Endometriosis

Question 1

What are the causes of Endometriosis?

Answer 1

Retrograde menstruation
Vascular or Lymphatic Dissemination
Coelomic Metaplasia

Question 2

What are the risk factors for Endometriosis?

Answer 2

Early menarche before 11 years
Shorter cycle interval
Prolonged heavy bleeding

Question 3

What are the protective factors for Endometriosis?

Answer 3

Higher parity
Increased duration of lactation
Regular exercise

Question 4

WHere is endometriosis most commonly found?

Answer 4

Ovaries(bilateral)
Posterior cul-de-sac
-uterosacral lig
-rectovaginal septum
Round ligaments 
Fallopian tubes
Sigmoid colon
Surgical scars, organs outside the pelvis

Question 5

How is endometriosis diagnosed?

Answer 5

Pt with Dysmenorrhea that doesn’t respond to oral cont or NSAIDS
Imaging only helpful if there’s a uterine mass
Laparoscopy or laparotomy
-Powder Burn
-red
-white
Histology by biopsy (Def Dx)

Question 6

What is the Tx of Endometriosis?

Answer 6

Reduce pain
Minimize surgery
Preserve fertility
Oral Cont + NSAID
Progesterone
Danazol
GnRH-agonist
Surgical

Question 7

What are the surgical Tx of Endometriosis?

Answer 7

Conservative: Excision, cautery, ablation by laser or electrocoag
Medical therapy before Surg

Definitive: Total Hysterectomy, salpingo-oophorectomy, lysis of adhesions, removal of endo implants

Question 8

What are the different types of uterine malformation?

Answer 8

Uterus Didelphys (double vagina)
Bicornate uterus (and unicolis)
Cervical atresia
Vaginal atresia
Arcautus Uterus