ENDOMETRIOSIS

Presented by Ritika
&
Vrushali Dharmendra Bhaiya
What is Endometriosis?
Endometriosis is most commonly found on
the pelvic peritoneum but may also be
found on the ovaries, rectovaginal septum,
ureter, and rarely in the bladder,
pericardium, and pleura.

Hormonally dependent
disease
Chiefly found in reproductive aged women
 Adenomyosis
Endometrial tissue located within the myometrium is termed
adenomyosis

Focal Diffuse
Signs and Symptoms
Dysmenorrh
ea

Pain with
Ovulation

Chronic
pelvic pain

Dyspareunia

Infertility
 Differential Diagnosis
Gynecologic

Pelvic inflammatory disease (Tubo-ovarian abscess, Salpingitis,

Endometritis )
Hemorrhagic ovarian cyst
Ovarian torsion
Primary dysmenorrhea
Degenerating leiomyoma

Nongynecological

Interstitial cystitis,
Chronic urinary tract infection,
Renal calculi,
Inflammatory bowel disease,
Irritable bowel syndrome,
Diverticulitis,
Diagnosis
History

Visual
inspection

Sonography

MRI

Markers –
CA 125
 Diagnosis

Gold standard-Diagnostic Laparoscopy

 Treatment
Observation
• preserves ovarian function
Surgery
• avoids surgical risk.
• definitive diagnosis,
• The risks of observation include lack of histologic
• symptom relief,
diagnosis,
• exclusion of malignancy
• inability to exclude malignancy,
• Risks of surgical resection
• potential for disease progression.
include potential decreased
ovarian reserve after
resection
Conservative
• standard surgical risks
• Nonsteroidal Anti-Inflammatory Drugs
• Combination Oral Contraceptives
• Progestins
• GnRH Agonists
Postoperative Management

Oral contraceptive therapy greater

than six months duration reduces
endometrioma recurrence