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In The Name of God
In The Name of God
Endometriosis
symptoms of endometriosis
• pelvic pain,
• infertility,
• pelvic mass
Treatment options
• ●Expectant management
• ●Analgesia
• ●Hormonal medical therapy
• •Estrogen-progestin oral contraceptives, cyclic or continuous
• •Gonadotropin-releasing hormone (GnRH) agonists
• •Progestins, given by an oral, parenteral, or intrauterine route
• •Danazol
• •Aromatase inhibitors
• ●Surgical intervention, which may be conservative (retain uterus
and ovarian tissue) or definitive (removal of the uterus and possibly
the ovaries)
• ●Combination therapy in which medical therapy is given
before and/or after surgery
• Laparoscopy is the gold standard for
establishing the diagnosis of endometriosis,
and provides an opportunity for conservative
surgical treatment.
• Therapeutic intervention is desirable at the
time of diagnosis to ablate or excise implants
and adhesions, thus potentially preventing or
delaying
• expectant management is considered
primarily for two groups of patients:
• women with no or minimal symptoms
• perimenopausal women
TREATMENT OF PELVIC PAIN
• empiric medical therapy prior to establishing a
definitive diagnosis by laparoscopy
• medical interventions neither enhance fertility
nor diminish endometriomas or adhesions
• Therefore, women with suspected
endometriomas and advanced stages of
disease, or infertility, are more appropriately
managed surgically.
• Analgesics
• Estrogen-progestin oral contraceptives
• GnRH agonists
• Progestins
• Danazol
• Aromatase inhibitors
Surgical management
• Surgery may be indicated for management of
endometriosis that cannot be treated with
medical therapy or to provide a definitive
diagnosis.
INDICATIONS
• Surgery allows both diagnosis and management for
women with known or suspected endometriosis.
Indications for surgery include: