Endometriosis

Download a presentation by Hima Kandimalla of Mount Hope Women's Hospital in Trinidad and Tobago.

Presentation by David B. Toub, MD.

Educational tutorial on endometriosis.

Endometriosis-An Overview Prof. Dr. Mohammad A. Emam Prof. of Obstetrics and Gynecology Mansoura Faculty of Medicine Mansoura Integrated Fertility Center (MIFC) EgyptEmam MA, EGYPT, 2003

Hysterectomy is one of the most common abdominal surgical procedures performed in women today with 600,000 hysterectomies in the USA annually, one in three women undergoing hysterectomy, and 6–20% in European countries.

The largest study to date of endometriosis in pregnant women has found that the condition is a major risk factor for premature birth, the 25th annual conference of the European Society of Human Reproduction and Embryology heard today (Wednesday July 1).

Neutrophils infiltrate the endometrium pre-menstrually and after long-term progestin only-contraceptive (LTPOC) treatment. Trafficking of neutrophils involves endothelial cell-expressed intercellular adhesion molecule (ICAM-1).

Many of the fibroid and endometriosis patients I see in my medical practice complain of major stress along with their physical symptoms. My personal impression as a physician who has worked with women patients for close to 20 years is that stress is a significant component of many recurrent and chronic health problems, including fibroids and endometriosis.

The Relationship Between Transvaginal Sonogram and Hysteroscopy Findings in the Assessment of Endometrial Lesions in Postmenopausal Bleeding: A Case Study

It has been reported that approximately 670,000 hysterectomies are performed each year in the United States. Close to one third (more than 200,000) of these operations are done because of intractable menorrhagia not responsive to medical therapy or to dilation and curettage. The Nd:YAG laser was first used by Goldrath and colleagues showing that this laser can photocoagulate the endometrium and the menstrual flow reduced to little or none.

Over the past decade, a technique has been developed that can reduce or stop your periods without a hysterectomy. This surgery can be done in women who have flooding either with or without fibroid tumors. Dr. Dott was one of the surgeons who introduced this minimally invasive procedure in Atlanta. He has performed this procedure many times and is certified by the Accreditation Council for Gynecological Endoscopy in Advanced Hysteroscopic Surgery. He has taught this procedure in training institutions both in the United States and Russia.

Endometriosis is a gynecological disease affecting women in their reproductive years. The reported incidence of endometriosis among infertile women is 20-50%, and 39-59% among those with pelvic pain. This is in contrast to 15-18% incidental findings of endometriosis among women undergoing tubal sterilization. The question of whether endometriosis causes infertility has been a subject of debate for many years. In this review, the association between infertility and endometriosis and the treatment are discussed.

Diagnosis and treatment of endometriosis is the most frequent reason for gynecologic operative laparoscopy in the United States (Peterson et al,1990). Therefore, the laparoscopist must be thoroughly familiar with the current standards of diagnosis and management of this complex disease.

Introduction: Intestinal endometriosis is a disabling disease present in 6% to 30% of deep endometriosis cases. It can be the cause of abdominal bloating, constipation, intestinal cramping and painful bowel movements, defecation pain and intestinal stenosis up to intestinal occlusion. Colorectal endometriosis requires surgical treatment that can be performed by abdominal route or by laparoscopy. The present study describes the total laparoscopic rectosigmoid resection in case of deep endometriosis with bowel involvement.

To interpret the literature describing the results of surgery for endometriosis, a clear understanding of the evolution and limitations of the various techniques is necessary. Up to the end of the 1970’s, minimal and mild endometriosis was destroyed endoscopically by heat application (endothermia) and by unipolar or bipolar coagulation. Treatment of more severe endometriotic disease was mostly radical by hysterectomy, often leaving some rectovaginal endometriosis which has not been fully recognised before 1989.

Endometriosis can infiltrate the surrounding tissues resulting in an important sclerotic, and inflammatory reaction which can translate clinically in nodularity, bowel stenosis and ureteral obstruction. The most severe forms such as rectovaginal endometriosis and endometriosis invading the rectum or the sigmoid have been known since the beginning of this century. These conditions, however, are relatively rare with an estimated prevalence of less than 1%.

Most patients with endometriosis do not have intestinal (GI) involvement. Among the difficult cases of endometriosis I see from around the world, only 27% have GI involvement. Since over 1900 patients with endometriosis have undergone surgery at St. Charles, that means I’ve operated on over 500 patients with GI involvement. The symptoms of GI involvement depend on the severity and location of the disease. The severity of disease depends on the depth of invasion into the bowel wall.

Objective: To present a case of catamenial pneumothorax and diaphragmatic endometriosis that was managed thoracoscopically. A review of the literature is also presented. A 28-year-old woman initially presented with bloody stools and chronic constipation. During a review of systems, the patient described monthly chest pain associated with her menses. The initial workup included a pre-operative chest x-ray that revealed a right pneumothorax and colonoscopy that revealed biopsy-proven endometriosis of the sigmoid colon.