopy in combination with a diagnostic biopsy. If the results of the study taken on the analysis of tissue, confirmed its pathological nature, appropriate treatment is selected.
How is the disease treated?
Unfortunately, the very fact of the appearance of an endometrioid focus on the walls of the bladder indicates that the disease is in the last stage. So the treatment options are significantly limited.
If a woman experiences severe painful symptoms, then surgery is prescribed. In most cases, the surgeon will not even need to make a cavity incision (enough laparoscopy). If, after the operation, the endometriotic lesions appear again and again, a part of the bladder wall is excised.
But if endometriosis of the bladder was nevertheless discovered at an early stage (for example, when the endometrial cells had not yet managed to implant in the wall of the organ), then it is possible to do without surgical intervention. Drug treatment is carried out using:
- Synthetic hormones
- Oral contraceptives
- Progestins (steroids with hormonal activity),
- Gonadotropin-releasing hormone agonists.
In order to avoid serious side effects, such drug therapy should be carried out for a short period of time (no more than six months). Otherwise, laparoscopy is prescribed.
No need to abandon laparoscopy due to unreasonable fears. After surgical removal of endometrial foci, the normal functioning of the bladder will be restored and all painful symptoms will disappear. Another advantage is that after surgery you will have to spend only 5-7 days at the hospital.
Is it possible to fight the disease at home?
Do not confuse endometriosis of the uterus with the appearance of endometrial cells in the bladder. If in the first case you can still try to solve the problem by popular methods, the appearance of endometrial cells on the walls of the bladder indicates that home treatment did not work.
It is better to entrust your health to professionals, especially since laparoscopic operations have a very small percentage of complications.
How does endometriosis occur?
Every month, during the menstrual cycle, the lining of the uterus exfoliates and leaves with blood.
Then, at the end of the critical days, the growth of endometrial cells begins, which lasts until the beginning of the next cycle, in order then to re-emerge.
This is a normal process called physiological hypertrophy of the endometrium. If the monthly does not occur, the growth of mucosal cells continues. This phenomenon is called hyperplasia.
Why does hyperplasia occur? The reasons for the enhanced growth of endometrial cells are as follows:
- Hormonal imbalance. The amount of estrogen increases, which help the endometrium recover after menstruation. The amount of progesterone that inhibits the growth of mucosal cells decreases.
- Disruption of carbohydrate balance, which leads to obesity. Adipose tissue also produces estrogen.
- Failure of the ovaries, where hormones are produced.
- Diabetes mellitus, chronic infectious diseases, weakened immunity.
- Inflammatory processes of the genital organs.
- Genetic predisposition. 1/5 of all diseases are diagnosed in 20-year-olds.
- Frequent abortions.
There are genital endometriosis, when endometrial tissue affects the genitals, and extragenital tissue, in which other organs, except the genital, are affected. This includes endometriosis of the bladder. The organ is located close to the uterus, so it is affected first.
Stage of the disease
Causes of bladder damage are as follows:
- hormonal imbalance
- reduced immunity
- genetic predisposition
- the use of a small amount of fluid
- poor nutrition,
- carelessness during gynecological operations.
There are 4 severity of the disease:
- isolated cases of endometrial formation on the surface of the bladder walls,
- foci of pathological tissue grow deep into,
- in the lumen of the bubble adhesions are formed,
- the walls of the organ are completely affected, there is a further development of the adhesions in the pelvis, a benign tumor is formed in the bladder.
The lesions are round, 2–5 mm in size, or grow to formless foci of 7–9 cm. They are separated from healthy tissues by scars. The urinary bladder may increase, especially during menstruation, and put pressure on neighboring organs, causing additional pain.
Symptoms of the disease
Endometriosis of the bladder has the following symptoms:
- Aching pains in the lower abdomen and pelvis, which are difficult to determine localization. Usually moderate, they increase during menstruation, it is difficult to stop with a severe form of the disease.
- The pains arising after an orgasm and at a sexual intercourse.
- Erythrocytes appear in the urine. Before menstruation, it becomes red. This is a characteristic sign of the disease.
- Dysuria, when urination becomes frequent or rare, or urinary incontinence due to cervical organ lesion is manifested.
- Painful urination.
- The pains extend to the back, lower limbs.
- Flakes appear in urine.
- Possible swelling of the face, limbs.
