Diagnosis and Management of Endometriosis

In: Handbook of Gynecology · 2023 · pp. 363–372 · doi:10.1007/978-3-031-14881-1_29 · W4389235492
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Endometriosis is a common gynecologic condition characterized by endometrial tissue outside the uterus, causing pain and infertility, with diagnosis confirmed histologically and treated with pain management, hormonal suppression, or surgery.

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This chapter reviews the diagnosis and management of endometriosis, describing how the condition—aberrant endometrial glands and stroma outside the uterus—affects up to 10% of reproductive-age women and is associated with dysmenorrhea, pelvic pain, and/or infertility. It outlines high-level approaches in which diagnosis may be suggested by history and physical examination but requires histologic confirmation from surgical biopsy as the gold standard, while disease staging is based on intraoperative extent despite imperfect correlation with symptom severity. The chapter summarizes treatment options including pain management, hormonal suppression, and/or surgical intervention, emphasizing that treatment decisions must be individualized based on symptoms and future fertility plans. This paper is centrally about endometriosis — it focuses on clinical diagnosis standards and an overview of management strategies.

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Abstract

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

References

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