L2: Endometriosis & Adenomyosis Flashcards
Def of Endometriosis
- Presence of endometrial tissue (glands & stroma outside normal uterine cavity.
Incidence of Endometriosis
- Accurate assessment of incidence is difficult because laparoscopy & laparotomy are needed for diagnosis (it is found in 5-30% of all laparoscopies)
Etiology of Endometriosis
Etiology of Endometriosis
- Implantation (transplantation) theory
Etiology of Endometriosis
- Celomic metaplasia theory
- Endometriosis develops from metaplasia of cells lining pelvic peritoneum.
- No clinical or experimental support to this theory.
Etiology of Endometriosis
- Vascular lymphatic theory
- Endometrium is transported via vascular & lymphatic systems.
- Evidence: Occurrence of endometriosis at distant sites (as umbilicus or Lungs
Etiology of Endometriosis
- Genetic factor
- Risk is 7 times greater if ist degree relative has endometriosis.
Etiology of Endometriosis
- Immunologic Factors
- Immune system may be altered in women รจ endometriosis because of decreased cell mediated cytotoxicity allowing endometrial cells to survive outside endometrial cavity.
PPT Factors for Endometriosis
Sites of Endometriosis
Sites of Endometriosis
- Most Common
NE of Endometriosis
ME of Endometriosis
CP of Endometriosis
CP of Endometriosis
- Symptoms
Symptoms of Endometriosis
- Asymptomatic
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Symptoms of Endometriosis
- Pelvic Pain
Symptoms of Endometriosis
- Infertility
Symptoms of Endometriosis
- Dys-Group
Symptoms of Endometriosis
- Menstrual Disturbances
As menorrhagia or polymenorrhagia.
Signs of Endometriosis
refer to the gross appearance above.
INvx for Endometriosis
INvx for Endometriosis
- Laparoscope
INvx for Endometriosis
- Lab
Serum CA 125 โincreased in endometriosis.
INvx for Endometriosis
- Rad
INvx for Endometriosis
- Histopathology (Bx)
ME
Prophylaxis for Endometriosis
Active TTT of Endometriosis
Active TTT of Endometriosis
- Expectant Medical TTT
Expectant Medical TTT Endometriosis
- NSAIDs
as pain killers and being anti-PGs.
Expectant Medical TTT Endometriosis
- Ovarian Suppression
Ovarian Suppresion as TTT of Endometriosis
- Pseudo-Pregnancy
Ovarian Suppresion as TTT of Endometriosis
- Pseudo-Menopause
Danazol in TTT of Endometriosis
- Structure
- Eff
- MOA
- SE
GnRH Agonists in TTT of Endometriosis
- Examples
- MOA
- SE
GnRH Antagonists in TTT of Endometriosis
- Examples
- Route of Adminstration
- Advantages
Surgical TTT of Endometriosis
Surgical TTT of Endometriosis
- Conservative
Conservative Surgical TTT of Endometriosis
- Indications
- young age needing further pregnancy.
Conservative Surgical TTT of Endometriosis
- Methods
Radical Surgical TTT of Endometriosis
Radical Surgical TTT of Endometriosis
- Indications
Radical Surgical TTT of Endometriosis
- Methods
Def of Adenomyosis
- It is the presence of endometrial glands and stroma in the myometrium, with adjacent smooth muscle hyperplasia.
Incidence of Adenomyosis
- Total
- Age
- Parity
- Race
Etiology of Adenomyosis
NE of Adenomyosis
ME of Adenomyosis
CP of Adenomyosis
CP of Adenomyosis
- Symptoms
CP of Adenomyosis
- Signs
INVx for Adenomyosis
INVx for Adenomyosis
- US
INVx for Adenomyosis
- MRI
INVx for Adenomyosis
- Hysteroscopy
Sub endometrial cysts.
INVx for Adenomyosis
- Laparoscsopy
โฆ..
INVx for Adenomyosis
- Histopathology
Mostly from hysterectomy specimen
TTT of Adenomyosis
- Prophylactic
avoidance of predisposing factors
TTT of Adenomyosis
- Active
Active TTT of Adenomyosis
Active TTT of Adenomyosis
- Medical
Active TTT of Adenomyosis
- Surgical