The initial stages of endometriosis are asymptomatic, then the disease enters a chronic phase. 3-5 years pass before the appearance of blood in the urine, although it should be noted that hemorrhagic syndrome occurs in only 25% of patients. In addition to these symptoms, you should stay on anxiety-depressive syndrome. Patients live in fear of a tumor.
They are exhausted by constant pain, discomfort in the pelvic area. Some women have impaired sexual function. Violation of the bladder causes dysfunction of other organs - the whole body suffers.
Therefore, the presence of even one of these symptoms is enough to consult a gynecologist or urologist for a comprehensive examination.
With endometriosis of the bladder, the symptoms are similar to the manifestations of other urological diseases, so it is difficult for doctors to make a correct diagnosis. With painful urination, cystalgia is diagnosed, and when blood appears in the urine, hemorrhagic cystitis is determined. Difficulties of diagnosis due to the fact that the disease was previously considered rare.
Doctors focused on the appearance of blood in the urine, which is not always the case, and did not find a connection between the patient's complaints and the menstrual cycle. As a result, the therapy used in diseases of the urinary organs did not produce an effect. Therefore, the following differential diagnosis.
Collecting anamnesis of the disease. Attention is drawn to the following data:
- were there any similar diseases in the genus
- what the patient was sick about, whether there were injuries
- previous genital diseases,
- the regularity of menstruation (delay, duration, and how to proceed),
- nature of pain,
- the number of pregnancies and childbirth,
- whether gynecological operations were performed.
Laboratory tests - urine tests show the condition of the urinary system.
- cystoscopy to determine the severity of tissue damage, the presence of scars and tumors,
- Ultrasound of the bladder or uterus,
- hysteroscopy - intracavitary examination of the uterus to detect endometrial hyperplasia,
- MRI (for difficulties in diagnosis).
Treatment of endometriosis of the bladder is carried out by two methods: conservative and surgical. When choosing a method, the doctor takes into account the following factors:
- age of the patient
- localization of the pathology and the severity of the disease,
- inflammatory and adhesive processes,
- the risk of transition of benign tumors to oncology,
- Does the patient plan to become pregnant in the future?
With a conservative treatment method, progestins (hormones) play a major role. Oral contraceptives provide good results and minimal side effects. The drugs are effective, but the treatment lasts for months, sometimes up to a year.
The dosage of drugs and the duration of the appointment is prescribed only by a doctor, self-treatment is unacceptable. Sometimes drugs are taken in cycles before menopause.
The complex provides physiotherapy, reflexology, hirudotherapy (use of leeches).
At 3-4 stages of the disease, only surgical treatment is used. Bladder resection is performed: part of the organ with endometrial pathology is removed. Her excised to healthy tissue.
Surgical intervention is a more radical treatment, followed by a minimal percentage of relapses. After the operation, anti-inflammatory, revitalizing and hormonal therapy is performed.
The treatment is complex and ends with a rehabilitation period.
To reduce the risk of morbidity, doctors recommend the following:
- quality treatment of chronic infectious diseases,
- restoration of hormonal imbalance,
- give up harmful habits, strengthen the immune system and follow the drinking regimen,
- regularly use products containing omega-3, omega-6 fatty acids and phytoestrogens,
- to cleanse the body and strengthen the immune system to drink decoctions and tinctures of herbs: celandine, chamomile, calendula, nettle and shepherd's bag,
- from contraceptives preference to give oral.
Considering that in the early stages it is difficult to diagnose endometriosis of the bladder and it is often detected by chance not to start the disease, women of the reproductive age 2 times a year are examined by a gynecologist.
Symptoms, diagnosis and treatment of bladder endometriosis in women
Endometriosis is a pathology affecting the urinary and other organs of the urine excretion system. The disease is accompanied by characteristic signs.
But there are cases when endometriosis is hidden and allows itself to be detected only as a result of preventive examinations.
The disease is considered female and is characterized by the displacement of the internal uterine membrane.
Endometrial tissues spread in the muscle layers of the uterus, leave the initial location, penetrating into the ovaries, uterus, abdomen, intestines, urea.
In patients who have recently undergone surgery on the organs of the urogenital system, the uterine mucosa is able to move into a surgical scar. It is believed that the symptoms experienced by patients will depend on the location of the endometrium.
In most cases, the disease can be found in women of the age category from twenty-three to forty years old, and the number of patients will reach twenty-six percent of the total.
With age, menstrual functions are activated only in ten to twelve percent of girls. Less commonly, the disease affects menopause - only three to six percent.
