Endometriosis and adenomyosis Flashcards
What is endometriosis?
Growth of ectopic endometrial tissue outside of uterine cavity
What are the common locations for endometriosis?
Ovary
Pouch of Douglad
Pelvic peritoneum
What are the features of endometriosis?
Chromic pelvic pain Dysmenorrhoea, often starting days before bleeding Abnormal bleeding Deep dyspareunia Subfertility Reduced organ mobility Uterine tenderness Non gynae
What abnormal bleeding can endometriosis cause?
Heavy prolonged periods
PCB
IMB
Spotting
What non gynae symptoms can endometriosis cause?
Dysuria, urgency, haematuria
Dyschezia
What investigations are done for endometriosis?
Laparoscopy
US
MRI for deep disease
What is the management of endometriosis?
Medical- analgesia, contraception, GnRH analogues
Surgery
What is adenomyosis?
Endometrial tissue in myometrium
What are the risk factors for adenomyosis?
Parity
C section
Surgical termination
What are the features of adenomyosis?
Chronic pelvic pain
Heavy, painful periods
Bulky render uterus
Dyspareunia
How is adenomyosis diagnosed?
MRI
Histology of uterine muscle- usually post hysterectomy
What is the management of adenomyosis?
Hormonal- mirena, progestogens, combined OCP
Hysterectomy
What are the complications of adenomyosis?
Subpertility
Preterm labour
PPROM
