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Endometriosis is a condition in where cells from the lining of uterus appear and flourish outside the uterine cavity most commonly on the layer which lines the abdominal cavity, the peritoneum The uterine cavity is lined with endometrial cells, which are under the influence of female HORMONES . Endometrial cells in areas outside the uterus are also influenced by hormonal changes and respond in a way that is similar to the cells found inside the uterus. Symptoms of endometriosis are pain and infertility. The pain often is worse with the menses and is the most common cause of secondary DYSMENORRHEA Endometriosis is typically seen during the reproductive years; it has been estimated that endometriosis occurs in roughly 6% to 10% of women. Symptoms may depend on the site of active endometriosis. Its main but not universal symptom is PELVIC PAIN in various manifestations. Endometriosis is a common finding in women with Endometriosis has a significant social and psychological impact. There is no cure for endometriosis, but it can be treated in a variety of ways, including pain medication, hormonal treatments, and surgery.
Symtoms of Endometriosis Dysmenorrhoea Severe pain during every menses requiring to take pain killer injections or tablets.Pain also affects daily routine activities. Chronic Pelvic PainSevere endometriosis also presents with severe chronic pain causing depression require repeated medical help.
Infertility Endometriosis also causes severe adhesions in internal genital organs like ovary and fallopian tube ,intestines causing their dysfunction leading to infertility. Dyspareunia Pain during sexual relationship or intercourse is common. Defecatory Pain Pain passing of stools present when endometriotic implants invades rectum and vaginal septum.
Diagnosis Clinical examination Pelvic examination may reveal cystic mass ,severe tenderness in vagina and lower abdomen.
Laboratory Testing Serum CA 125 is tumor marker elevated in endometriosis also increased cancer of Ovary.
Sonography Transvaginal sonography is the main stay of diagnosis of endometriosis. Ovarian Endometrioma is classically diagnosed. C.T. Scan And MRI also used for involvement of bowls and extent of disease. Diagnostic laparoscopy Primary method to diagnose endometriosis affirmatively. On Laparoscopy typical powder gun appearing implants ,chocolate cysts ,white endometriotic implants are seen.
Treatment Expectant Management For mild and asymptomatic women expectant treatment may be appropriate. Medical treatment Nonsteroidal Antiinflammatory Drugs like Ibuprofen,Mefenamic Acid Oral Contraceptive pills, Progesterone tablets Medroxy progesterone acetate,norethisterone ,dydrogestrone etc. GnRH Angonist Leoprolide acetate 3.75 mg given intramusculraly.
Surgical treatment Laparoscopic lesion removal and adhesiolysis is the main stay of treatment. Especially endometrioma removal . Hysterectomy with bilateral removal of Ovaries is definitive treatment. Treatment Related to Fertility Surgical ablation of Endometriosis followed by assisted reproduction treatment enhance fertility. Watch viedeo.