The disease has two forms:
- genitalin which a lesion is inflicted on the genitals,
- extragenital - the reproductive system is not affected.
Degree of development of pathology
There are four degrees of the disease:
- Changes in the surface tissue of a single character, shallow germination of the endometrium.
- Numerous foci, deeply (to the middle) damaging tissues.
- Deeper germination, the appearance of single adhesions in the abdomen.
- Sealing adhesive spots, an increase in the areas affected.
Focal lesions may vary in their shape and size.
There are rounded foci of only a few millimeters, but there are also atypical growths in their forms, reaching a diameter of seven to nine centimeters.
They are characterized by a non-characteristic dark cherry shade with whitish scars along the edges. With its features, the disease can trigger the formation of adhesions in the pelvic area.
All the symptoms inherent in this pathology, or the feeling of other signs confirming endometriosis of the bladder, should be the main reason for the prompt visit to a specialist who is able to provide qualified assistance.
The doctor will study the history to find out the list of previous diseases, hereditary changes and injuries, listen to the patient's complaints, take an interest in the duration and frequency of the menstrual cycles. The number of births, abortions and gynecological operations is specified on a mandatory basis. After the survey, urine and blood tests will be assigned.
Taking into account all the symptoms, the specialist will prescribe a diagnostic examination to specify the pathology and determine the exact diagnosis for the preparation of a therapeutic course.
Cystoscopy is quite effective in this. This is a method in which studies are performed using a cystoscope.
The procedure is inherent pain, because you have to enter the technique into the urethral canal while filling it with fluid. To eliminate painful signs, the diagnosis is performed under the influence of anesthesia.
The effectiveness of ultrasound and MRI, which are appointed only in the most difficult situations.
The concept of endometriosis
Endometrium is a mucous membrane lining the uterus from the inside. Every month its elements exfoliate and leave the body during menstruation. After the end of menstruation, the growth of endometrial cells resumes, which continues until the beginning of the next cycle. This is a normal repetitive process - physiological hypertrophy of the endometrium. If menstruation does not occur, the growth of mucosal cells does not stop. This phenomenon is called hyperplasia.
Among the reasons for increased growth and germination of endometrial cells, doctors distinguish the following:
- hormonal imbalance
- ovarian dysfunction,
- inflammatory processes of the genital organs,
- frequent abortions in history.
There are genital endometriosis with lesions of the genital organs and extragenital. Во втором случае в патологический процесс вовлекаются соседние органы, в том числе и мочевой пузырь.
Причины развития болезни
The bladder is located in the pelvis and plays an important role in the process of removing urine from the body. The violation of its functions adversely affects the human life. Since the bladder is in close proximity to the uterus, extragenital endometriosis affects it in the first place.
The disease is most often diagnosed in women whose age varies from 18 to 45 years. Doctors explain this hormonal factor. Outside this age range, endometriosis is detected in 5% of patients.
In the medical literature, several hypotheses of disease occurrence are considered:
- Implantation. Elements of the endometrium enter the bladder through the fallopian tubes.
- Fetal. The causes of the disease are formed during fetal development.
- Metaplastic. Under the influence of various causes, cellular elements are transformed into the endometrium.
In most cases, the disease develops as a result of hormonal imbalance, deterioration of immunity, as well as against the background of inflammatory processes in the organs of the urogenital system. We must not forget about hereditary predisposition.
In 20% of cases, pathology is diagnosed in young women and in the absence of problems on the part of the genitals.
First of all, doctors note a long and constantly progressive course of endometriosis of the bladder. Its relative regression is possible only at the onset of menopause, when hormones practically cease to influence the female body.
One of the characteristic signs of pathology is pain. Its intensity increases 2-3 days before the date of the expected menstruation, and subsides only after the end of menstruation. With severe disease, such discomfort persists for a long time, and is stopped only with the help of potent drugs.
The bladder can grow in size, exerting pressure on neighboring organs. Changing its size also depends on the phase of the menstrual cycle. For endometriosis, there are other symptoms of the urinary system:
- the presence of blood impurities in urine, its clouding,
- pain in the pelvic organs, which are permanent,
- urinary incontinence,
- the occurrence of edema of the lower extremities.
A few days before menstruation, urine can change its color to red, because the endometrium in the bladder is subject to the influence of sex hormones.
