Obstetrics and Gynecology for Medical Students
Endometriosis
10
Quick facts
by Daniel Kozan
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What is the incidence?
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15-30% of premenopausal women
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What are the risk factors? (4)
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1. family history
2. obstructive anomalies of the genital tract
3. nulliparity
4. age >25 years
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What is the most common site of occurrence?
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ovaries
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What are the main symptoms? (2)
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1. cyclic perimenstrual pain
2. infertility (30-40%)
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What is a chocolate cyst?
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an endometrioma - a cyst that contains classic chocolate-colored fluid
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How is the definitive diagnosis established?
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laparoscopy & biopsy
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What are mulberry spots?
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dark blue or brownish-black implants in the pelvis (uterosacral ligaments, cul-de-sac, or elsewhere)
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What blood test can you use for detecting endometriosis, and as a marker of response to therapy?
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CA-125
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What medical treatment options are there? (5)
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1. NSAIDs i.e. naproxen
2. OCP
3. Depo-Provera
4. danazol (weak androgen)
5. leuprolide (GnRH agonist)
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What is the definitive treatment?
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laparoscopic ablation/resection of implants, lysis of adhesions, cystectomies
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