Publication details
Konzervativní terapie klinických projevů endometriózy v reprodukční gynekologii
| Title in English | NON-SURGICAL TREATMENT OF CLINICALLY SYMPTOMS OF ENDOMETRIOSIS IN REPRODUCTIVE GYNECOLOGY |
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| Authors | |
| Year of publication | 2019 |
| Type | Article in Periodical |
| Magazine / Source | Bolest |
| MU Faculty or unit | |
| Citation | |
| Web | http://www.tigis.cz/images/stories/Bolest/2019/02/Konzervativn%C3%AD%20terapie.pdf |
| Keywords | endometriosis; chronical pelvic pain; sterility; therapy of endometriosis |
| Description | Endometriosis is defined as the ectopic presence of endometrial tissue outside of the uterine cavity which causes a chronic inflammatory response. The etiology of endometriosis is probably multifactorial, the widespread theory of the onset is retrograde menstruation, but the immune system plays a major role. Endometriosis includes chronic pelvic pain, irregular and severe menstrual bleeding, bleeding between menstruation, dyspareunia and dysfertility.This article presents an overview of the current possibilities of classification of small pelvis endometriosis, summarizes epidemiological factors and pathogenic mechanisms in connection with localization of ectopic deposits. It defines possible clinical manifestations of individual forms of endometriosis and provides a current overview of pharmacological treatment options. Hormonal therapy includes the use of combined oral contraceptives, progestin alone pills, depot progestins - implants, intrauterine systém with levonorgestrel, progestins taking into account the results of current clinical trials of dienogest. Furthermore, the therapeutic effects of selective progesterone receptor modulators, GnRH analogue and antagonists and add-back therapy is presented. The review captures the therapeutic options of selective estrogen receptor modulators, selective aromatase inhibitors, and anti-inflammatory and immunomodulatory therapies.When deciding on medication or surgical treatment of genital forms of endometriosis or their possible combination, it is necessary to consider what type of endometriosis is involved. Whether peritoneal, ovarian, rectovaginal, extragenital or adenomyosis. Also, the nature of pelvic pain and the presence of infertility influence the choice of a suitable therapeutic procedure. Microscopic characterization of endometrial ectopic deposits also affects the resulting hormone therapy effect. |