Diagnosis and Management of Endometriosis

Endometriosis is a chronic, benign gynecologic condition, affecting up to 10% of reproductive-age women. It is characterized by the abnormal presence of endometrial glands and stroma outside of the uterus. Clinically, endometriosis is associated with dysmenorrhea, pelvic pain, and/or infertility. The diagnosis of endometriosis can be suggested based on history and physical examination, but the gold standard for diagnosis is histologic confirmation from a surgical biopsy. The stages of endometriosis are determined based on the extent of disease intraoperatively. However, the stages of disease do not always correlate well with symptom severity. Treatments include pain management, hormonal suppression, and/or surgical intervention. Treatment decisions must be individualized to each patient, taking into consideration her symptoms and her plans for future fertility. Endometriosis presents a challenging problem to affected women and their gynecologists. As such, there continues to be investigation into the pathogenesis and potential treatments of the condition. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

ACOG Practice Bulletin. Management of endometriosis. Number 114, July 2010. Available from: www.acog.org Albee Jr RB, Sinervo K, Fisher DT. Laparoscopic excision of lesions suggestive of endometriosis or otherwise atypical in appearance: relationship between visual findings and final histologic diagnosis. J Minim Invasive Gynecol. 2008;15(1):32–7. Burney RO, Giudice LC. Pathogenesis and pathophysiology of endometriosis. Fertil Steril. 2012;98(3):511–9. Chiang HJ, et al. The impact of previous ovarian surgery on ovarian reserve in patients with endometriosis. BMC Womens Health. 2014;15:74. de Venecia C, Ascher SM. Pelvic endometriosis: spectrum of magnetic resonance imaging findings. Seminars in Ultrasound, CT MRI. 2015;36(4):385–93. Fritz MA, Speroff L. Clinical gynecologic endocrinology and infertility, 8th ed. Lippincott Williams and Wilkins; 2011. Hornstein M, Gibbons W, Barbieri R, Eckler K. Gonadotropin releasing hormone agonists for long-term treatment of endometriosis. Available on www.uptodate.com. Last updated 25 Aug 2015. Kim HS, Kim TH, Chung HH, Song YS. Risk and prognosis of ovarian cancer in women with endometriosis: a meta-analysis. Br J Cancer. 2014;110(7):1878–90. Macer ML, Taylor HS. Endometriosis and infertility: a review of the pathogenesis and treatment of endometriosis-associated infertility. Obstet Gynecol Clin N Am. 2012;39(4):535–49. Marcoux S, Maheux R, Bérubé S. Laparoscopic surgery in infertile women with minimal or mild endometriosis. Canadian Collaborative Group on Endometriosis. N Engl J Med. 1997;337(4):217–22. Mounsey A, Wilgus A, Slawson D. Diagnosis and management of endometriosis. Am Fam Physician. 2006;74(4):594–600. Practice Committee of American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis. Fertil Steril. 2008;90:S260. Practice Committee of American Society for Reproductive Medicine. Endometriosis and infertility: A committee opinion. Updated 2012. Available from: www.asrm.org/guidelines Sainz de la Cuesta R, Eichhorn JH, Rice LW, Fuller Jr AF, Nikrui N, Goff BA. Histologic transformation of benign endometriosis to early epithelial ovarian cancer. Gynecol Oncol. 1996;60(2):238–44. Santulli P, et al. Increased serum cancer antigen-125 is a marker for severity of deep endometriosis. J Minim Invasive Gynecol. 2015;22(2):275–84. Schenken RS, Barbieri RL, Eckler K. Overview of the treatment of endometriosis. Updated July 2013. Available from: http://www.uptodate.com Schenken RS, Barbieri RL, Eckler K. Endometriosis: pathogenesis, clinical features, and diagnosis. Updated November 2015. Available from: http://www.uptodate.com Shin J, Howard FM. Management of chronic pelvic pain. Curr Pain Headache Rep. 2011;15:377–85. Sinaii N, Cleary SD, Ballweg ML, Nieman LK, Stratton P. High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis. Hum Reprod. 2002;17(10):2715–24. Smorgick N, Marsh CA, As-Sanie S, Smith YR, Quint EH. Prevalence of pain syndromes, mood conditions, and asthma in adolescents and young women with endometriosis. J Pediatr Adolesc Gynecol. 2013;26(3):171–5. Somigliana E, Berlanda N, Benaglia L, Viganò P, Vercellini P, Fedele L. Surgical excision of endometriomas and ovarian reserve: a systematic review on serum antimüllerian hormone level modifications. Fertil Steril. 2012;98(6):1531–8. Taylor HS, Osteen KG, Bruner-Tran KL, et al. Novel therapies targeting endometriosis. Reprod Sci. 2011;18(9):814–23. Vercellini P, Viganò P, Somigliana E, Fedele L. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol. 2014;10(5):261–75. Vignali M, et al. Surgical excision of ovarian endometriomas: does it truly impair ovarian reserve? long term anti-müllerian hormone (AMH) changes after surgery. J Obstet Gynaecol Res. 2015;41(11):1773–8. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2017 Springer International Publishing AG About this entry Cite this entry Kelley, A.S., Moravek, M.B. (2017). Diagnosis and Management of Endometriosis. In: Shoupe, D. (eds) Handbook of Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-319-17798-4_29 Download citation DOI: https://doi.org/10.1007/978-3-319-17798-4_29 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-319-17797-7 Online ISBN: 978-3-319-17798-4 eBook Packages: MedicineReference Module Medicine