Endometriosis

Endometriosis

• Highly variable and difficult in diagnosing
• Confirmation of diagnosis required "Laproscopy"
• It is the most common cause of Chronic Pelvic pain in the most developed countries
• Medical treatment only improved symptoms but not the fertility
• May associated with IBS

Usually delay in diagnosis from 8 to 10 YEARS with onset in adolescence.

• Cyclical abdominal and pelvic pain
• Dysmenorrhoea 60 ~80%
• Deep Dyspareunia 40~50%
• Infertility 30~50%
• Dysuria 5%
• Paniful abdominal bloating 10~40%

Dyspareunia esp. when the endometriomas are located in the cul-de-sac, the fornices or the uterosacral ligaments

Dyschezia (pain on defecation), +/- dysuria

hematochezia, hematuria, and premenstrual or postmenstrual spotting may be seen

In fact, 30-40% of infertile couples are diagnosed with endometriosis (secondary to adhesions, scar formation and cytokinase)

P/E typically reveals a tender adnexal mass and firm nodularity located in the broad ligaments, the uterosacral ligaments or in the cul-de-sac