EndometriosisEndometriosis

Sanja Sanja NačinovićNačinović

Mentor: A. Žmegač Mentor: A. Žmegač HorvatHorvat

DefinitionDefinition

• endometrial-like cells appear in areas endometrial-like cells appear in areas outside the uterine cavityoutside the uterine cavity

• endometrial-like cells are influenced endometrial-like cells are influenced by hormonal changes by hormonal changes

Epidemiology Epidemiology

• typically seen during the typically seen during the reproductive years reproductive years

• occurs in roughly 5-10% of women occurs in roughly 5-10% of women

Sings and symptomsSings and symptoms

Pelvic pain

Dysmenorrhea Chronic pelvic pain Dyspareunia

InfertilityInfertility

• link between infertility and link between infertility and endometriosis remains enigmatic endometriosis remains enigmatic

Other symptomsOther symptoms

• constipationconstipation

• chronic fatigue chronic fatigue

• mild to severe fever mild to severe fever

• headaches headaches

• depression depression

• hypoglycemia (low blood sugar) hypoglycemia (low blood sugar)

• anxiety anxiety

CausesCauses

• the exact cause of endometriosis the exact cause of endometriosis remains unknown remains unknown

• Retrograde menstruationRetrograde menstruation

• Coelomic metaplasiaCoelomic metaplasia

• GeneticsGenetics

• TransplantationTransplantation

• EnvironmentEnvironment

How to diagnose it?How to diagnose it?

• laparotomylaparotomy

• laparoscopylaparoscopy

• ultrasoundultrasound

Co-morbidityCo-morbidity

• ovarian cancerovarian cancer

• non-Hodgkin's lymphoma non-Hodgkin's lymphoma

• leiomyomaleiomyoma

• autoimmune disorders autoimmune disorders

• hypothyroidismhypothyroidism

Possible locationsPossible locations

• ovariesovaries

• fallopian tubes fallopian tubes

• back of the uterus back of the uterus

• front of the uterus front of the uterus

• uterine ligaments uterine ligaments

• pelvic and back wall pelvic and back wall

• intestines intestines

• urinary bladder and ureters urinary bladder and ureters

StagingStaging

• Stage I (minimal) Stage I (minimal)

• Stage II (mild) Stage II (mild)

• Stage III (moderate) Stage III (moderate)

• Stage IV (severe) Stage IV (severe)

MarkersMarkers

• high levels of estrogen high levels of estrogen

• low levels of progesterone low levels of progesterone

• antigen C-125antigen C-125

TreatmentsTreatments

1.1. hormonal medications - progestins, hormonal medications - progestins, oral contraceptives, Danazol, oral contraceptives, Danazol, aromatase inhibitorsaromatase inhibitors

2.2. other medications - NSAID, other medications - NSAID, DiclofenacDiclofenac

• surgery- excision, hysterectomy, surgery- excision, hysterectomy, presacral neurectomypresacral neurectomy