PENATALAKSANAAN ENDOMETRIOSIS

Erna Suparman
In: JURNAL BIOMEDIK (JBM) · 2012 · vol. 4(2) · doi:10.35790/jbm.4.2.2012.754 · W4243593612
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This paper reviews endometriosis diagnosis via laparoscopy and ultrasound, discusses hormonal and surgical treatments including GnRH agonists and atraumatic surgery, and highlights ovulation induction's success in improving pregnancy rates.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This paper is a narrative overview of endometriosis, describing its pathology (endometrial tissue outside the uterine cavity) and downstream effects such as increased macrophage activity, bleeding that can cause adhesions, and resulting changes in tubal motility, pelvic pain, and infertility. It outlines diagnosis and treatment approaches at a high level, stating that laparoscopy is necessary to confirm diagnosis and that while transvaginal ultrasound is accurate, it provides limited help for detecting cystic masses in the parametrium. The paper reports that estrogen-based treatment is being abandoned due to risk of endometrial hyperplasia progressing to endometrial cancer, while danazol is described as effective via hormonal and immunologic effects, and it lists management steps including NSAIDs or oral contraceptives as first-line therapy, GnRH agonists with add-back therapy if needed, and operative laparoscopy in certain situations. Relevance to endometriosis: this paper is centrally about endometriosis—specifically its clinical features, diagnostic approach, and hormonal and surgical management options.

