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Obs-Gyne Department
“tract obstruction”
Pathogenesis (several theories)
5.”Induction Theory”
The induction theory proposes that some hormonal or biologic
factor(s) may induce the differentiation of undifferentiated
cells into endometrial tissue.
Epidemiology
The true prevalence of endometriosis in the general population
is unknown
approximately 1% of women undergoing major surgery for all
gynecologic indications
•6% to 43% of women undergoing sterilization
•12% to 32% when laparoscopy is performed to determine the
cause of pelvic pain in reproductive-age women
•21% to 48% of women undergoing laparoscopy for infertility
Adhesions
Bladder
Rectum
Vagina
Pelvic Pain
Dysmenorrhea
Dyspareunia
Dysuria
Infertility
Abnormal uterine Bleeding
Defecatory Pain
The type and severity of symptoms are dependent on the
extent of disease, the location, and the organs involved.
Clinical presentation
Clinical Signs
Localized tenderness in the cul-de-sac or uterosacral
ligament.
Treatment
Surgical Combination
therapy therapy
Expectant Management
Avoiding specific therapy is considered when patients :
- have minimal or no symptoms
- have suspected minimal or mild endometriosis
Drugs:
Progestins
Continuous oral contraceptives
Danazol
GnRH analogues
Medical therapy
Progestins:
inhibit endometriotic tissue growth
Mecanism.
inhibit pituitary gonadotropin secretion and ovarian hormone
production.
Treatment:
Medroxyprogesterone acetate (10 mg three times a day)
Or
Norethindrone acetate (5 mg daily for 2 weeks), increased by 2.5
mg per day every 2 weeks until a daily dose of 15.0 mg is
reached.