Endometriosis

Question 1

what is it?

Answer 1

endometrial glands and stoma outside the uterine body

Question 2

what can it cause?

Answer 2

pelvic inflammation
infertility
pain

Question 3

what are the sites cysts can form as a result of endometriosis?

Answer 3

Ovary (‘chocolate’ cyst)
Pouch of Douglas 
Peritoneal surfaces, including uterus 
Cervix, vulva, vagina 
Bladder, bowel etc.

Question 4

what is the pathogenesis of ovarian endometriosis?

Answer 4

regurgitation
metaplasia
vascular or lymphatic dissemination

macroscopic - peritoneal spots or nodules, fibrous adhesions, chocolate cysts

microscopic - endometrial glands and stroma, haemorrhage, inflammation, fibrosis

Question 5

how is it diagnosed?

Answer 5

• Can be difficult to diagnose and patients may need diagnostic laproscopy
• Endometriosis deposits contain altered blood and haemoglobin degradation products – can be seen on MRI

Question 6

what are the complications of endometriosis>

Answer 6

pain 
cyst formation 
adhesions 
infertility 
ectopic pregnancy 
malignancy