Hyperplasia - an increase in the number of structural elements of tissues as a result of their excess neoplasm, which occurs by amyotic - direct and mitotic - indirect division. During which there is also an increase in cytoplasamatic ultrastructures, in which ribosomes, endoplasmic reticulum, mitochondria, myofilaments primarily change. According to the cellular composition, histologically, the following are distinguished: glandular-cystic hyperplasia, endometrial hyperplasia, atypical endometrial hyperplasia (synonymous with adenomatous hyperplasia, adenomatosis), endometrial polyps.
Unlike the first two, atypical endometrial hyperplasia is a precancerous disease, which, in the absence of the necessary therapy, can lead to degeneration into a malignant tumor. The process that most often occurs during menopause with the cessation of menstrual function by age. Approximately hyperplastic precancerous processes that turn into endometrial cancer occur in ten percent of patients and sometimes persist for a long time, and sometimes undergo reverse development processes.
However, given the reality of the threat of the transition of ongoing processes into endometrial cancer, when the first symptoms of the disease occur, a more attentive attitude of the doctor to patients with adenomatous polyps and endometrial adenomatosis is necessary.
The risk of malignancy or malignancy of hyperplastic processes increases with progressive metabolic disorders expressed by extragenital diseases - impaired lipid and carbon metabolism, disorders of the gastrointestinal tract, functional disorder of the hepatobiliary system, obesity, concomitant with the development of endometrial pathology.
A local, limited form of hyperplasia is the endometrial polyp. Which, depending on the regenerative predominance of a particular cell structure, is divided into: glandular-fibrous, glandular and fibrous polyps.
Hyperplasia - causes
The reasons for the development of hyperplasia, stimulating cell proliferation, can serve:
- disorders of regulation of the processes of growth and metabolism, violation of correlation in the internal secretion system, increased predominance of the functions of certain organs, under the influence of tissue growth stimulants - carcinogenic and blastomogenic substances, tissue decay products, etc .;
- hereditary burden - breast and genital cancer, uterine fibroids, hypertension, etc., diseases and disorders of the menstrual and reproductive functions, hyperplastic processes, surgery on the genitals;
- concomitant - obesity, hyperglycemia, mastopathy, disorder of the liver function responsible for hormonal metabolism, endometriosis.
Hyperplasia - Symptoms
With the disease, the following symptom is most often pronounced:
- intermenstrual spotting;
- occurring after a delay in the menstrual cycle, uterine bleeding is short in time, but with heavy blood loss or long-lasting with moderate blood loss;
- frequent deviations, terminations or stops of the menstrual cycle, as well as meager premenstrual and intermenstrual sucrose discharge during the normal menstrual cycle.
Hyperplasia - diagnosis
To make a diagnosis it is necessary:
- ultrasound using a transvaginal probe;
- curettage of the uterine mucosa and cytological examination of the material. It is better to curettage with the onset of bleeding or on the eve of menstruation. After that, examination of the uterus with an optical probe is necessary. The degree of activation of hyperplastic processes can be determined using a radioisotope study.
Hyperplasia - treatment methods
When choosing methods of treatment for ongoing hyperplastic processes, it is necessary to take into account features: testimony, age of the patient, and other gynecological diseases.
The treatment process is divided into 3 categories - surgical, medical and combined.
Surgical involves curettage of the uterine mucosa for the purpose of diagnosis or to stop bleeding. Conducted by laser ablation - cauterization. In case of low efficiency or relapse, a hysterectomy - removal of the uterus can be prescribed.
Medication aimed at lowering estrogen levels is carried out mainly by a group of drugs, which include progesterone analogs and gonadropine releasing hormone agonists. Combined includes hormone therapy and surgery.
