Endometriosis Flashcards
What is endometriosis?
Ectopic endometrial tissue found outside the uterus
What are possible aetiologies for endometriosis?
Retrograde menstruation - endometrial tissue flows backwards
Embryonic cells remain outside the uterus
Cell metaplasia
Spread of endometrial cells though lymphatic system
What is the pathophysiology of endometriosis?
Cells outside the uterus also respond to hormones
- tissues shed lining
- cause irritation + inflammation of surrounding tissue
Deposits in bladder/bowel
Adhesions
Subfertility
What are features of endometriosis?
Cyclical pain
Dysmenorrhoea
Dyspareunia
Subfertility
What is found in examination in endometriosis?
Visible endometrial tissue
Fixed cervix/uterus
Tenderness
- vagina
- cervix
- adnexa
What investigations are done for suspected endometriosis?
Gold standard = laparoscopy +/- biopsy
Pelvic USS
What is seen on laparoscopy in endometriosis?
Chocolate cysts - endometrial tissue in ovaries
Adhesions
Peritoneal deposits
How is endometriosis managed?
Establish diagnosis + explain
Pain relief = NSAIDs
Hormonal management
- COCP
- mirena coil
- GnRH agonist
Surgery
- laparoscopy
- hysterectomy
