子宫内膜异位症enmetrisis张喜.pptVIP

Medication others： gestrinone （孕三烯酮） mifepristone（米非司酮） * Surgical treatment Purposes： ⑴ diagnosis and classification ⑵ excise or destroy all endometriotic tissue ⑶ remove all adhesions, restore pelvic anatomy ⑷ enhance fecundity ⑸ relieve pain * Surgical treatment laparoscopy + medicine golden standard of treatment * Surgical treatment Modes of surgical operation: (1) Fertility preservation (2) Ovarian function preservation (3) Radical surgery (4) Surgery for pain relief * Treatment Combination of medication and surgery surgery + medication medication + surgery + medication Treatment for patients with infertility * Prevention Prevent retrograde flow of menses Contraception with medicine Avoid iatrogenic (医源性) implantation of the ectopic endometrium * Adenomyosis * Definition Adenomyosis is defined by the presence of endometrial glands and stroma within the myometrium. It is associated with myometrial hypertrophy and proliferation. * Endometriosis ＆ Adenomyosis Pathogenesis ＆ histological confirmation Sites of lesions Clinical findings Adenomyosis is thought to be unrelated to endometriosis. * Clinical findings Multiparas（＞40 y） were most commonly affected. Symptoms： prolonged and heavy menses Dysmenorrhea that worsens over time Pelvic exam： enlargement of uterus tenderness * Diagnosis Typical symptoms and signs Histopathologic examination —— standard of the diagnosis B ultrasound would suggest the disease. * Treatment 1. Medication ：GnRH-a 2. Surgical treatment : total hysterectomy * Thank you ! * * Free template from Free template from   EndometriosisWomen’s Hospital, School of Medicine Zhejiang University    Prof. Lin Jun * Definition Endometriosis is usually defined as the presence of endometrial-like tissue, that is, glands and stroma, outs