Endometriosis is a dangerous disease that requires timely and quality treatment. Otherwise it increases the likelihood of complications. Among them, the greatest danger is adhesions in the pelvic organs. The disease can lead to the formation of cystic lesions in the ovaries. Such a complication leads to such consequences as infertility.
Endometriosis often affects the psycho-emotional state of a woman. Due to constant discomfort and pain, she becomes irritable and nervous, and her quality of life suffers. In rare cases, pathology contributes to the development of lesions with malignant elements.
What is bladder endometriosis?
Endometriosis is an exclusively female disease. Endometrium, which is presented in the form of uterine tissue, begins its movement, which leads to pathological processes. The endometrium begins to spread to the muscle tissue of the uterus or goes beyond its original location. Symptoms of a developing disease will depend on where the endometrium has moved.
Typically, the pathology is unaware of the fair sex in the reproductive age. In the period of menopause, the development of the disease is extremely rare. Endometriosis can affect the reproductive system or not at all.
Symptoms of Bladder Endometriosis
Doctors note several main symptoms that manifest themselves at any location of the modified areas. The course of the disease always remains long with constant progression. Regression begins only in the period of menopause, when the female hormones no longer affect the body in any way.
The main symptom of endometriosis is always pain. Before the onset of menstruation in a few days, the pain intensifies and disappears after they end. Often the bladder grows in size and begins to interfere with nearby organs.
Symptoms of damage in endometriosis:
- Urine becomes cloudy with blood,
- The pain spreads to the pelvis,
- Urinary incontinence occurs at night.
- There is swelling of the face and legs.
More on the symptoms of endometriosis in the video:
To reduce the likelihood of developing such a disease, experts recommend:
- Conduct compulsory treatment of diseases of a chronic nature,
- Monitor the state of hormones,
- Follow a normal lifestyle, drink plenty of fluids,
- As a decoction for cleaning the body, you can use celandine, chamomile and other herbs,
- Use only oral contraceptives.
Thus, adherence to a set of measures necessarily leads to full recovery, and methods of prevention will avoid such problems.
Treatment of pathology in women
If the diagnosis is confirmed, the doctor immediately prescribes a treatment for endometriosis of the bladder, so as not to provoke more serious complications. There are two ways to do this:
- Conservative. It involves taking medications that affect hormones. The doctor will make sure that the patient’s plans include a pregnancy, will take into account the body's perception of drugs. To improve the condition of the urea and eliminate the disease, it is necessary to take contraceptive drugs in courses lasting from three to four months. It is not recommended to break treatment regimens, otherwise the effect will not be achieved. As a supplement, medications that restore the immune system can be prescribed,
- Operational. According to it, the decision is made in the event that the patient does not experience improvements. When the disease is started, and medications do not help eliminate the inflammation, a woman can remove the affected areas of the urea. The greatest danger in this way is the possible introduction of endometrial cells into the adjacent organs of the urethral system. However, doctors closely monitor this during the operation. Next, the patient is prescribed hormonal medications to heal the wounds quickly.
The causes of the disease
Endometriosis provokes retrograde menstruation, in which the blood does not fully exit from the vagina. Its part falls on adjacent organs. Over time, extensive endometriotic foci form. They are dependent on the level of hormones in the female body. Normal endometrial thickness before menstruation is 13-15 mm. With hyperplasia, it exceeds the permissible level. Menstruation does not come on time, so the growth of the endometrium continues. The causes of the pathology are as follows:
- disruptions in hormone production
- inflammatory processes
- frequent abortive interventions
- carbohydrate imbalance,
- genetic predisposition.
Mainly there are four stages of endometriosis of the bladder. At the initial stage there are single pathological foci ranging in size from 2 to 5 mm. At the next stage, they germinate inside, causing discomfort in the stomach. The third stage is characterized by the development of adhesions. In the fourth, the bladder is completely affected. In addition to adhesions, benign tumors appear. The condition of the woman is significantly deteriorating.
The basis of endometriosis treatment is medication and surgery. Anti-inflammatory therapy is performed before removing endometriotic foci. The physician should consider the age of the woman and her readiness for future pregnancy. During therapeutic manipulations, a history of the disease is collected and its stage is detected.
With the running form of endometriosis, one cannot do without surgical intervention. In this case, partial cystectomy or transurethral resection is performed. As part of the procedure, excision of endometriosis lesions is performed without affecting healthy tissues. Laparotomy is prescribed in rare cases. Most often, pathological lesions are removed using laparoscopy.
