Endométriose et douleur

Résumé L’endométriose est une maladie bénigne, très invalidante et fréquente, définie par la présence d’endomètre, épithélium et stroma, en situation ectopique. Sa physiopathologie, et celle des douleurs qui l’accompagnent, est mal connue. Les signes cliniques de cette pathologie hormonodépendante sont dysménorrhée, dyspareunie et douleur chronique. On distingue deux grands types d’endométriose: l’endométriose superficielle ou minime et les formes sévères ou infiltrantes. Même s’il n’existe pas de parallélisme anatomoclinique, on sait que les lésions infiltrantes sont plus souvent à l’origine de dyspareunie, de troubles digestifs ou urinaires associés. Le traitement est soit un traitement médical qui stoppe la maladie en induisant une aménorrhée, soit un traitement chirurgical qui consiste en une destruction ou une excision des lésions. Ce traitement chirurgical est le plus souvent réalisé par coelioscopie. Les indications respectives de ces deux traitements dépendent du type de lésion et des circonstances diagnostiques et cliniques. Abstract Endometriosis is a benign disease, very incapacitating and common disease that is characterised by the endometrium, epithelium and stroma existing in an ectopic presentation. The physiopathology of this disease and its associated painisnotwell known.The clinical symptomsof this hormone-dependent disease are dysmenorrhea, dyspareunia and chronic pain. There are two main types of endometriosis: superficial endometriosis and more severe forms of endometriosis. Although there are no anatomical and clinical similarities, deep lesions very often cause dyspareunia, and associated digestive or urinary disorders. Treatment is either medical, which stops the disease by inducing amenorrhea; or surgical, which involves destroying or excising the lesions. Surgery ismost commonly doneby laparoscopy. 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