[Treatment of genital endometriosis].

This article combines the authors experience with 49 cases of endometriosis treated in 3 years with a review on historical theories medical and surgical treatment progestagen dose and side effects and indications classified by sites of endometriosis. Historically theories of embryoinc dysplasia metaplasia diverticulation and implantation have been proposed to account for endometriosis. Surgical treatment can range from radical hysterectomy and ovariectomy which is curative in almost all cases to subtotal hysterectomy or partial tubectomy with improvement in 50-60% and cures in 20-30%. Medical treatments in the past included x-ray estrogens or androgens. Now progestagens alone or more commonly combined with estrogens are prescribed either cyclically or continuously for 6-12 months (pseudopre gnancy). The authors usually prescribed 1-2 tablets of Metrulene daily; in 4 cases of intolerance they prescribed Lutometrodiol a pure progestagen. Common side effects are edema nausea aggravation of cystic mastitis (in 2 of the authors patients) and increased uterine volume with metrorrhagia (4 cases). Endometriosis should be diagnosed by celioscopy and histology: it is very common when sought systematicall y and is found in 10% of gynecologic laparotomies. The authors usually prescribed progestagens first to suppress the lesions. They encountered 2 tubal 5 ovarian 24 peritoneal and 2 perineal localizations. They concluded that progestagens alone almost never cure endometriosis.