During laparoscopic surgery, abdominal incisions in the peritoneum are not made. Access to the bladder opens through small punctures in the abdomen. This type of surgery is characterized by a low degree of injury. The duration of the manipulations does not exceed 40 minutes. The recovery period lasts up to four days. The likelihood of relapse upon completion of surgery is extremely small.
Medication is prescribed after surgery. To prevent re-growth of the endometrium, prescribed hormones. The most commonly prescribed pills. They are taken from three to six months. As a result of drug therapy, the menstrual cycle is restored, and well-being is normalized. After the course of treatment, the woman can take a break, then start taking oral contraceptives again.
Alternative medicine are used in consultation with the doctor. Herbal decoctions help strengthen the immune system and improve reproductive health in the postoperative period. Contraindications and possible side effects should be studied first. Broths of chamomile and nettle help to increase immunity. Improve the work of the genitals will help the following recipes:
- Little aloe juice must be mixed with grains propolis and 1 tbsp. l honey. The resulting mixture is processed hygienic tampon. Then it must be placed in the vagina for 20 minutes. During this time should be in a horizontal position.
- Calendula decoction used for douching or impregnation of hygienic tampons. For cooking means required to fill a glass of water 2 tbsp. l grass For oral use, calendula can be combined with leaves. raspberries, hunters and immortelle.
- With endometriosis red brush and boron womb take in complex. The broth is prepared from a dry mixture, which can be purchased at the pharmacy. Borovoy grass is allowed to take only in the second half of the cycle. There are no restrictions for receiving a red brush. A single dosage is 80 ml. Take the medicinal drink should be three times a day.
If you diagnose endometriosis in time, it will not have a negative impact on reproductive function. But with advanced forms of the disease there is a risk of infertility. Therefore, it is extremely important to detect pathology in the initial stages of its occurrence. Do not ignore the violation of the regularity of the menstrual cycle and abdominal pain. If anxious symptoms appear, you should visit a gynecologist. If surgical intervention is required, then you should not refuse the operation.
Treatment of endometriosis in women
Disease therapy is performed in one of two ways:
Conservative treatment involves taking drugs that affect hormones (oral contraceptives). The doctor will ask whether the patient plans to become pregnant and takes into account the perception of drugs by her body. To improve the condition of the bladder and cope with the manifestations of the disease, contraceptives are taken by courses for 3-4 months. Remember that you can not violate the regimen, otherwise the treatment will be ineffective. Additionally prescribed drugs aimed at restoring immunity.
If there is no improvement in the patient's condition, the question of the operation will be raised. When the condition of the disease is neglected and the medications cannot stop the inflammatory process, the affected parts of the bladder will be removed. The most dangerous in surgical intervention is the possibility of introducing pathological endometrial cells into other organs of the urogenital system. But doctors carefully monitor this during the operation. In the postoperative period, the patient is prescribed hormonal drugs for the speedy healing of tissues.
Prevalence of Bladder Endometriosis
Various forms of endometriosis affect from 6 to 10% of women of reproductive age, so most of the patients the condition in question is diagnosed during this period of life. The average age of a woman who has learned about the presence of endometriosis is 27 years.
Endometriosis of the bladder is much less common. In 2014, Spanish scientists published a report according to which from 1 to 2% of women with endometriosis have endometrial implants affecting the urinary system, where the bladder is the most likely place of their appearance.
Stages of Endometriosis
As soon as the diagnosis of endometriosis is confirmed, the doctor will assess the stage of the disease. The stages determine how widely endometrial implants are represented and how deeply they have grown into other organs.
Endometriosis has four stages.
- Stage 1. Minimum. At the first stage of endometriosis, a woman has a small amount of endometrial tissue, which is located only on or near the surface of the organs.
- Stage 2. Light. In the second stage of endometriosis, the woman has more extensive lesions, but they also grow only on the surface of the organs.
- Stage 3. Moderate. In the third stage of endometriosis, the woman has extensive lesions that begin to grow into the tissues of the organs of the pelvic cavity.
- Stage 4. Heavy. At the fourth stage of endometriosis, a woman has a large number of endometrial implants that have grown into several organs of the pelvic cavity.
Treatment for endometriosis of the bladder
Endometriosis is an incurable disease. However, this condition can be controlled by medication or surgical procedures.
