Endometriosis Flashcards
What is endometriosis?
Condition where there is deposits of endometrium outside the uterine
What are the tissue changes in endometriosis?
Cyclical changes and will breakdown and bleed at time of menstruation
Where does endometriosis commonly occur?
Ovaries
Uterosacral ligaments
Rectovaginal septum
an also occur in
- Peritoneum
- Uterine tubes
- Rectum
- Sigmoid colon
- Bladder
Who gets endometriosis?
- Runs in families
- More prevelant in some ethnic groups
3 main theories of cause of endometriosis?
- Retrograde spill of menstrual debris
- Metaplasia of tissue into Mullerian duct elements
- Lymphatic and blood borne emboli of endometrial tissue
Presentation of endometriosis?
- Pelvic pain
- Severe period pain
- Dyspareunia
- Pain on urination or defecation in period
- Heavy periods
- Nausea, constipation, diarrhoea
- Infertility
What can develop in the ovary in endometriosis?
Chocolate cysts
full of old menstrual blood
What can you see macroscopically in endometriosis?
Peritoneal spots or nodules, fibrous adhesions and chocolate cysts
What can be seen microscopically in endometriosis?
Endometrial glands and stroma with haemorrhage, inflammation and fibrosis are seen
Complications of endometriosis?
- Chronic pain
- Cyst formation
- Adhesions
- Infertility
- Increased risk of ectopic pregnancy
- Increased risk of malignancy due to cyst undergoing malignant change to endometroid adenocarcinoma
Investigations for endometriosis?
Abdominal US
Transvaginal US
MRI
Diagnostic laparoscopy can be done
Management of endometriosis?
- Analgesics
- Hormonal treatment
- Surgery can be done if these options are unsuccessful
- Should take into account whether the woman has had her family or wants more family
Examples of analgesics?
NSAIDs
Paracetamol
Neuromodulators
Examples of hormonal treatment?
COCP
Progesterone
GnRH analogues (short term)
IUS Mirena
