Endometriosis

Question 1

management for endometriosis ?

Answer 1

mild pain: paracetamol, NSAIDS

severe pain:
1st line is medical;
- hormonal treatment such as OCP or a progestogen i.e. LNG IUD, POP,

surgical;

• diathermy of lesions
• adhesiolysis
• ovarian cystectomy (if endometrioma)
• laparoscopic pelvic clearance
• bilateral oophorectomy

Question 2

treatment for endometriosis if fertility is desired ?

Answer 2

if mild: NSAID, paracetamol

severe: surgery

don’t give medical treatment if fertility desired

Question 3

complications of endometriosis ?

Answer 3

infertility 
bladder/bowel problems 
endometrioma
adhesions
affects QOL

Question 4

surgical treatment for endometriosis ?

Answer 4

adhesiolysis
diathermy of lesions
laparoscopic pelvic clearance

ovarian cystectomy if endometrioma

hysterectomy

Question 5

1st line investigations for a patient presenting with dysmenorrhoea and/or menorrhagia ?

Answer 5

FBC: anaemia
TFT: hypothyroidism
clotting factors: coagulopathy

Question 6

diagnostic investigation for endometriosis ?

Answer 6

diagnostic laparoscopy

Question 7

classic presentation of endometriosis ?

Answer 7

female of reproductive age with dysmenorrhoea and/or menorrhagia + subfertility