Endometriosis and adenomyosis: common and disparate features

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Abstract

Endometriosis and adenomyosis are diseases of the gynecological profile, which are ectopic endometrioid tissue and have long been considered tangible manifestations of the process. Only recently have scientists begun to put forward a theory about the unequal origin of these pathologies. In endometriosis, the lining of the uterus extends beyond it, mainly to the ovaries, fallopian tubes, and bladder. With adenomyosis, the nodes grow into the muscular wall of her uterus and thicken. They do not go outside the uterus. Both conditions cause severe pain due to local inflammation, swelling and adhesions in the abdominal cavity. The only reliable way to identify the diagnosis of endometriosis is invasive exploratory laparoscopy with biopsy of tissue samples. In contrast, an enlarged uterus with adenomyotic nodules can be assessed even on routine examination, and on ultrasound or MRI they are visualized in the report. Obviously, despite the high frequency of pathophysiological and molecular mechanisms, endometriosis and adenomyosis has rare causes, clinics and effects on the reproductive system of the female body, which significantly reduces the risk and treatment of diseases.

The review provides a comparative characteristic of endometriosis and adenomyosis in terms of prevalence, etiology, pathogenesis, clinical manifestations, effects on fertility and experimental modeling, obtained from domestic and foreign sources.

Understanding the pathophysiology of adenomyosis and endometriosis opens up additional possibilities for diagnosis, prevention, and treatment. The development of new diagnostic methods based on modern high-tech methods allows us to assume a preclinical stage and identify the diagnosis, predict and carry out adequate treatment depending on the histological picture.

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About the authors

Viktoriya A. Deryabina

St. Petersburg State Pediatric Medical University

Email: vika.deryabina@mail.ru

Student, Pediatric Faculty

Russian Federation, Saint Petersburg

Tatiana V. Brus

St. Petersburg State Pediatric Medical University

Author for correspondence.
Email: bant.90@mail.ru
SPIN-code: 9597-4953

MD, PhD, Associate Professor of the Department of Pathological Physiology with the Course of Immunopathology

Russian Federation, Saint Petersburg

Sarng S. Pyurveev

St. Petersburg State Pediatric Medical University

Email: dr.purvvev@gmail.ru
SPIN-code: 5915-9767

Assistant of the Department of Pathological Physiology with the Course of Immunopathology

Russian Federation, Saint Petersburg

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Supplementary files

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1. Fig. 1. Rationalizing the origin of endometriosis retrograde menstruation theory

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2. Fig. 2. Pathogenesis of adenomyosis: TIAR mechanism. TNF-α — tumor necrosis factor α; IL-1β — interleukin-1β; COX-2 — cyclooxygenase-2; PGE2 — prostaglandin E2; StAR — steroidogenic acute regulatory protein; ER-α — estrogen receptor α; ER-β — estrogen receptor β

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3. Fig. 3. The structure of the reproductive system of rats

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