Scribd Logo
Upload

Welcome to Scribd!

  • 48 views

    Endometriosis & Adenomyosis Dr. Selly Septina, Spog

    Uploaded by

    RezkiRamadhan
    Endometriosis occurs when endometrial tissue grows outside the uterus, most commonly on the ovaries, ligaments, and pelvic peritoneum. It responds to changes in hormones and can cause pain, especially with menstruation and intercourse. While symptoms vary, common ones include painful periods, pain with deep penetration during sex, and infertility. Diagnosis is usually done through laparoscopy to visualize lesions. Treatment options include medications like hormonal contraceptives and GnRH agonists, as well as surgery. Adenomyosis involves the growth of endometrial tissue within the uterine muscle wall and causes heavy periods and pelvic pain. Hysterectomy is often the only effective treatment for adenomyosis.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    Endometriosis & Adenomyosis Dr. Selly Septina, Spog

    Uploaded by

    RezkiRamadhan
    48 views25 pages
    Endometriosis occurs when endometrial tissue grows outside the uterus, most commonly on the ovaries, ligaments, and pelvic peritoneum. It responds to changes in hormones and can cause pain, especially with menstruation and intercourse. While symptoms vary, common ones include painful periods, pain with deep penetration during sex, and infertility. Diagnosis is usually done through laparoscopy to visualize lesions. Treatment options include medications like hormonal contraceptives and GnRH agonists, as well as surgery. Adenomyosis involves the growth of endometrial tissue within the uterine muscle wall and causes heavy periods and pelvic pain. Hysterectomy is often the only effective treatment for adenomyosis.

    Original Description:

    fd

    Original Title

    Endometriosis and Adenomyosis1

    Copyright

    © © All Rights Reserved

    Available Formats

    PPT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Endometriosis occurs when endometrial tissue grows outside the uterus, most commonly on the ovaries, ligaments, and pelvic peritoneum. It responds to changes in hormones and can cause pain, especially with menstruation and intercourse. While symptoms vary, common ones include painful periods, pain with deep penetration during sex, and infertility. Diagnosis is usually done through laparoscopy to visualize lesions. Treatment options include medications like hormonal contraceptives and GnRH agonists, as well as surgery. Adenomyosis involves the growth of endometrial tissue within the uterine muscle wall and causes heavy periods and pelvic pain. Hysterectomy is often the only effective treatment for adenomyosis.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    48 views25 pages

    Endometriosis & Adenomyosis Dr. Selly Septina, Spog

    Uploaded by

    RezkiRamadhan
    Endometriosis occurs when endometrial tissue grows outside the uterus, most commonly on the ovaries, ligaments, and pelvic peritoneum. It responds to changes in hormones and can cause pain, especially with menstruation and intercourse. While symptoms vary, common ones include painful periods, pain with deep penetration during sex, and infertility. Diagnosis is usually done through laparoscopy to visualize lesions. Treatment options include medications like hormonal contraceptives and GnRH agonists, as well as surgery. Adenomyosis involves the growth of endometrial tissue within the uterine muscle wall and causes heavy periods and pelvic pain. Hysterectomy is often the only effective treatment for adenomyosis.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    You are on page 1of 25

    Endometriosis &

    Adenomyosis

    dr. Selly Septina, SpOG


    Description of
    Endometriosis
     presence of endometrial tissue, composed of
    glands and stroma, at sites outside
    endometrial cavity
     most common sites
    – ovary
    – broad ligament
    – cul-de-sac
    – rectovaginal septum
     endometrial tissue responds cyclically to estrogen
    – swelling
    – producing local inflammation
     severity of pain unrelated to extent of disease
    – There may be more pain associated with active lesions
    in mild disease than with adhesions in severe disease
     commonly occurs in women in 20’s and 30’s
    – tends not to occur before menarche or after menopause
     major cause of infertility
    Theories for Etiology
     Sampson’s theory of retrograde
    menstruation
     Halban’s lymphatic spread theory
     Meyer’s mullerian metaplasia theory
    – metaplasia of mesothelial cells into endometrial
    epithelium under some unidentified influence,
    such as repeated inflammation
     Hematogenous spread
    Epidemiology
     found equally among all races
     more likely to occur and progress in
    women with
    – early menarche
    – in those with menstrual flow exceeding seven
    days
    – cycles of less than 27 days
    – years of menstruation uninterrupted by
    pregnancy
    – family history of endometriosis
    Incidence

     10-15 % of women of reproductive age


     40-50 % of women undergoing surgery for
    evaluation of infertility
     average age at diagnosis is 28
    History
     most common symptoms
    – dysmenorrhea
    – dyspareunia (especially on deep penetration)
    – perimenstrual back pain
    – infertility
     other symptoms reported
    – dyschezia
    – abdominal pain
    – irregular bleeding patterns, especially pre-
    menstrual spotting
     less common symptoms
    – urgency in urination
    – hematuria
    – rectal bleeding
    Physical Exam Findings
     may appear normal if lesions = small & few
     advanced disease
    – cervical displacement of 1 cm or more to the
    left or right of midline
    – bimanual exam tenderness and nodularity of
    the uterosacral ligaments and posterior cul-de-
    sac are detected
    – adnexal masses that vary in size, shape, and
    consistency and may be asymmetric, fixed,
    cystic, or indurated
    – fixed retroversion of the uterus
    Endometriosis on /in the
    Ovary
     Forms a dark, chocolate cystic mass.
    Diagnostic Tests
     CA-125 elevated
     CBC normal
     Diagnostic laparoscopy

    http://medstat.med.utah.edu/kw/human_repro
    d/mml/hr08.html
    Differential Diagnoses
     chronic PID
     recurrent acute salpingitis
     hemorrhagic corpus luteum
     benign or malignant ovarian neoplasm
     ectopic pregnancy
     adenomyosis
    Treatment Plan
     psychosocial intervention
     medications
    – danazol
    – progestogens
    – combined Ocs
    – gonadotropin-releasing hormone agonists
    (GnRH-a)
    • Lupron injection qmo x 6 mos
    • Synarel nasal spray bid x 6 mos
     surgical interventions: conservative vs.
    definitive
    GnRH analogs
     Decreases secretion of gonadotropins
     Major concerns are…
    – Cost
    – Parenteral administration
    – Potential for accelerated bone mineral loss
    – Hot flashes & hypo-estrogen states
    Adenomyosis
     Growth of the glands & stroma within the
    myometrium (muscle wall)
     Affects the parous women over 40 y/o
     Etiology - downward growth of surface
    endometrium
    Adenomyosis - S &S
     Dysmenorrhea
     Menorrhagia
     Bulky, boggy, tender, uterus on exam : if
    menstruating, uterus may be board-like!
    Treatment of Adenomyosis
     Medical therapy used to treat endometriosis
    does not help!
     Abdominal Hysterectomy
     Will cease after menopause
    Thank You

    You might also like

    pFad - Phonifier reborn

    Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

    Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


    Alternative Proxies:

    Alternative Proxy

    pFad Proxy

    pFad v3 Proxy

    pFad v4 Proxy