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In principle the various stages show these findings: Micrograph of the wall of an endometrioma.

All features of endometriosis are present endometrial glands igrls, endometrial stroma and hemosiderin -laden macrophages. Typical endometriotic lesions show histopathologic features similar to endometriumnamely endometrial stromaendometrial epitheliumand glands that respond to hormonal stimuli. Older lesions may display no glands but hemosiderin deposits see photomicrograph on right as residual. For Pashto girls pussy purposes, and for more detailed pain measurement in clinical practice, VAS or NRS for each type of typical pain related to endometriosis dysmenorrheadeep dyspareunia and non-menstrual chronic pelvic paincombined with the clinical global impression CGI and birls quality of glrls scale, are used.

In younger women, surgical treatment attempts to remove endometrial tissue and preserve the ovaries without damaging normal tissue. Further steps depend on circumstances: As to the surgical procedure, ablation or fulguration of endometriosis burning and vaporizing the lesions with an electric device has shown a high rate of short-term recurrence after the procedure. The best surgical procedure with much lower rate of short-term recurrence is to excise cut and remove the lesions completely. It's considered a "minimally invasive" surgery because the surgeon makes very small openings incisions at or around the belly button and lower portion of the belly. A thin telescope-like instrument the laparoscope is placed through one incision, which allows the doctor to look for endometriosis using a small camera attached to the laparoscope.

Small instruments are inserted through the incisions to remove the endometriosis tissue and adhesions. Because the incisions are very small, there will only be small scars on the skin after the procedure, and all endometriosis can be removed, and women recover from surgery quicker and have a lower risk of adhesions. Trehan's temporary ovarian suspension, a technique in which the ovaries are suspended for a week after surgery may be used to reduce the incidence of adhesions after endometriosis surgery.

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However, this should only be done when combined with girl of the endometriosis by excision, as if endometriosis is not also removed at the time of hysterectomy, pain may persist. However, this technique is almost never Psshto due to the high incidence of associated complications including presacral hematoma and irreversible problems with urination and constipation. Pseudopregnancy Hormonal birth control therapy: Birth control pills reduce the menstrual pain associated with endometriosis. Progesterone counteracts estrogen and inhibits the growth of the endometrium.

Progestins are chemical variants of natural progesterone. An example of a progestin is dienogest Visanne. Whilst progestogens are often given as part of a combined hormonal therapy with the addition of estrogen, progestogen-only therapy may be an acceptable alternative.

Danazol Lussy and gestrinone Dimetrose, Nemestran are suppressive steroids with some androgenic activity. These drugs include GnRH agonists such as leuprorelin Lupron and GnRH antagonists such as elagolix Orilissa and are thought to work by decreasing estrogen levels. Evidence for aromatase inhibitors is limited due to the limited number and quality of studies available, though show promising benefit in terms of pain control.


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