Alternativne metode liječenja endometriotičnih cista jajnika u pacijentica adolescentne dobi

master's thesis

• Title (english): Alternative treatment for the endometriosis of ovarian cyst in adolescent patients
• Author: Marijeta Mišolongin
• Mentor: Mario Ćorić (mentor)
• Committee member: Goran Vujić (predsjednik povjerenstva)
• Committee member: Željko Duić (član povjerenstva)
• Committee member: Mario Ćorić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2021-09-02, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Endometriotične ciste jajnika su invaginirane ciste kore jajnika koje u sebi sadrže endometrijske žlijezde i stromu. Tkivo endometrija koje se implantiralo na ovom mjestu je osjetljivo na hormone i prolazi kroz iste cikličke promjene kao i endometrijsko tkivo unutar maternice za vrijeme menstrualnog ciklusa. Zbog ovih promjena ciste izazivaju širok spektar simptoma, no u adolescentnoj dobi oni su nešto drugačiji i često neprepoznati na vrijeme. Osim tipičnih simptoma, kao što su dismenoreja i bolovi u zdjelici tijekom cijelog ciklusa, tu su i nespecifične tegobe, a najčešće je bolest u toj dobi asimptomatska. Endometriotične ciste jajnika su aktivne tvorbe koje ispuštanjem metaloproteinaza i drugih tvari uzrokuju oštećenje kore jajnika i samih folikula te u konačnici dovode do problema s plodnošću. U dijagnostici endometriotičnih cista koristi se transvaginalni ultrazvuk, no dijagnostika zlatnog standarda je laparoskopija s patohistološkom potvrdom bolesti. Konzervativno liječenje uključuje farmakološku terapiju i kirurgiju te njihovu kombinaciju. S obzirom da se kod adolescentnih pacijentica izbjegava radikalna terapija nakon detaljnog pregleda kreće se sa simptomatskom medikamentoznom terapijom. Ukoliko nema poboljšanja kreće se na laparoskopiju i kirurške zahvate s maksimalnom poštedom jajnika. Alternativne metode liječenja endometriotičnih cisti jajnika nisu još dovoljno istražene, no u zadnje vrijeme se sve više mlađih pacijentica okreće njima zbog minimalnih nuspojava i izbjegavanja radikalne terapije. Akupunktura se koristi primarno za ublažavanje simptoma, prvenstveno bolova u zdjelici. Fitoterapija ima širok spektar djelovanja pa tako neke biljke i njihovi produkti djeluju simptomatski, dok druge djeluju na smanjenje samih endometriotičnih cisti. Kombinacija mikrovalova i kineske biljne klizme pokazala se vrlo učinkovitom jer ljekovite tvari puno bolje prodiru do lezija i zaobilaze probavne enzime i jetru. Postoji još puno slabije istraženih alternativnih metoda te se one biraju kao adjuvantna terapija konzervativnoj terapiji ovisno o željama pacijentica.

Abstract (english)

Endometriotic ovarian cysts are invaginated cysts of the ovarian cortex that contain endometrial glands and stroma. The endometrial tissue that is implanted in this spot is sensitive to hormones and undergoes the same cyclical changes as the endometrial tissue inside the uterus during the menstrual cycle. Due to these changes, cysts cause a wide range of symptoms, however in adolescence they are somewhat different and often not identified in time. In addition to typical symptoms such as dysmenorrhea and pelvic pain throughout the cycle, there are also nonspecific ailments, and in most cases the disease is asymptomatic at that age. Endometriotic ovarian cysts are active formations that, by releasing metalloproteinases and other substances, cause damage to the ovarian cortex and the follicles themselves, and ultimately lead to fertility problems. Transvaginal ultrasound is used in the diagnosis of endometriotic cysts, but the gold standard diagnosis is laparoscopy with pathohistological confirmation of the disease. Conservative treatment includes pharmacological therapy and surgery and their combination. Since radical therapy is avoided in adolescent patients, after a detailed examination, the patient starts with symptomatic drug therapy. If there is no improvement, the patient moves on to laparoscopy and surgery with maximum ovarian sparing. Alternative methods of treating endometriotic ovarian cysts have not yet been sufficiently explored, but recently more and more younger patients are turning to them for minimal side effects and to avoid radical therapy. Acupuncture is used primarily to relieve symptoms, chiefly pelvic pain. Phytotherapy has a wide range of effects, so some plants and their products act symptomatically, while others act to reduce the endometriotic cysts themselves. The combination of micro-waves and Chinese herbal enemas has proven to be very effective because the medicinal substances penetrate the lesions much better and bypass digestive enzymes and the liver. There are many less researched alternative methods and they are chosen as adjuvant therapy to conservative therapy depending on the wishes of patients.

• Keywords: endometrioza; endometriotična cista jajnika; adolescencija; alternativna medicina
• Keywords (english): endometriosis; endometriotic ovarian cyst; adolescence; alternative medicine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:438496
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-03-16 12:19:38