Endometriosis Flashcards
1
Q
What is it?
A
- endometrial like tissue outside of the uterine cavity
- chronic oestrogen dependant condition
2
Q
usually seen?
A
- pouch of douglas
- ovaries
- pelvic peritoneum
3
Q
pathogenesis?
A
3 theories have been suggested
- Retrograde menstruation
- Mesothelial metaplasia
- Haematogenous spread
4
Q
symptoms?
A
LARGE VARIATION
- may present asymptomatically
- PAIN - main presentation
- premenstrual pelvic pain
- dysmenorrhoea
- dyspareunia
- subfertility
5
Q
signs?
A
- may be none
- tender nodules in rectovaginal septum
- adnexal mass / tenderness
- on bimanual palpation, a fixed retroverted uterus is commonly seen
6
Q
diagnosis?
A
gold standard- laparoscopy and histological biopsy for confirmation
MRI for deep endometriosis
US - chocolate cyst
7
Q
what is a “chocolate cyst”?
A
endometrioma
- growth of endometrial tissue in the ovaries
8
Q
Treatment?
A
- medical
- progestogen
- COC pill
- GnRH analogue
- surgery
- ablation/ excision / diathermy of deposits
- removal of ovaries +/- hysterectomy
9
Q
when is the surgical option persued?
A
when medical treatment fails