Surgery is the most common treatment for endometriosis of the bladder. During surgery, doctors try to remove all endometrial implants that have grown into the wall of the bladder. This helps to significantly reduce the symptoms.
Endometriosis of the bladder uses two types of surgery.
- Transurethral surgeryin which the doctor inserts a cystoscope inside the urethra and bladder. At one end, the cystoscope has a tool to remove endometrial tissue.
- Partial cystectomy involves the removal of the affected part of the bladder. The surgeon can accomplish this through laparotomy when one large incision is made, or through laparoscopy, when the surgeon needs to make several small incisions.
A doctor can prescribe hormones for a woman to slow the growth of endometrial tissue and ease pain. Hormonal treatment may include gonadotropin-releasing hormone (GnRH) or birth control pills.
Causes of Bladder Endometriosis
Doctors do not know exactly why bladder endometriosis develops. Possible causes of this condition include the following.
- Operations in the pelvic cavity. According to one theory, previously performed operations, such as cesarean section or hysterectomy, can cause endometrial tissue to fall on the bladder.
- Early cell transformation. This process involves the transformation of the remaining cells of the embryo into endometrial tissue.
- Retrograde menstruation. With retrograde menstruation, the flow of blood that leaves the uterus during menstruation does not leave the body, but is directed into the pelvic cavity. Then the endometrial cells can be implanted in the bladder wall.
- Transplantation. Transplantation is a process during which endometrial cells move through the lymphatic system or blood vessels and ultimately enter the bladder.
- Genetics. It is believed that endometriosis can be inherited.
Types of endometriosis
Bladder endometriosis is a female disease that occurs in two forms:
- Genital. The disease spreads to the ovaries, pelvic cavity and myometrium (muscular tissue of the uterus, consisting of cells - myocytes).
- Extragenital. Endometrium grows beyond the borders of the genitals and does not damage them. Depending on which pelvic organ is hooked, the symptom complex of the problem is determined.
Depending on how the symptoms of the disease appear and at what stage of the development of the disease the appropriate treatment is selected. There are 4 stages of development of endometriosis, presented in the table:
Often, endometriosis "freezes" at one of the stages and it becomes chronic.
Symptoms of endometriosis are similar to other diseases of the genitourinary system, but when they first appear, you should consult a doctor:
With this disease there is a heaviness in the lower abdomen.
- pain attacks a few days before and a few days after menstruation,
- painful urination,
- urinary incontinence,
- bleeding when urinating, muddy color of urine,
- weight gain and swelling of the body,
- feeling of heaviness in the lower abdomen.
The cycle of medication treatment lasts 3-4 months. Progestins (hormonal medications), for example, Linestrenol, Norkolut, etc., take a special role in therapy. Danazol is widely used abroad, but this drug suggests a longer course of treatment. Effective is also considered "Gestrinon."
Treatment of folk remedies
The use of traditional medicine can help in the early stages of the development of the disease in combination with medical preparations. The use of alternative medicines should be carried out under the supervision of a physician to avoid allergic reactions. Popular folk remedies:
- decoctions of chamomile, nettle, calendula,
- decoctions and infusions of red brushes.
To get rid of the need to treat the disease, it is better to prevent it. For prevention it is necessary to actively engage in sports and eat right, maintain personal hygiene, give up bad habits, regularly visit a gynecologist. At the first manifestations of the disease, you need to consult a doctor: timely diagnosis will help to quickly and painlessly solve the problem.
Symptoms and treatment of bladder endometriosis
Endometriosis of the bladder, whose symptoms do not appear for a long time, is considered a rare disease.
The spread of endometriosis is an actual problem in medicine today. Revealed frequent cases in different age categories.
One of the vital organs of the excretory system is the bladder. It performs the function of the accumulation of urine and its elimination from the body. It is located in the pelvis behind the pubic joint. Not only the general condition of the organism, but also the work of its other systems depends on the quality of its work. May change shape depending on the content and position of neighboring organs. Endometriosis is one of the pathologies of the genitourinary system, the urinary organs are usually affected for the second time, the uterus and its appendages suffer more often.
Endometriosis: degree of the disease
Endometriosis (Endometriosis) is a pathological process in a woman’s body in which the tissue of the uterine mucosa (endometrium) is located elsewhere in the body. It can grow into the muscle layer of the uterus, it may be outside the cavity: in the ovaries, cervix and even in the peritoneum, intestines, bladder, postoperative scars. Clinical manifestations depend on the localization of the process. The basis of this disease are disorders of the immune system and burdened heredity. The population suffering from this disease is constantly increasing.
