Click here to view next page of this article

Endometriosis

Ten percent of women will develop endometriosis characterized by the presence of endometrial tissue at sites outside the endometriosis, pelvic pain, dysmenorrhea, menstrual pain uterine cavity. The ectopic endometrial cells cause the cyclical dysmenorrhea of endometriosis.

The most common sites are the ovaries, posterior cul-de-sac, uterosacral ligaments, posterior broad ligament, and anterior cul-de-sac. The uterine serosa, rectovaginal septum, cervix, vagina rectosigmoid, endometriosis, pelvic pain, dysmenorrhea, menstrual pain and bladder are less frequent locations.

Endometriosis is characterized by cyclical pain, usually beginning prior to menses. Deep dyspareunia and sacral backache with menses are common.

Infertility is a frequent consequence of endometriosis. Premenstrual tenesmus or diarrhea may indicate rectosigmoid endometriosis. Cyclic dysuria or hematuria may indicate bladder endometriosis.

Diagnosis

Tender nodules are often palpable through the posterior vaginal fornix on bimanual examination and along the uterosacral ligaments on rectovaginal examination. Ovarian enlargement, fixation of the adnexal structures, and uterine retrodisplacement may also be detected.

Ultrasound may identify adnexal masses.

Endometriosis can be treated.