Endometriosis

Hana ʻia ka endometriosis ke ulu nā hunaola mai ka pale o kou ʻōpū (uterus) i nā wahi ʻē aʻe o kou kino. Hiki i kēia ke kumu i ka ʻeha, ke kahe nui o ke kahe, ke kahe ʻana o ke kahe ma waena o nā wā, a me nā pilikia e hāpai ana (infertility).

I kēlā me kēia mahina, hana nā ovaries a kahi wahine i nā hormoni e haʻi i nā hunaola e uhi ana i ka pūpū e pehu a mānoanoa. Ua hoʻokahe kāu kōpū i kēia mau pūnaewele me ke koko a me nā mea i loko o kāu ʻōpala ke loaʻa iā ʻoe kou manawa.

Hana ʻia ka endometriosis ke ulu kēia mau hunaola ma waho o ka uterus i nā ʻāpana ʻē aʻe o kou kino. Pili paha kēia kiko i kāu:

• ʻOihana
• Nā paipu fallopian
• ʻŌpū
• Rectum
• ʻAdmiʻi
• Ka pale o kāu wahi pelvic

Hiki iā ia ke ulu i nā wahi ʻē aʻe o ke kino.

Noho kēia mau mea ulu i kou kino, a like me nā hunaola i ka uhi o kou kōpū, pili kēia mau ulu i nā hormones mai kāu ovaries. Hiki iā ʻoe ke ʻeha i loko o ka mahina ma mua o ka hoʻomaka ʻana o kāu wā. I ka hala ʻana o ka manawa, hoʻohui paha nā mea ulu i nā mea hou a me ke koko. Hiki i nā ulu ke kūkulu i loko o ka ʻōpū a me nā pelvis e alakaʻi ai i ka ʻeha pelvis maʻi mau, nā pōʻai kaumaha, a me ka infertility.

ʻAʻohe mea i ʻike i ke kumu o ka endometriosis. ʻO kahi manaʻo ke loaʻa iā ʻoe kou manawa, hiki i nā pūnaewele ke hele hope i waena o nā paipu fallopian i loko o ka pelvis. Aia a hele a pili, pili nā aʻa a ulu. Eia nō naʻe, kū kēia kahe o hope i nā wahine he nui. Hiki paha i ka ʻōnaehana pale ke hoʻokau i ka endometriosis i nā wahine me ke ʻano.

He mea maʻamau ka endometriosis. Loaʻa ia ma kahi o 10% o nā wahine o ka hānau hānau. I kekahi manawa, holo paha i loko o nā ʻohana. Hoʻomaka paha ka endometriosis ke hoʻomaka ka wahine i nā manawa. Eia naʻe, ʻaʻole ʻike pinepine ʻia a hiki i nā makahiki 25 a 35.

E hoʻomohala paha ʻoe i ka endometriosis inā ʻoe:

• He makuahine a he kaikuahine paha me ka endometriosis
• Ua hoʻomaka kou wā i kou wā ʻōpio
• ʻAʻole keiki keiki
• Loaʻa i nā wā pinepine, a i ʻole 7 mau lā a ʻoi paha lākou i hala

ʻO kaʻeha ka hōʻailona nui o ka endometriosis. Loaʻa iā ʻoe:

• Nā wā ʻeha - Hoʻomaka ka ʻeha a ʻeha paha i loko o kou ʻōpū haʻahaʻa i hoʻokahi pule a i ʻole ʻelua mau pule ma mua o kou wā. Kūmau paha nā ʻōpala a kau mai ka ʻūlū a i ʻole ʻino.
• ʻEha i ka wā a i ʻole ma hope o ka moekolohe.
• ʻEha me ka urination.
• ʻEha me nā ʻōpū o ka ʻōpū.
• ʻO ke pelvic wā lōʻihi a i ʻole ʻeha haʻahaʻa e hiki ke hana ʻia i kēlā me kēia manawa a hala no 6 mau mahina a ʻoi.

ʻO nā ʻōuli ʻē aʻe o ka endometriosis:

• ʻO ke kahe menstrual kaumaha a kahe paha i waena o nā wā
• Infertility (paʻakikī i ka noho a hāpai ʻana paha i ka hāpai ʻana)

ʻAʻohe ou mau ʻōuli. ʻO kekahi mau wahine me ka nui o nā kiko i loko o kā lākou pelvis ʻaʻohe ʻeha iki, ʻoiai ʻo kekahi mau wahine me ka maʻi milder he ʻeha nui loa.

E hana i kāu mea mālama ola i kahi hoʻokolohua kino, me kahi hōʻike pelvic. Loaʻa paha iā ʻoe kekahi o kēia mau hoʻāʻo e kōkua i ke kuhi ʻana i ka maʻi.

