Endometriosis Flashcards
What is endometriosis?
A condition where ectopic endometrial-like tissue grows outside the uterus.
What are the potential causes of endometriosis?
Exact cause remains unclear but may include:
* genetic component
* retrograde menstruation
List risk factors for endometriosis.
- early menarch
- late menopause
- nulliparity
- family history
- vaginal outflow obstruction
- white ethnicity
- low BMI
- smoking
What is the main symptom of endometriosis?
Cyclical pain.
What causes irritation and inflammation in endometriosis?
Endometrial tissue sheds lining and bleeds.
What types of pain are associated with endometriosis?
- cyclical, dull, heavy, or burning pain during menstruation
- chronic, non-cyclic pain
What can cause blood in stool or urine in endometriosis patients?
Endometrial deposits in bladder or bowel.
What are some clinical features of endometriosis?
- chronic, cyclic abdominal/pelvic pain (>6 months)
- deep dyspareunia
- dysmenorrhoea
- infertility
What examination findings are associated with endometriosis?
- endometrial tissue in vagina (especially posterior fornix)
- fixed cervix on bimanual exam
- tenderness in the vagina, cervix, and adnexa
What investigations are used for diagnosing endometriosis?
- transvaginal ultrasound
- laparoscopy (diagnostic) - biopsy of lesions
What are the stages of endometriosis according to ASRM?
- Stage 1 - small superficial lesions
- Stage 2 - mild, but deeper lesions
- Stage 3 - deeper lesions with lesions on ovaries and mild adhesions
- Stage 4 - deep and large lesions affecting ovaries with extensive adhesions
What are the management options for endometriosis?
- analgesia as required for pain (NSAIDs, paracetamol)
- hormonal management - COCP, progesterone only pill, injection, implant, coil, GnRH agonists
- surgical management - laparoscopy, hysterectomy
True or False: Hormonal therapies for endometriosis may improve symptoms but not fertility.
True.
True or False: Laparoscopic treatment for endometriosis may improve fertility.
True.
