Uterine disorders Flashcards
Defintion of Endometriosis?
The presence of endometrial glands and stroma outside the endometrial cavity and uterine musculature causes an inflammatory response
What is Endometriosis a risk factor for?
Ovarian cancers
What is the pathophysiology (reasoning) for endometriosis?
Retrograde menstruation
o Retrograde flow of endometrial tissue through fallopian tubes and peritoneum
Deficient cell immunity
Hereditary
Risk factors for Endometriosis?
−Nulliparity (never pregnant) −Prolonged exposure to endogenous estrogen −Heavy menstrual bleeding −Obstruction of menstrual outflow −DES exposure in utero (Diethyst..) −Height greater than 68 inches −Lower BMI −High consumption of unsaturated fat
Clinical presentation of Endometriosis?
- Premenstrual pelvic pain–> pain subsides after menses
- Infertility in 30-40%
- Dysmenorrhea
- Dypareunia (pain with intercourse)
What are physical exam findings found in endometriosis?
Tenderness / nodules at posterior cul-de-sac
Fixed or retroverted uterus (2o to adhesions)
o Cervix displaced laterally
Endometriomas cause adnexal masses or tenderness
How is Endometriosis diagnosed definitively.
Need to see lesions with Laparoscopy
What is seen on Laparoscopy when diagnosing endometriosis?
MC site will be the ovaries
Chocolate cysts
Which tumor marker can support the diagnosis of endometriosis?
CA-125
Treatments for Endometriosis in mild diseases?
NSAIDS and OCPs
Treatment for MOderate to severe Endometriosis?
OCPs
Progestiins
GnRH agonists
Which population is most likely to have Uterine Fibroids?
African american women
Clinical presentation of Uterine fibroids
Abnormal uterine bleeding
What is Adenomyosis?
overgrowht of the endometrial glands and stroma into the uterine myometrium
Clinical Presentation of Adenomyosis?
Menorrhagia (more severe than fibroids) Dysmenorrhea Pelvic pain History of previous uterine surgery (C - section) Prior myomectomy