Endometriosis

In: Diagnostic Criteria in Autoimmune Diseases · 2008 · pp. 271–275 · doi:10.1007/978-1-60327-285-8_51 · W4246447368
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Endometriosis, a common estrogen-dependent disorder causing pelvic pain and infertility, is diagnosed via laparoscopy and treated with medication or surgery to alleviate symptoms and improve quality of life.

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This paper is a narrative overview defining endometriosis as a benign, estrogen-dependent gynecologic disorder linked to pelvic pain and infertility, and it reviews reported incidence among women undergoing surgery for pain and/or infertility. It summarizes proposed serum markers (e.g., CA-125, CA-19.9, sICAM-1, PP14, IL-6) while stating that none have sufficient diagnostic accuracy for clinical use, and it contrasts clinical suspicion with lesion confirmation by imaging and laparoscopy as the gold standard. It also describes treatment options, noting that medical therapy primarily targets pain without evidence of reducing lesion extent, and that exogenous estrogens should be avoided, while surgical excision via laparoscopy can improve pain and quality of life. This paper is centrally about endometriosis — it focuses on diagnostic criteria and diagnostic/treatment limitations for endometriosis.

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Abstract

Endometriosis is a benign, estrogen-dependent, gynecological disorder associated with pelvic pain and infertility. It affects between 10 and 47% of women undergoing surgery because of pain symptoms and/or infertility. Pain and infertility represent the major clinical problems of women with endometriosis. Several serum markers have been proposed for the diagnosis of endometriosis (including CA-125, CA-19.9, sICAM-1, PP14, and IL-6), but none of them has been proved to have sufficient accuracy to be used in clinical setting. It is possible to suspect the presence of endometriosis on the basis of patient’s history and gynecological examination, but imaging techniques are required to confirm the presence of the lesions and establish the severity of the disease. The gold standard for the diagnosis of endometriosis is the visual inspection of the pelvis at laparoscopy. The treatment of endometriosis may be medical, surgical or combined. Medical therapy aims primarily to decrease the intensity of pain symptoms but there is no evidence that it can reduce the extent of the lesion; exogenous estrogens should be avoided. Surgical excision of endometriotic lesions is associated with improvements not only in pain symptoms but also in quality of life, and it can usually be performed by laparoscopy.
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Abstract

Endometriosis is a benign, estrogen-dependent, gynecological disorder associated with pelvic pain and infertility. It affects between 10 and 47% of women undergoing surgery because of pain symptoms and/or infertility. Pain and infertility represent the major clinical problems of women with endometriosis. Several serum markers have been proposed for the diagnosis of endometriosis (including CA-125, CA-19.9, sICAM-1, PP14, and IL-6), but none of them has been proved to have sufficient accuracy to be used in clinical setting. It is possible to suspect the presence of endometriosis on the basis of patient’s history and gynecological examination, but imaging techniques are required to confirm the presence of the lesions and establish the severity of the disease. The gold standard for the diagnosis of endometriosis is the visual inspection of the pelvis at laparoscopy. The treatment of endometriosis may be medical, surgical or combined. Medical therapy aims primarily to decrease the intensity of pain symptoms but there is no evidence that it can reduce the extent of the lesion; exogenous estrogens should be avoided. Surgical excision of endometriotic lesions is associated with improvements not only in pain symptoms but also in quality of life, and it can usually be performed by laparoscopy. Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

References

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