Endometriosis Flashcards
What is endometriosis?
Endometriosis is a condition where there is ectopic endometrial tissue outside of the uterus
What are the features of endometriosis?
Abdominal or pelvic pain (cyclical)
Deep dyspareunia
Dysmenorrhoea
Infertility
Cylical urinary and bowel symptoms
Cyclical bleeding from other areas
What might be seen on examination of someone with endometriosis?
Endometrial tissue in the vagina
Fixed cervix
Tenderness in the vagina, cervix and adnexa
What is the gold standard investigation of endometriosis?
Laparascopic surgery and biopsy of lesions
What is the initial investigation in patients with symptoms of endometriosis and what does it show?
Trans-vaginal ultrasound - often normal
What are the differentials of endometriosis?
Adenomyosis
Interstitial cystitis
PID
IBS
Ovarian cyst
Ovarian cancer
What is the medical management of endometriosis?
Analgesia - paracetamol or NSAIDs
Hormonal therapies
- Combined OCP
- Progesterone only pill
- Depo injection
GnRH agonists
What are the surgical management options for endometriosis?
Laparascopic surgery to ablate or excise endometrial tissue
Hysterectomy
What do GnRH agonists do in endometriosis?
Essentially induce menopause
How long must symptoms have persisted for a diagnosis of endometriosis?
Cyclical or continuous pain for over 6 months
Where is endometrial tissue commonly found outside of the uterus?
Pouch of douglas
Ovaries
Uterosacral ligaments
What is an endometrioma?
A cystic lesion that stems from endometriosis
What is the appearance of endometriomas?
Cysts filled with dark brown endometrial fluid commonly found on the ovaries
What is the management of endometriomas?
Laparoscopic ovarian cystectomy with excision of the cyst wall