• ʻO ke ultrasound Transvaginal
• Pelvic laparoscopy
• Mākēneki resonance kiʻi (MRI)

Ke aʻo ʻana pehea e hoʻokele ai i kāu mau hōʻailona hiki ke maʻalahi ke ola me ka endometriosis.

He aha ke ʻano o kāu mālama ʻana e pili ana:

• Kou makahiki
• Ka paʻakikī o kāu mau ʻōuli
• Ka nui o ka maʻi
• Inā makemake ʻoe i nā keiki i ka wā e hiki mai ana

ʻAʻohe mea ola i kēia manawa no ka endometriosis. Aia kekahi mau koho lapaʻau ʻokoʻa.

NA KUMU PAINI

Inā loaʻa iā ʻoe nā ʻōuli akahai, hiki iā ʻoe ke hoʻokele i ka cramping a me ka ʻeha me:

• Nā hana hoʻoikaika kino a hoʻomaha.
• ʻO nā mea hōʻoluʻolu ʻāpala over-the-counter - Hoʻopili kēia i ka ibuprofen (Advil), naproxen (Aleve), a me ka acetaminophen (Tylenol).
• Nā painkillers kuhikuhi, inā pono, no ka ʻeha ʻoi loa.
• Nā hōʻike maʻamau i kēlā me kēia 6 a 12 mau mahina i hiki i kāu kauka ke loiloi i ka maʻi.

HORMONE THERAPY

Hiki i kēia mau lāʻau ke hōʻoki i ka endometriosis mai ka ʻino ʻana. Hāʻawi ʻia lākou ma ke ʻano he mau pila, pana ʻāʻī, a i ʻole nā ​​kī ʻana. ʻO nā wahine wale nō e hoʻāʻo ʻole nei e hāpai, pono e loaʻa kēia lāʻau. E pale aku kekahi ʻano o ka hoʻōla hormonone iā ʻoe mai ka hāpai ʻana ʻoiai ʻoe e lawe nei i ka lāʻau.

Nā lāʻau kaohi hānau - Me kēia ʻano hoʻomaʻamaʻa, lawe ʻoe i nā huaale hormonone (ʻaʻole nā ​​pila hana ʻole a placebo) no 6 a 9 mau mahina mau. ʻO ka lawe ʻana i kēia mau huaale e hōʻoluʻolu i ka nui o nā ʻōuli. Eia naʻe, ʻaʻole ia e mālama i kekahi pohō i hala.

ʻO nā pila o Progesterone, nā injection, IUD - kōkua kēia mālama i ka hōʻemi ʻana i nā ulu. Hiki i nā hopena ke hoʻopili i ka loaʻa ʻana o ke kaumaha a me ke kaumaha.

ʻO nā lāʻau Gonadotropin-agonist - Hoʻopau kēia mau lāʻau i kāu ovaries mai ka hana ʻana i ka hormone estrogen. ʻO kēia ke kumu o kahi mokuʻāina menopause. ʻO nā hopena e pili ana i nā uila wela, ka maloʻo ʻana o ka ʻōpū, a me nā loli o ke ʻano. Hoʻopau pinepine ʻia ka mālama ʻana i 6 mau mahina no ka mea hiki ke hoʻonāwaliwali i kou mau iwi. Hāʻawi paha kāu mea hāʻawi iā ʻoe i nā kaha liʻiliʻi o ka hormone e hōʻoluʻolu i nā ʻōuli i kēia mālama ʻana. ʻIke ʻia kēia ma ke ʻano he add-back 'therapy. Hiki iā ia ke kōkua i ka pale ʻana i ka nalo ʻana o ka iwi, ʻoiai ʻaʻole e hoʻomaka i ka ulu ʻana o ka endometriosis.

ʻO ka lāʻau lapaʻau antagonist ʻo Gonadotropin - kōkua kēia lāʻau oral i ka hoʻohaʻahaʻa ʻana i ka estrogen e hopena ai i ka menopausal e like me ka mokuʻāina a kaohi i ka ulu ʻana o nā kiko endometrial e hopena ana i nā menses ʻeha a me nā kaumaha.

NA MEA HANA

Koi paha kāu mea hāʻawi i ke ʻoki inā loaʻa iā ʻoe ka ʻeha nui ʻaʻole maikaʻi me nā lāʻau ʻē aʻe.

