Endometriosis Flashcards Preview

JCU Obstetrics & Gynaecology > Endometriosis > Flashcards

Flashcards in Endometriosis Deck (10)
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1
Q

What is the most common site of occurrence for endmoetriosis

A

The ovaries, followed by the pouch of douglas

2
Q

What are the common symptoms of endometriosis

A

Dysmenorrhoea

Dyspareunia

Infertility

Chronic pelvic pain

Dyschezia

3
Q

Which serum cancer marker may be elevated in a blood test in someone with endometriosis?

A

Ca 125

4
Q

Which medical treatments that can be used in the treatment of endometriosis?

A

NSAIDs

Combined oral contraceptive pill (cyclically or continuously)

Progestogens (depo-provera, oral, Mirena)

GnRH agonists (2nd line to OCP)

5
Q

What findings might you find on vaginal examination of someone with endometriosis?

A

Tender nodules on uterine ligaments

Fixed retroversion of the uterus

Firm, fixed adnexal mass (endometrioma)

6
Q

What is the typical symptom presentation for endometriosis?

A

Can be asymptomatic but typically:

Cyclic pain preceding menses (by 24-48 hours) and continuing throughout menses can be associated with dysmenorrhea and dyschezia. Pain may radiate throughout pelvis and into the back.

Infertility

7
Q

What are 2 ways endometriosis can cause infertility?

A

Structural damage

Damage to fallopian tubes (inflammation, adhesions, scarring)

Ovarian injury

Impaired implantation of eggs into the endometrium

Adhesion damage resulting in impaired ability for sperm to reach the oocyte

Release of inflammatory cytokines from endometriosis deposits, which are directly toxic to ova

8
Q

Laparoscopic surgery is the preferred method to remove endometriomas, what are some specific risks associated with this laparoscopic ovarian cystectomy?

A

Pelvic infection from the surgery

Adhesions post op (may affect fertility if attached to the fallopian tubes or ovaries)

Uncontrolled bleeding from damage to vasculature

Damage to other local structures (bowel, bladder, ureters, and the reproductive organs themselves)

Removal of excess normal ovarian tissue

9
Q

What is the most effective method of reversing infertility associated with endometriosis

A

Surgical removal of all endometriosis deposits and ovarian endometriomata is the most effective way of restoring fertility.

GnRH analogues may be used prior to IVF treatment if surgery is not an option

Medical treatments do not significantly improve fertility

10
Q

What are 5 Risk factors for developing endometriosis?

A

Reproductive age

Postive family history

Nulliparity

Mullerian anomalies

White ethnicity

Low BMI

History of autoimmune disease (Increased prevalence)

Smoking

Late first sexual encounter (weak association)

Previous Caesarean section (weak association)

(No marks for saying female gender!)