Endometriosis

Question 1

What is an ectopic growth of endometrium outside the uterus, particularly in the dependent parts of the pelvis and in the ovaries?

Answer 1

Endometriosis

Question 2

What ectopic growth has the principal manifestations of chronic pain and infertility?

Answer 2

Endometriosis

Question 3

Lesions of endometriosis are located in the pelvis but can also include what?

Answer 3

bowel or diaphragm

Question 4

What are these symptoms of?

1. dysmenorrhea
2. chronic pelvic pain
3. dyspareunia
4. abnormal uterine bleeding
5. may be asymptomatic

Answer 4

Endometriosis

Question 5

The physical exam for a patient with possible endometriosis may show what?

Answer 5

1. tender nodules in the cul-de-sac or rectovaginal septum
2. cervical motion tenderness
3. adnexal mass or tenderness

Question 6

True or False

Definitive diagnosis of endometriosis is made only by histology of lesions removed at surgery (laparoscopy)

Answer 6

True

Question 7

What imaging has low value and is only useful in the presence of a pelvic or adnexal massses in patients with suspected endometriosis?

Answer 7

Transvaginal ultrasound

Question 8

What treatment is used to inhibit ovulation for 4-9 months to prevent cyclic stimulation of endometriotic growths inducing atrophy?

Answer 8

Hormonal therapy

Question 9

What are some commonly used hormonal therapies used for endometriosis?

Answer 9

1. low dose combined oral contraceptives (used continuously for 6-12 months)
2. contraceptive patch
3. vaginal
4. progestins
5. progestin intrauterine device

Question 10

What is the definitive surgical therapy for those with intractable pelvic pain, adnexal masses, or multiple previous ineffective conservative surgical procedures for endometriosis?

Answer 10

Hysterectomy, with bilateral salpingooopherectomy

Question 11

All patients suspected of having endometriosis should be referred to where?

Answer 11

OB/GYN