Endometriosis

Question 1

What is endometriosis?

Answer 1

Endometriotic tissue outside uterus

Question 2

Who does endometriosis affect?

Answer 2

Women of repro age due to oestrogen drive

Question 3

Cause of endometriosis?

Answer 3

Unknown

Question 4

Presentation of endometriosis?

Answer 4

Sub fertility
A symptomatic 
Pain :
- cyclical
- constant
- dysmenorrhea
- dyspareunia 
- dysuria/ dyschezia

Question 5

Findings on examination of endometriosis?

Answer 5

May be normal.
With speculum may show visible lesions in vagina/ cervix.
May have tenderness.
May have fixed retroverted uterus.

Question 6

Investigations for endometriosis?

Answer 6

Laparoscopy with biopsy

MRI to see extend of endometriosis if affecting defaecation

Question 7

Treatment of endometriosis if medical treatment fails?

Answer 7

Laparoscopy using ablation / excision/ coagulation techniques to destroy endometriosis.
Excise nodules
Hysterectomy last resort

Question 8

Initial medical treatment of endometriosis?

Answer 8

COCP
Progestogens
Mirena
HRT

Question 9

Sites where endometriosis can occur?

Answer 9

Ovary - chocolate cyst
Pouch of Douglas
Peritoneal surfaces 
Cervix, vulva, vagina
Bladder, bowel etc