Endometriosis Flashcards
What is endometriosis?
Endometrial tissue (stroma/glands) outside the uterus
Where are common sites for endometrial tissue to be?
Ovaries and peritoneum most common
Pouch of douglas
What is the pathology?
Not well known
Retrograde bleeding may be the cause
Mullerian abnormalities
What is retrograde bleeding?
When blood during menstruation goes back up the fallopian tubes
What are mullerian abnormalities?
Abnormalities left behind from mesonephric ducts
Acronym for symptoms of endometriosis?
DIPS
What does DIPS stand for?
Deep dyspareunia
Infertiliy/subfertility
Pelvic pain
Secondary amenorrhoea
Typical presentation
” 32 y/o nulliparous woman presents with progressively worsening menstrual pain. She describes it as much worse than usual. She has recently stopped taking the OCP and been trying to conceive, but has been unsuccessful. “
OCP is protective because it stops menstruation therefore the endometrial tissue elsewhere does not proliferate
Investigation?
Vaginal exam
TVUS
MRI
Laparoscopy
What may be found on vaginal exam?
Pelvic floor tenderness
Uterine cysts
Uterosacral ligament nodules
What may be seen on TVUS?
Endometriomas
If nothing found on TVUS what should be done?
MRI
- Ovaries
What is definitive diagnosis?
Laparoscopy
Typical laparoscopic findings?
Powder burn lesions
1st line pharmacological management?
1st line
- OCP
- NSAIDs
