endometriosis Flashcards
what is it
functioning endometrial like tissue in an abnormal location outside the uterus inducing a chronic inflammatory reaction
diagnosis
laparascopy and biopsy
where are the more common sites
ovary, uterosacral ligament, broad ligament, bladder, rectum
does it bleed at menstruation
yes provoking fibrosis, adhesions and subfertility
features
lower abdominal pain- associated with menstruation, menstrual disturbances, dyspaurenia (if involves cul de sac), infertility
what happens to extra pelvic endometriosis
pain and bleeds at the time of menstruation at the site
management mild
hormonal treatment
management moderate
surgery- fulguration or laser
management severe
surgery- conservative or hysterectomy
hormonal treatment endometriosis
combined pill, progestogen pill- norethisterone, Mirena; danazol, GnRH analogues
how does danazol work
decreases no of GnRH receptors in the pituitary and leads to decr sex hormones so decreased oestradiol
aim of hormonal treatment
decrease oestrogen synthesis so menstruation ceasesm inhibiting further growth of the lesions
complications
obstruction (GI, ureteric, fallopian); ovarian endometriod and clear cell cancers; Hodgkins; melanomas
prognosis
chronic or relapsing, progressive in 50%
