Endometriosis Flashcards
Define endometriosis.
Presence of endometrial tissue outside the uterus.
Explain the aetiology of endometriosis.
Suggested theories include:
Retrograde menstruation – passage of endometrial tissue through tubes into pelvis during menstruation (Samson’s)
Metaplasia of coelomic epithelium into endometrial glands (Meyer’s)
What are the risk factors for endometriosis?
Nulliparity
Family history
Short cycle
Long periods.
Summarise the epidemiology of endometriosis.
15% women in reproductive age.
Recognise the presenting symptoms of endometriosis.
Cyclical dysmenhorrea, chronic pelvic pain, dyspareunia, infertility.
Rarely involvement of other organs: haematuria, PR bleed, epistaxis, haemoptysis
Recognise the signs of endometriosis on physical examination.
Vaignal: unremarkable, immobile uterus, tender uterosacral ligament, palpate uterosacral nodules.
Identify appropriate investigations for endometriosis and interpret the results.
USS: endometrioma
Laparoscopy: Gold standard for diagnosis
Generate a management plan for endometriosis.
Medical: analgesia (NSAID), suppress ovulation (COCP, progestogens, Mirena, GnRH analogues.
Surgical: Laparoscopic ablation.excision of lesions, adhesionolysis, overian cystectomy, Total hysterostomy with bilateral salpingo-oophrectomy
Identify the possible complications of endometriosis and its management. Summarise the prognosis for patients with endometriosis.
Cyst accident, infertility, chronic pain, adhesions, sexual dysfunciton. Medicla management improves symtpoms in 80%. Symptoms subside in pregnancy/menopause.