In most cases, endometriosis occurs in women of reproductive age (at 23-40 years old - approximately 26%). In the period of formation of menstrual function is diagnosed in 10-12%. More rarely found in women of menopausal age (3-6%).
Depending on the localization of foci, the genital form is distinguished (organs of the reproductive system are affected) and extragenital (foci arise outside the reproductive system).
There are four degrees of the disease:
- Single lesions are located on the surface of the fabric, germination at a shallow depth.
- Lesions to the middle of the fabric, many lesions.
- The lesions are deep, in the area of the peritoneum separate adhesions.
- Loss in large quantities, spikes dense.
Endometriotic lesions vary in size and shape. There are from the round size of several millimeters to growths of various shapes with a diameter of several centimeters. More often dark cherry color, from the next fabrics separate scars of whitish color. Usually, due to this disease, adhesions in the pelvis occur.
Endometriosis of the bladder is accompanied by the development of a benign tumor formation in the wall of the bladder. Diagnosis is complicated by the similarity of symptoms of other pathologies of the urogenital system.
Causes: inflammatory processes, operational errors (especially during caesarean section and removal of an ovarian cyst), hormonal disruptions, decreased immunity, inadequate fluid intake, unhealthy diet.
What is dangerous endometriosis of the bladder and how to treat it?
Endometriosis is a pathological process that affects the bladder and other organs of the urinary system, accompanied by characteristic symptoms.
However, in some cases it may be hidden, therefore it can only be revealed during preventive examinations.
- Pathology description
- Degrees of pathology
The structure of the bladder
The bladder is the organ of the urinary system that is responsible for the process of urination.
It is placed in the pelvis, is a transporting authority that allows you to store the accumulated urine to a certain limit, and then remove it from the body.
Any failure of the bladder causes disturbances in other vital processes. Its shape may vary depending on the level of urine overflow or the location of adjacent internal organs.
Endometrium is a special tissue that represents the mucous membrane of the uterus in women, which, with pathological disorders, begins to vigorously grow and pass on to neighboring organs.
The bladder is no exception, therefore endometriosis is a fairly common pathology. The main reason for its appearance is a weakened immune system, as well as burdened heredity.
Endometriosis is characteristic of women of almost any age.
Persons of reproductive age from 23 to 40 years are most susceptible to such a disease, almost every fourth woman of this age experiences the consequences of a violation.
And only 16% of girls under 23 and 12% of women over 40 can diagnose endometriosis. Unfortunately, every year the incidence rate only increases significantly.
Degrees of pathology
Endometriosis can be localized in different parts of the body.
Based on its localization, taking into account the organs that are affected due to its growth, the disease is classified into genital and extragenital forms.
In the first case, the female genitals are affected, in the second case, organs not related to reproductive functions.
Also endometriosis is divided into four stages of development:
- single growths that penetrate shallowly into the tissues,
- multiple focal growths penetrating to the middle,
- deep penetrations with characteristic spikes,
- maximum lesions with dense spikes.
Pathology of the bladder
The lesions resulting from endometriosis can vary in size, from one millimeter to several centimeters.
A very close fit to the organs and the separation of scars from them, subsequently leads to adhesive processes. Endometriosis of the bladder is accompanied by the formation of a tumor formation inside the organ.
Among the most common causes of this pathology can be hormonal disorders, inflammatory processes, unhealthy diet, minimal fluid intake, as well as the consequences of surgery, when women underwent caesarean section or cysts on the ovaries were removed.
Endometriosis of the bladder may not show any symptoms at all, as a result of which the diagnosis takes place at late stages, at a time when the pathology has already gained excessive momentum.
Symptoms of endometriosis specifically the bladder in women as such are not observed. Common symptoms of endometriosis include:
- severe pelvic pain,
- muddy urine with flakes,
- pain when urinating,
- urinary incontinence,
- a sharp increase in body weight.
A characteristic symptom for such a disease is that before the onset of menstruation, urine acquires a red hue, due to the fact that pathological changes occur in the mucous membrane.
When the pathological process develops, the walls of the bladder are most affected, the lesion expands, adhesions appear, as a result of all these processes, specific symptoms appear in the form of pain in the pelvic region.
When urinating, symptoms such as severe burning and pains accompanying it may also occur.