Endometriosis Flashcards
What is the most common site of occurrence for endmoetriosis
The ovaries, followed by the pouch of douglas
What are the common symptoms of endometriosis
Dysmenorrhoea
Dyspareunia
Infertility
Chronic pelvic pain
Dyschezia
Which serum cancer marker may be elevated in a blood test in someone with endometriosis?
Ca 125
Which medical treatments that can be used in the treatment of endometriosis?
NSAIDs
Combined oral contraceptive pill (cyclically or continuously)
Progestogens (depo-provera, oral, Mirena)
GnRH agonists (2nd line to OCP)
What findings might you find on vaginal examination of someone with endometriosis?
Tender nodules on uterine ligaments
Fixed retroversion of the uterus
Firm, fixed adnexal mass (endometrioma)
What is the typical symptom presentation for endometriosis?
Can be asymptomatic but typically:
Cyclic pain preceding menses (by 24-48 hours) and continuing throughout menses can be associated with dysmenorrhea and dyschezia. Pain may radiate throughout pelvis and into the back.
Infertility
What are 2 ways endometriosis can cause infertility?
Structural damage
Damage to fallopian tubes (inflammation, adhesions, scarring)
Ovarian injury
Impaired implantation of eggs into the endometrium
Adhesion damage resulting in impaired ability for sperm to reach the oocyte
Release of inflammatory cytokines from endometriosis deposits, which are directly toxic to ova
Laparoscopic surgery is the preferred method to remove endometriomas, what are some specific risks associated with this laparoscopic ovarian cystectomy?
Pelvic infection from the surgery
Adhesions post op (may affect fertility if attached to the fallopian tubes or ovaries)
Uncontrolled bleeding from damage to vasculature
Damage to other local structures (bowel, bladder, ureters, and the reproductive organs themselves)
Removal of excess normal ovarian tissue
What is the most effective method of reversing infertility associated with endometriosis
Surgical removal of all endometriosis deposits and ovarian endometriomata is the most effective way of restoring fertility.
GnRH analogues may be used prior to IVF treatment if surgery is not an option
Medical treatments do not significantly improve fertility
What are 5 Risk factors for developing endometriosis?
Reproductive age
Postive family history
Nulliparity
Mullerian anomalies
White ethnicity
Low BMI
History of autoimmune disease (Increased prevalence)
Smoking
Late first sexual encounter (weak association)
Previous Caesarean section (weak association)
(No marks for saying female gender!)
