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Adenomyosis nodularis

Adenomyosis nodularis is a form of adenomyosis in which endometrial cells invade the myometrium (the muscular lining of the uterus) and form localized nodules or nodules that can be clearly seen during diagnosis. This disease is usually diagnosed in the late stages and can have a significant impact on a woman's health, causing pain and menstrual irregularities.

Symptoms of adenomyosis nodularis:

Lower abdominal pain, especially during menstruation, which can be intense.
Increased length and volume of menstruation.
Irregular menstruation or intermenstrual bleeding.
Pain during intercourse.
Infertility or difficulty conceiving.
Enlargement of the uterus, which can be detected during a gynecological examination.

Causes of nodular adenomyosis:

As with other forms of adenomyosis, the exact causes of nodular adenomyosis are still not fully understood. However, among the possible risk factors:

Hormonal changes, in particular high estrogen levels.
Trauma to the uterus (cesarean section, abortions, surgical interventions).
Consequences of previous pregnancies or childbirth.
The presence of inflammatory processes in the uterus.
Heredity.

Diagnosis of nodular adenomyosis:

Gynecological examination: The doctor palpates the uterus to identify painful areas or changes in the size of the uterus.
Ultrasound examination (USG): Helps to detect the presence of nodes or abnormal changes in the uterus.
Magnetic resonance imaging (MRI): This is the most accurate method for detecting nodular formations in the myometrium.
Hysteroscopy: Used to evaluate the inner surface of the uterus and to determine the presence of polyps or other changes.
Laboratory tests: Blood tests to detect anemia or other pathological changes, as well as hormone tests.

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Treatment of adenomyosis nodules:

Medical treatment:

Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.
Hormonal drugs such as oral contraceptives, progestins, hormonal spirals (Mirena), which reduce estrogen levels and can help reduce the size of the nodules.
Gonadotropin-releasing hormone (GnRH) agonists to block estrogen production and slow the growth of the nodules.

Surgical treatment:

Laparoscopy to remove the nodules or reduce their size.
Hysterectomy (removal of the uterus) in case other methods are ineffective or if the patient no longer plans to have children.

Prevention:

Early detection of adenomyosis nodules allows you to avoid complications such as infertility or persistent pain.
Regular check-ups with a gynecologist and following the doctor's recommendations are important for controlling the disease.

How is the consultation for suspected adenomyosis?

Initial examination: The doctor conducts a detailed conversation with the patient, clarifying symptoms such as pain during menstruation, duration and nature of bleeding, pain during intercourse and other complaints.
Medical history assessment: It is important to take into account the patient's chronic diseases, previous uterine surgeries, abortions and other factors that may be the causes of the disease.
Gynecological examination: Palpation of the uterus to determine its enlargement or painful areas.
Diagnostic procedures: The doctor may refer for ultrasound, MRI or hysteroscopy to confirm the diagnosis and determine the localization of the nodes.
Discussion of the treatment plan: After the results of the examinations, the doctor develops an individual treatment plan. This may be drug therapy or surgical intervention, depending on the patient's condition.

Nodular adenomyosis requires careful attention to a woman's health and timely treatment to prevent complications such as infertility or chronic pain.