• Kōkua ʻo Laparoscopy i ka diagnose i ka maʻi a hiki ke hoʻoneʻe i nā ulu a me nā ʻili scar. No ka mea he ʻoki liʻiliʻi wale nō i hana ʻia i kou ʻōpū, e hoʻōla wikiwiki ʻoe ma mua o nā ʻano ʻoki ʻē aʻe.
• Pili ʻo Laparotomy i ka hana ʻana i kahi ʻoki nui (ʻoki) i loko o kou ʻōpū e hoʻoneʻe i nā mea ulu a me nā ʻili maka. ʻO kēia ke kaha nui, no laila ʻoi aku ka lōʻihi o ka hoʻōla.
• He koho maikaʻi paha ʻo Laparoscopy a i ʻole laparotomy inā makemake ʻoe e hāpai, no ka mea mālama lākou i ka maʻi a waiho i kāu mau mea pono ma kahi.
• ʻO Hysterectomy kahi ʻoki e wehe ai i kou kōpū, nā paipu fallopian, a me nā ovaries. Ke wehe nei i kāu mau ovaries ʻelua ʻo ia hoʻi ke komo ʻana i ka menopause. E ʻoki wale ʻoe iā ʻoe inā loaʻa iā ʻoe nā ʻōuli koʻikoʻi ʻaʻole maikaʻi me nā lāʻau ʻē aʻe a makemake ʻole e hānau keiki i ka wā e hiki mai ana.

ʻAʻohe lāʻau lapaʻau no ka endometriosis. Hiki ke kōkua i ka Hormone therapy ke hōʻoluʻolu i nā ʻōuli, akā hoʻi pinepine nā ʻōuli ke kū ʻia ke kāohi. Hiki ke kōkua i ka hana ʻoki kino e hōʻoluʻolu i nā ʻōuli no nā makahiki. Eia naʻe, ʻaʻole kōkua ʻia nā wahine āpau me ka endometriosis e kēia mau ʻano hana.

Ke komo koke ʻoe i ka menopause, ʻaʻohe paha he pilikia ka endometriosis.

Hiki i ka Endometriosis ke alakaʻi i nā pilikia e hāpai ana. Eia nō naʻe, hiki i ka hapa nui o nā wahine me nā ʻōuli mālie ke hāpai. Hiki i ka Laparoscopy ke hoʻoneʻe i nā mea ulu a me nā mea ʻili e kōkua i ka hoʻomaikaʻi ʻana i kou manawa e hāpai ai. Inā ʻaʻole, makemake paha ʻoe e noʻonoʻo i nā mālama ʻana no ka momona.

ʻO nā pilikia ʻē aʻe o ka endometriosis me:

• ʻO ka ʻeha pelvis wā lōʻihi e hoʻopilikia i nā hana kaiaulu a me nā hana
• Nā cist nui i nā ovaries a me nā pelvis e haki hāmama (haki)

I nā hihia maʻamau, hiki i nā kikoʻī endometriosis ke ālai i nā ʻōpū a i ʻole nā ​​wahi urinary.

ʻAno ʻole loa, ulu paha ka maʻi ʻaʻai ma nā wahi o ka ulu ʻana o ka iʻa ma hope o ka menopause.

Kāhea i kāu mea hāʻawi inā:

• Loaʻa iā ʻoe nā ʻōuli o ka endometriosis
• Pīhoihoi a uila paha ma muli o ka nui o ke kahe o ke koko menstrual
• Paʻi kua a i ʻole nā ​​hōʻailona ʻē aʻe e hoʻi hou ana ma hope o ka mālama ʻia ʻana o ka endometriosis

Hiki paha iā ʻoe ke nānā ʻia no endometriosis inā:

• Loaʻa i kou makuahine a kaikuahine paha ka maʻi
• ʻAʻole hiki iā ʻoe ke hāpai ma hope o ka hoʻāʻo ʻana no 1 makahiki

Hiki i nā lāʻau hoʻomalu hānau ke kōkua i ka pale a hōʻemi paha i ka hoʻomohala ʻana o ka endometriosis. Hoʻohana ʻia nā lāʻau hoʻomalu hānau ma ke ʻano he lapaʻau no ka hana endometriosis ke lawe mau ʻia a kū ʻole e ʻae i kahi manawa menstrual. Hiki ke hoʻohana ʻia lākou no nā wahine ʻōpio i ka hopena o ka ʻōpio a i ʻole 20 mau makahiki me nā wā ʻeha e pili ana i ka endometriosis.

ʻEha pelvis - endometriosis; Endometrioma

• Hysterectomy - ʻōpū - hoʻokuʻu
• Hysterectomy - laparoscopic - hoʻokuʻu
• Hysterectomy - heʻe - hoʻokuʻu

• Pelvic laparoscopy
• Endometriosis
• Nā wā menstrual maʻamau

Advincula A, Truong M, Lobo RA. Endometriosis: etiology, pathology, ʻike, hoʻokele. I: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Gynecology Comprehensive. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 19.

Brown J, Crawford TJ, Datta S, Prentice A. Nā lāʻau lapaʻau oral no ka ʻeha e pili ana me ka endometriosis. ʻO Cochrane Database Syst Rev.. 2018; 5 (5): CD001019. PMID: 29786828 pubmed.ncbi.nlm.nih.gov/29786828/.

Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020; 382 (13): 1244-1256. PMID: 32212520 pubmed.ncbi.nlm.nih.gov/32212520/.