ENDOMETRIOSIS 2003

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MOHAMMED KASHIFGROUP:6YEAR:4


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Endometriosis is a condition where tissuesimilar to the lining of the uterus (theendometrial stroma and glands, which should

only be located inside the uterus) is foundelsewhere in the body.Example : - Ovaries,bladder, fallopian tubes

Lesions may occur at distant sites: pleural

cavity, liver, kidney, gluteal muscles, bladder,etc . 10% of all women during their reproductive

years are affected by endometriosis .

Affects an estimated 176 million womenworldwide re ardless of their ethnic and social


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Illustration of the organs inside awoman's abdomen, showing siteswhere endometriosis can develop.Possible sites are shown in blue.From top: abdominal wall,intestines, fallopian tubes, ovary,appendix, uterus, peritoneum,

cervix, rectum, bladder, vulva.


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The exact cause of endometriosis remainsunknown, many theories have been presentedto better understand and explain its

development. Estrogens Retrograde menstruation Mllerianosis

Coelomic Metaplasia Genetics Transplantation Immune system

Environment Birth Defect


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Endometriosis lesions react to hormonalstimulation and may "bleed" at the time ofmenstruation. The blood accumulates

locally, causes swelling, and triggersinflammatory responses with the activationof cytokines. It is thought that this processmay cause pain.

Pain can also occurfrom adhesions (internal scar tissue)binding internal organs to each other,causing organ dislocation. Fallopian tubes,ovaries, the uterus, the bowels, and the

bladder can be bound together in ways that


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Pelvic pain(acute or chronic) Infertility

DysmenorrheaDyspareuniaDysuria


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Constipation chronic fatigue heavy or long uncontrollable menstrual periods with

small or large blood clots gastrointestinal problems including diarrhea, bloating

and painful defecation extreme pain in legs and thighs pain from adhesions which may bind an ovary to the

side of the pelvic wall, or they may extend betweenthe bladder and the bowel,uterus, etc.

extreme pain with or without the presence of menses premenstrual spotting mild to severe fever headaches depression hypoglycemia (low blood sugar) anxiety


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Endoscopic image ofendometriotic lesions at

the peritoneum of thepelvic wall.

A small adhesion on anovary about to be removed

surgically


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Severe endometriosis on theback of the uterus causingadhesions of the bowel andpelvic organs

Endometriosis growingon the ovary andfallopian tube


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Complications of endometriosisinclude:

Internal scarringAdhesionsPelvic cystsChocolate cyst of ovariesRuptured cystBowel obstruction


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Pelvic exam.Ultrasound

MRILaparoscopy
http://images.google.com/imgres?imgurl=http://www.emedicine.com/radio/images/2277ultrasound.jpg&imgrefurl=http://www.emedicine.com/radio/topic250.htm&h=200&w=200&sz=10&hl=en&start=1&tbnid=lKBrQGzOiToZFM:&tbnh=104&tbnw=104&prev=/images?q=endometrioma&svnum=10&hl=en&lr=&sa=G


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Procedures are classified as conservative when reproductive organs

are retained -Cystectomy semi-conservative when ovarian function

is allowed to continue, and

radical when the uterus and ovaries areremoved Hysterectomy, Bilateralsalpingo-oophorectomy

Laparoscopy


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Use of fertility medication thatstimulates ovulation (clomiphene

citrate, gonadotropins) combinedwith intrauterine insemination (IUI)enhances fertility in the patients.

In-vitro fertilization (IVF) proceduresare effective in improving fertility inmany women with endometriosis


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Men can also develop endometriosisafter prolonged treatments involvingsynthetic estrogen

Reported cases in primates such asbaboons, African Green Monkeys, andRhesus Monkeys

Pharmaceutical companies cashing inon womens pain= 3 monthEndometriosis Kit $525.95 USD

Endometriosis has been removed fromareas other than the abdomen such asthe thigh, thumb, and knee


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This is a disease without a cure butwith the proper communication, a

woman with endometriosis canattempt to live a normal, functioninglife. Using cystectomy and ablativesurgery, pregnancy rates areapproximately 40%


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ENDOMETRIOSIS 2003

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