Endometriosis

Question 1

Etiology of endometriosis?

Answer 1

1. Retrograde flow during mentrastion
2. Blood/lymph spread
3. Coelomic metaplasia

Question 2

Symptoms of endometriosis

Answer 2

Chronic Pelvic Pain
Dysmenorrhea
Dysparaunia
Dysuria
Dyschezia
Infertility

Question 3

Diagnosis of endometriosis

Answer 3

1. Laparoscopy - direct visualisation + biopsy to confirm
2. US - shows Ovaries (presence of chocolate cyst)
3. Ca-125 levels increased

Question 4

Treatment of endometriosis

Answer 4

Medical -
Combined Oral contraceptive - PSEUDO pregnancy state - Amenorrhea
GnRH agonists
Progestin - suppresses ovulation

Surgical -
remove the implants
Total hysterectomy

Question 5

Pathogenesis of endometriosis

Answer 5

Implant cells -
-release inflammatory mediators - inflammation - > scaring - > adhesions - > adhesions of the Fallopian tube -> infertility
-Contain enzyme aromatase - release more oestrogen.

Question 6

Definition of endometriosis

Answer 6

Functional glandular endometrial cells present outside the uterus.
Found in Ovaries, Fallopian tubes, ligaments, bladder, rectum