Endometriosis Flashcards
What is endometriosis?
A chronic condition in which endometrial tissue is located at sites other than the uterine cavity
Where can endometriosis be located?
Ovaries, pouch of Douglas, uterosacral ligaments, pelvic peritoneum, bladder, umbilicus and lungs
When are most diagnoses of endometriosis made?
25-40
Describe the theory of retrograde menstruation as a theory for the pathophysiology of endometriosis
Endometrial cells travel backwards from the uterine cavity, through the fallopian tubes and deposit on pelvic organs where they can seed and grow
The cells may also travel to distant sites through the lymphatic system and vasculature
Which hormone is the endometrial tissue sensitive to?
Oestrogen
What happens to the ectopic tissue during menstruation?
Bleeding - pain and bloating/distension at ectopic sites
What can form as a result of endometriosis?
Adhesions
When will symptoms of endometriosis be reduced?
Pregnancy
Menopause
What are the risk factors for endometriosis?
Early menarche Short menstrual cycles Long duration of menstrual bleeding Family history of endometriosis Defects in the uterus or fallopian tubes
What is the most common presenting symptom of endometriosis?
Cyclical pelvic pain
Or constant pelvic pain if adhesions have formed
What are some other symptoms of endometriosis
Dysmenorrhoea Dyspareunia Dysuria Dyschezia (painful defecation) Subfertility Focal symptoms at time of menstruation from distant sites - haemothorax
What may be noted on bimanual examination of endometriosis
Fixed, retroverted uterus
Uterosacral ligament nodule
General tenderness - enlarged, tender and boggy uterus
What are the differentials for endometriosis?
Pelvic inflammatory disease
Ectopic pregnancy
Fibroids
IBS
What is the gold standard of diagnosis of endometriosis
Laparoscopy
What are the typical findings of endometriosis on laparoscopy?
Chocolate cysts
Adhesions
Peritoneal depositis
