Endometriosis Flashcards
Definition of what issue?
(1) Ectopic growth of endometrium outside the uterus, particularly in the dependent parts of the pelvis and in the ovaries
(2) Principal manifestations are chronic pain and infertility
Endometriosis
Signs and symptoms of what issue?
(1) Dysmenorrhea
(2) Chronic pelvic pain
(3) Dyspareunia
(4) Abnormal uterine bleeding
(5) Infertility
(6) May be asymptomatic
(7) Physical exam may show
—(a) Tender nodules in the cul-de-sac or rectovaginal septum
—(b) Cervical motion tenderness
—(c) Adnexal mass or tenderness
Endometriosis.
DDx for Endometriosis
(1) Pelvic inflammatory disease
(2) Ovarian neoplasm
(3) Polycystic ovarian syndrome
(4) Uterine fibroids
(5) Bowel neoplasm (if there is blood in the stool)
(6) Dysmenorrhea
definitive diagnosis of endometriosis is made only by what?
histology of lesions removed at surgery.
(Laparoscopy)
Transvaginal ultrasound imaging for endometriosis is only useful for what?
the presence of a pelvic or adnexal mass
Treatment for endometriosis
(a) NSAIDS
(b) Hormonal therapy
—Inhibit ovulation for 4-9 month preventing cyclic stimulation of
endometriotic growths inducing atrophy
(c) Surgical
—Laparoscopic ablation of endometrial implants
—Hysterectomy, with bilateral salpingooophorectomy
-Endometriosis
What is definitive therapy for those with intractable pelvic pain, adnexal masses, or multiple previous ineffective conservative surgical procedures?
Hysterectomy, with bilateral salpingooophorectomy,
What surgical intervention of endometriosis is effective in reducing pain and promoting fertility?
Laparoscopic ablation of endometrial implants
How is hormonal therapy used to treat endometriosis
Inhibit ovulation for 4-9 month preventing cyclic stimulation of
endometriotic growths inducing atrophy.
How long are Low dose combined oral contraceptives used to treat Endometriosis?
used continuously for 6-12 months
Any patient suspected of having endometriosis should be referred to where?
OB/GYN
