2. ENDOMETRIOSIS
DEFINATION:
Presence of Functioning endometrium (gland and
stroma) in site other than uterine mucosa is called
endometriosis.
It is mot neoplastic condition, although malignant
transformation is possible.
3. PREVALENCE
The prevalence is about 10% of all
women between menarche and
menopause
The prevalence increase both in term of
real and apparent.
4. SITE
ABDOMINAL: it can occur at any site but mainly
confined to the abdominal structure below the level of
umblicus.
EXTRA-ABDOMINAL:- the common site are
abdominal scar of hysterotomy, CS, espisiotomy scar,
vagina and cervix.
REMOTE:- umblicus, lungs, pleura, ureter, kidney,
arms, legs, nasal mucosa
8. INVESTIGATIONS
CT & MRI: identical picture as in USG
COLOUR DOPPLER FLOW: Increased Vascularity
CYTOSCOPY: involvement of bladder
SIGMOIDOSCOPY: if the women develops bowel
symptoms
9. DIAGNOSIS
EXAMINATION
on bimanual pelvic examination, fixed
retroverted uterus, bilateral pelvic tenderness,
fixed or enlarged ovaries and painful
uterosacral nodularity
11. SURGERY
Laparotomy:
In advcanced & larger lesions if medical therapy fails
Inspect the letral side wall, all ovarian surface, both side of
the broad ligament, the bladder, bowel serosa, inferior
aspect of cul-de-sac
Total hysterectomy & B/L oophorectiomy:
Women with severe symptoms & those with fertility is not a
problems.