endometriosis Flashcards
what
ectopic endometrial tissue outside uterus
endometrial tissue in ovaries
chocolate cysts
presentation
cyclical abdo/pelvic pain dyspereunia dysmenorrhoea infertility urinary symptoms bowel symptoms
OE
enodmetrial tissue seen in vagina on speculum examination esp posterior fornix
fixed cervix
tenderness
tender nodulatiry posterior vaginal fornix
common area
uterosacral ligaments
gold standard for diagnosis
laparoscopy with biopsy
stage 1
small superficial lesions
stage 2
mild but deeper lesions
stage 3
deeper lesions with lesions on ovaries
mild adhesions
stage 4
deep and large lesions affective ovaries
extensive adhesions
options for hormonal Mx
COCP POP depo injection implant mirena coil GnRH agnoists
surgical Mx options
excision or ablation
hysterectomy
Mx 1st line treatment for symptomatic relief
NSAIDs +/- paracetomol
Mx - 2nd line if analgesia doesnt help
hormonal treatment e.g. COCP or progestogens
Mx - if analgesia/hormonal Rx doesnt work
gynae referall
GnRH analogues
surgery - excision, laser treatment