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Abstract

Abstract: Endometriosis is characterized by the occurence of endometrial cells outside the uterine cavity. Endometrial tissue in the pelvic cavity increases the activity of macrophages to phagocyte endometrial tissue debris and influences intrauterine implantation. Bleeding, arising from endometriosis lesions, will lead to adhesions with surrounding tissues, resulting in changes of tubal motility, pain, and infertility. Laparoscopy examination is necessary for confirming the diagnosis. While transvaginal ultrasound is famous for its accuracy, it provides just a little help for finding cystic masses in the parametrium. Nowadays, the treatment of endometriosis with estrogen is begining to be abandoned because it may cause endometrial hyperplasia that can develop into endometrial cancer. Albeit, danazol treatment succeeds due to its hormonal and immunologic effects. The first-line of therapy given for reducing pelvic pain is NSAIDs or oral contraceptives. If this fails, a GnRH agonist is given in combination with estrogen and progestin as an add-back therapy, otherwise an operative laparoscopy has to be done. Concerning the degree of severe and extensive endometriosis, atraumatic surgery is the main option. The induction of ovulation shows a satisfactory result. Randomized trials using the GnRH agonist administration associated with the hormones (FSH and LH), clomiphene citrate, and intrauterine insemination, showed an increased incidence of pregnancy compared to those without therapy.Key words: endometriosis, hormones, pain, infertilityAbstrak: Endometriosis ditandai adanya sel-sel endometrium di luar kavum uteri. Jaringan endometrium di dalam rongga pelvis akan meningkatkan aktifitas makrofag untuk memfagositosis debris jaringan endometriosis serta mempengaruhi nidasi intrauterin. Perdarahan yang timbul dari lesi endometriosis akan menyebabkan perlekatan dengan jaringan sekitarnya, yang berakibat perubahan motilitas tuba, nyeri, dan infertilitas. Laparoskopi sangat diperlukan untuk diagnosis endometriosis. USG transvaginal yang tersohor karena akurasinya hanya sedikit membantu menemukan lesi di daerah parametrium. Dewasa ini, pengobatan endometriosis dengan estrogen mulai ditinggalkan karena mengakibatkan hiperplasia endometrium yang dapat berkembang menjadi kanker endometrium. Keberhasilan pengobatan dengan danazol disebabkan karena efek hormonal dan imunologiknya. Terapi lini pertama pada nyeri pelvis ialah NSAID atau kontrasepsi oral. Bila gagal, diberikan agonis GnRH dikombinasi dengan estrogen dan progestin add-back therapy, atau laparoskopi operatif. Pada endometriosis derajat berat dan luas, pembedahan atraumatik merupakan pilihan utama. Induksi ovulasi memberikan hasil yang cukup memuaskan. Randomized trials pada pemberian GnRH agonis dengan hormon FSH dan LH, clomifen sitrat, serta inseminasi intrauterin, memperlihatkan peningkatan angka kehamilan dibandingkan pada yang tanpa terapi.Kata kunci: endometriosis, hormon, nyeri, infertilitas
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PENATALAKSANAAN ENDOMETRIOSIS DOI: https://doi.org/10.35790/jbm.4.2.2012.754Abstract Abstract: Endometriosis is characterized by the occurence of endometrial cells outside the uterine cavity. Endometrial tissue in the pelvic cavity increases the activity of macrophages to phagocyte endometrial tissue debris and influences intrauterine implantation. Bleeding, arising from endometriosis lesions, will lead to adhesions with surrounding tissues, resulting in changes of tubal motility, pain, and infertility. Laparoscopy examination is necessary for confirming the diagnosis. While transvaginal ultrasound is famous for its accuracy, it provides just a little help for finding cystic masses in the parametrium. Nowadays, the treatment of endometriosis with estrogen is begining to be abandoned because it may cause endometrial hyperplasia that can develop into endometrial cancer. Albeit, danazol treatment succeeds due to its hormonal and immunologic effects. The first-line of therapy given for reducing pelvic pain is NSAIDs or oral contraceptives. If this fails, a GnRH agonist is given in combination with estrogen and progestin as an add-back therapy, otherwise an operative laparoscopy has to be done. Concerning the degree of severe and extensive endometriosis, atraumatic surgery is the main option. The induction of ovulation shows a satisfactory result. Randomized trials using the GnRH agonist administration associated with the hormones (FSH and LH), clomiphene citrate, and intrauterine insemination, showed an increased incidence of pregnancy compared to those without therapy. Key words: endometriosis, hormones, pain, infertility Abstrak: Endometriosis ditandai adanya sel-sel endometrium di luar kavum uteri. Jaringan endometrium di dalam rongga pelvis akan meningkatkan aktifitas makrofag untuk memfagositosis debris jaringan endometriosis serta mempengaruhi nidasi intrauterin. Perdarahan yang timbul dari lesi endometriosis akan menyebabkan perlekatan dengan jaringan sekitarnya, yang berakibat perubahan motilitas tuba, nyeri, dan infertilitas. Laparoskopi sangat diperlukan untuk diagnosis endometriosis. USG transvaginal yang tersohor karena akurasinya hanya sedikit membantu menemukan lesi di daerah parametrium. Dewasa ini, pengobatan endometriosis dengan estrogen mulai ditinggalkan karena mengakibatkan hiperplasia endometrium yang dapat berkembang menjadi kanker endometrium. Keberhasilan pengobatan dengan danazol disebabkan karena efek hormonal dan imunologiknya. Terapi lini pertama pada nyeri pelvis ialah NSAID atau kontrasepsi oral. Bila gagal, diberikan agonis GnRH dikombinasi dengan estrogen dan progestin add-back therapy, atau laparoskopi operatif. Pada endometriosis derajat berat dan luas, pembedahan atraumatik merupakan pilihan utama. Induksi ovulasi memberikan hasil yang cukup memuaskan. Randomized trials pada pemberian GnRH agonis dengan hormon FSH dan LH, clomifen sitrat, serta inseminasi intrauterin, memperlihatkan peningkatan angka kehamilan dibandingkan pada yang tanpa terapi. Kata kunci: endometriosis, hormon, nyeri, infertilitas Downloads Published Issue Section License Penyunting menerima sumbangan tulisan yang BELUM PERNAH diterbitkan dalam media lain. Naskah yang masuk dievaluasi dan disunting keseragaman format istilah dan cara penulisan sesuai dengan format penulisan yang terlampir dalam jurnal ini. Segala isi dan permasalahan mengenai tulisan yang yang diterbitkan dalam jurnal menjadi tanggung jawab penuh dari penulis.

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