Recently, we have encountered several incisional endometriosis of the abdominal wall in the clinic, and with the liberalization of the two-child policy feel the need to reiterate the dangers of cesarean delivery! Not to mention the surgical procedure and post-operative tangles, what is worse is the distant complications of cesarean delivery – incisional pregnancy and incisional endometriosis.
Endometriosis of the abdominal wall belongs to a special site of endometriosis, which is a kind of endometriosis and is generally considered to be caused by endometrial fragments, which are difficult to detect with the naked eye, scattered in the abdominal wall incision and planted in it during the cesarean section.
Causes
Endometriosis of the abdominal wall is thought to be caused by endometrial fragments, which are difficult to detect with the naked eye, being scattered and implanted in the abdominal wall incision during a cesarean section.
What is the incidence?
The incidence of abdominal wall endometriosis is increasing year by year. What are the clinical symptoms of abdominal wall endometriosis? How to treat endometriosis of the abdominal wall? A number of questions arise. Let’s learn more about endometriosis in the abdominal wall.
Symptoms of the disease
The majority of the masses are closely related to menstruation, and the pain increases before and during menstruation, while the pain subsides and the masses shrink after menstruation. It is accompanied by dysmenorrhea, excessive menstruation, prolonged menstruation, infertility, unpleasant sexual intercourse, cramped stool, and bladder symptoms.
Differential diagnosis
In endometriosis of the abdominal wall with atypical symptoms, preoperative differentiation is required from other conditions, including incisional sclerosis, incisional suture granulation tissue, incisional hernia, abscess, hematoma, and abdominal wall tumor.
In addition to palpation by the surgeon through both hands, ultrasonography is applied in a relatively simple and non-invasive way to measure the size of the lesion, the depth of invasion and infiltration, and the relationship between the lesion and the surrounding tissue structures. CT and MRI can also be used for preoperative evaluation and are usually used when the lesion is large, or if the invasion is deep, or if malignant changes are suspected.
How to treat
The first is to catch early cure, the second is to control the progression of endometriosis, and the third is to prevent recurrence after healing.
Surgical treatment for endometriosis.
The scope and nature of the lesion can be basically clarified under direct vision, and it is more effective in relieving pain.
Drug therapy for abdominal wall endometriosis mainly involves the application of sex hormone drugs to inhibit the proliferation of ectopic endometriosis and to induce atrophy and degeneration of the endometrium of the ectopic uterus; surgical treatment of abdominal wall endometriosis can be combined with drug therapy, and the two complement each other to improve the therapeutic effect in order to reduce the chance of recurrence.
Postoperative precautions
(1) Pay attention to adjusting your emotions and maintaining an optimistic and cheerful state of mind so that the function of the immune system of the body is normal.
(2) Pay attention to keep yourself warm and avoid getting cold.
(3) During menstruation, all strenuous sports and heavy physical labor are prohibited.
(4) If endometriosis is detected and the ovarian chocolate cyst is larger than 6 cm, you should pay attention to keep emotional stability and avoid overexertion during menstruation or the middle of menstruation. If the tension in the cystic cavity suddenly rises, the cystic wall will rupture, resulting in an acute abdomen.
(5) Minimize abortion and curettage, and do family planning.
(6) Menstrual period should do a good job of their own health care, pay attention to control their emotions, do not sulk, otherwise it will lead to endocrine changes.
(7) Girls should avoid being frightened during puberty to avoid amenorrhea or overflow.
(8) Women must refrain from having sex during menstruation.
Endometriosis factors
1) Menstrual abnormalities: shortened or long menstrual cycle, frequent menstruation, excessive menstrual pain, etc.
2) Exertion, menstrual intercourse: overexertion, strenuous exercise, especially during menstruation, do not avoid intercourse;
3) Multiple abortions, caesarean section: multiple abortions, endometrial debris and blood through the fallopian tube into the pelvic cavity;
4) Genital abnormalities and malposition of the uterus: such as uterine occlusion, vaginal transverse septum, hymenal atresia, malposition of the uterus, etc.
5) Excessive stress and poor immunity: long-term mental stress, which affects the endocrine regulation of the body, may also cause endometriosis.