Endometriosis

Proliferation and functioning of endometrial tissue outside of the uterine cavity

Risks:

  • Nulliparity
  • Age > 25 yo
  • Family history
  • Obstructive anomalies of genital tract

Most often occurs on the ovaries, but may be anywhere.

Symptoms

Gyne

  • Pelvic pain
  • Deep dyspareunia
  • 2O dysmenorrhea
  • Prementrual/Postmenstrual spotting
  • Uterus (fixed, retroverted)
  • Infertility
  • Adnexal mass (endometrioma) firm and fixed

Surgical diagnosis (Mulberry spots, chocolate cysts)



 

Treatment

Medications

  • Pseudopregnancy with OPC/Provera
  • Pseudomenopause with Danazol (androgen) and Lupron (GnRH agonist)

Surgery

  • Electrocautery/laser
  • Excision, lysis, drain
  • TAH BSO

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