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2024 | OriginalPaper | Hoofdstuk

35. Endometriosis

Auteurs : Dr. Marit C. I. Lier, MD/PhD, Dr. Lisette E. E. van der Houwen, Prof. dr. Velja Mijatovic

Gepubliceerd in: Textbook of Obstetrics and Gynaecology

Uitgeverij: Bohn Stafleu van Loghum

Summary

Endometriosis is a benign gynaecological disorder, characterised by endometrial-like tissue growing outside the uterine cavity under the influence of oestrogens. It affects 2–10 % of women of reproductive age. The exact pathogenesis is not entirely clear, but a complex multifactorial process of immunologic, inflammatory and hormonal factors seems to be involved. Endometriosis can be suspected based on clinical symptoms and findings by physical examination and/or imaging modalities. Surgical identification, including histological verification, is no longer the gold standard for the diagnosis. Currently, laparoscopy is recommended only in patients with negative imaging and/or where empirical treatment has failed. Since curative treatment options for endometriosis are not available, treatment is challenging. Symptomatic treatment of this chronic disease consists of analgesia, hormonal suppression therapy and surgical intervention. In infertile women, assisted reproductive techniques may be considered. A multidisciplinary and life course approach is advocated.

vorige hoofdstuk Benign ovarian mass

volgende hoofdstuk Cervical premalignancies and cervical cancer

Adenomyosis

The invasion of endometrial-like tissue into the myometrium, enlarging the uterine volume, with microscopically ectopic endometria! glands and stroma surrounded by hypertrophic and hyperplastic myometrium.

Assisted reproductive techniques (ART)

All fertility treatments in which sperm, eggs or embryos are handled.

Central sensitisation

Chronic pain associated changes in brain function and brain structure, resulting in an amplification and/or generation of endometriosis related pain.

Deep endometriosis

Endometriotic lesions extending more than 5 mm under the peritoneal surface and/or involving bowel, bladder, ureter or vagina.

Endometriosis

A common benign gynaecological disorder. It is defined as the presence of endometrial-like tissue (glands and stroma) outside the uterine cavity, growing by the influence of oestrogens, inducing a chronic inflammatory reaction.

Infertility

The inability to conceive after at least 1 year of unprotected intercourse.

Intrauterine insemination (IUI)

Artificial insemination of washed and concentrated sperm, which is directly placed in the uterus during ovulation.

In vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI)

Fertilisation of an egg with sperm in a laboratory setting.

Ovarian endometriosis (or endometriomas)

Cysts formed by deposits of endometriosis within the ovary.

Peritoneal endometriosis

The presence of deposits of endometrial glands and stroma on the pelvic peritoneal surface and ovaries.

Sampson’s theory

Theory about the pathogenesis of endometriosis based on observations of shed endometrial cells into the abdominal cavity through the fallopian tubes.

Spontaneous Hemoperitoneum in Pregnancy (SHIP)

Spontaneous non-traumatic intraperitoneal bleeding during pregnancy (up to 42 days postpartum).

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Titel: Endometriosis
Auteurs: Dr. Marit C. I. Lier, MD/PhD
Dr. Lisette E. E. van der Houwen
Prof. dr. Velja Mijatovic
Uitgeverij: Bohn Stafleu van Loghum
Boek: Textbook of Obstetrics and Gynaecology
Print ISBN: 978-90-368-2993-9

Elektronisch ISBN: 978-90-368-2994-6

Copyright: 2024
DOI: https://doi.org/10.1007/978-90-368-2994-6_35

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