Sklerokistoz ovaries - a process of degeneration, accompanied by the formation of small cystic formations of up to 1cm.
When sklerokistoz ovaries increased and densified shell formed on the surface thereof.
Sometimes the syndrome called Stein-Leventhal syndrome. Typically sklerokistoz formed as a result of polycystic ovaries with the progression of disorders.
Occurrence of 3-5% of all gynecologic disease, approximately 30% of these resistant ovarian sklerokistoz causes infertility.
Causes
A major role in the development of ovarian sklerokistoz assign a violation of synthesis and release of sex hormones. In addition, they play a role in disorders of the endocrine organs, one way or another involved in the regulation of the menstrual cycle.
Some doctors are of the opinion that sklerokistoz occurs due to excessive production of the hormone follicle (FSH). This leads to suppression of the normal operation of the ovary and the formation in it of small immature cysts coated with a dense shell.
In the development sklerokistoz role is also removed and impaired synthesis of luteinizing hormone (
LH).Another theory identifies the main cause of excessive activity of the adrenal cortex, as well as defects in the formation of steroid hormones and estrogen deficiency. For this reason, it disturbed maturation of follicles, increased levels of male sex hormones and infertility arises.
Kinds
Sklerokistoz can be caused by hereditary or acquired, usually occurs in women after puberty and young nulliparous women.
Sklerokistoz may be at increased or polycystic ovaries, or at reduced or shriveled ovaries. In both cases, their surface is covered with a dense membrane, which may be contoured cystic degenerating follicles.
symptoms sklerokistoz
For sklerokistoz characterized by the following symptoms:
- sharp and bilateral enlargement of the ovaries,
- menstrual disorders,
- infertility,
- increased body hair growth, often with male features,
- hypoplasia of the uterus, breasts and genitals,
- violation of body weight,
- problems with the hormonal metabolism.
Very often accompanies sklerokistoz overweight and obesityAlthough this is not mandatory.
May be a violation of general health due to an imbalance of androgens and adrenal hormones, general lethargy and weakness, headache, lethargy, neurasthenia, insomnia, decreased sexuality.
One of the most common manifestations are sklerokistoz absence of menstruation, or violations: first menstrual period extended, become very abundant, or vice versa, scarceAnd then disappear altogether.
Sklerokistoz manifests infertility, it usually occurs in 90% of patients. While gradually growing phenomenon hirsutism - excessive body hair, hair growing on his upper lip, cheeks and chest, a lot of them on the hands and legs, on the abdomen. In this case, there is hypoplasia (underdevelopment) of the uterus, or its atrophy may be underdeveloped mammary glands.
Diagnostics
The basis of diagnosis sklerokistoz are complaints of the patient, as described above, and a long period of infertility.
Main Survey - Survey on the gynecological chair - the doctor probes the normal or reduced uterus, with enlarged, lumpy and dense ovaries, usually on both sides. In rare cases, the ovaries are reduced.
Functional tests with measurement of basal body temperature, kolpotsitogrammoy and scraping of the endometrium show single-phase cycle, which indicates the absence of ovulation.
Basis instrumental diagnostics - ultrasound, in which are seen ovaries compacted, dense skin coated and filled cysts.
Also it is shown holding gas pelveogrammy - it is usually marked by a decrease in uterine and ovarian enlargement with the formation of an oval or round shape them.
For invasive diagnosis method using the diagnostic laparoscopy (Sometimes simultaneously with the treatment).
Laboratory diagnosis is to determine the level of hormones in the serum - examine sex hormones, pituitary hormones, adrenal hormones and thyroid.
At higher levels of adrenal hormones and adrenal tumors exclude pituitary tumor.
sklerokistoz treatment
Sklerokistoz treatment involved doctors, gynecologists and endocrinologists. Allocate a conservative and operational treatment.
By conservative therapy sklerokistoz include:
- clomiphene therapy in the first 5 days of the cycle with the fifth day of menstruation. This leads to the stimulation of ovulation.
- tsiklofenilom therapy used to improve the level of luteinizing hormone,
- for treating increased pilosis ovosiston used, which regulates the exchange of steroids, which reduces the unwanted hair growth. The course is sometimes supplemented with metronidazole.
- in case of problems with adrenal prednisolone scheme, sometimes with the addition of a second phase hydroxyprogesterone. If there is no menstruation, they can cause bisekurinom, effective hCG.
Today is actively used surgical treatment - a method of complete or partial decapsulation ovaries. Dense membranes are cut from the ovaries laparoscopically, are cut and stapled, wedge excised.
Due to such operations is formed to remove the possibility of inhibition of follicles, resulting in restoration of menstrual function and enables conceiving a child. Excised cysts that produce estrogen, leading to normalization of ovarian function. Before the operation is carried out scraping of the uterine cavity, to eliminate the degeneration of the mucosa.
However, surgical treatment of unstable, averaging effect without further treatment lasts up to six months. Surgical treatment is administered in the absence of results with conservative therapy.
