Endometriosis: current management

Lu PY, Peter Y. Lu, P Y Lu, S J Ory, Steven J. Ory
Mayo Clinic proceedings · 1995 · vol. 70(5) , pp. 453–463 · doi:10.4065/70.5.453 · PMID:7731255 · W1977583704
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This review details current therapeutic strategies for endometriosis, focusing on hormonal, surgical, and pain management approaches.

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Abstract

OBJECTIVE: To review the clinical features, theories of pathogenesis, and current treatment of endometriosis-associated pain and infertility. DESIGN: We review the manifestation of endometriosis and the possible mechanisms that lead to its symptoms, examine the efficacy of current therapeutic options for pelvic pain and infertility, and provide specific recommendations for treatment based on the current literature. MATERIAL AND METHODS: Endometriosis is the presence of hormonally responsive endometrial tissue occurring outside the uterine cavity. This condition may be asymptomatic but is often found in association with pelvic pain or infertility (or both). The precise pathogenesis has not been clearly established but likely involves retrograde menstruation with subsequent seeding of endometrial glands at extrauterine sites. The definitive diagnosis and staging of endometriosis are performed by laparoscopy. Various strategies have been used to treat endometriosis including expectant, medical, surgical, and combination management. RESULTS: The efficacy of treatment varies for pelvic pain and infertility. Endometriosis-associated pain may respond to both medical and surgical management. The use of medical therapy for endometriosis-associated infertility is not supported by current studies. Surgical management of infertility may be efficacious when pelvic anatomy is distorted because of endometriosis. The use of superovulation strategies and in vitro fertilization has been shown to be effective in overcoming endometriosis-associated infertility. CONCLUSION: Pelvic pain and infertility in the presence of endometriosis necessitate individualization of therapy to achieve treatment goals. Neither medical nor surgical management is efficacious in all circumstances. As a better understanding of the pathogenesis of endometriosis evolves, treatment of this perplexing condition will probably continue to improve.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Adult Adult CA-125 Antigen CA-125 Antigen CA-125 Antigen Endometriosis Endometriosis Endometriosis Endometriosis Female Female Fertilization in Vitro Fertilization in Vitro Hormones Hormones Hormones Humans Humans Hysterectomy

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (75)

Cited by (50)

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License: CC0 · commercial use OK