Common appearance of endometriosis

1
Common appearance of endometriosis
2
Etiology Theories

• Sampson Retrograde Menstruation
• Hematologic Spread
• Lymphatic Spread
• Coelomic Metaplasia
• Genetic Factors
• Immune Factors
• Combination of the Above
• No Single Theory Explains All Cases of
  Endometriosis

3
Age at Diagnosis
gt 45
lt 19
3
36 45
6
15
19 25
24
26 35
52
4
Prevalence
5
Common endometriosis related problems

• Dysmenorrhea, Chronic Pelvic Pain
• Infertility
• Deep Dyspareunia
• Pelvic Mass (Endometrioma)
• Other Tenesmus, Hematuria, Hemoptysis

6
In the USA, endometriosis is the leading
indication for hysterectomies in women aged 30-34
years.CDC data for 1980 - 1993
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Diagnosis

• Laparoscopy
• Laparotomy
• Inconclusive CA-125, Pelvic Exam, History,
  Imaging Studies, empiric medical therapy
• Biopsy Preferable Over Visual Inspection

8
Classification / Staging

• Several Proposed Schemes
• Revised AFS System Most Often Used
• Ranges from Stage I (Minimal) to Stage IV
  (Severe)
• Staging Involves Location and Depth of Disease,
  Extent of Adhesions