Endometriosis Flashcards
1
Q
what is it?
A
endometrial like tissue outwith uterine cavity
2
Q
classification?
A
- lump of endometrial tissue outside uterus = endometrioma
- endometrioma on ovaries= chocolate cyst
- endometrial tissue in myometrium= adenomyosis
3
Q
pathogenesis?
A
theories proposed:
- genetic component
- retrograde menstruation
- metasplasia of cells outside uterus
- embryonic cells destined to become endometrial tissue remain outside uterus
4
Q
presentation?
A
- can be asymptomatic
- cyclical pelvic pain
- dysmenorrhoea
- deep dyspareunia
- dyscheczia
- infertility
- cyclical bleeding from other sites ie haematuria
5
Q
examination?
A
- visvible endometrial tissue on speculum exam
- tenderness
- fixed, retroverted uterus
- adnexal mass (chocolate cyst)
6
Q
Ix?
A
- pelvic US
- endometriomas & chocolate cyst
- MRI
- laparoscopy w biopsy- gold standard
7
Q
Mx?
A
- Medical
- COCP (tricycling- suppression of ovarian function)
- progestogens
- IUS
- NSAIDs
- GnRH agonists
- Surgical
- laparoscopic surgery (excise/ablation)
- hysterectomy w bilateral salpingo-oophorectomy
- iatrogenic induction of menopause
8
Q
what is the downside of medical mx?
A
provides symptomatic relief but doesn’t improve fertility, whereas surgery does
