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Endometriosis

Kimberly S. Tustison, MD, Maegen Dupper, MD and Kenneth A. Ballou, MD, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Endometriosis is a common but potentially painful and debilitating estrogen-dependent gynecologic condition affecting women of predominately reproductive age (1)[A].

  • Symptoms and sign...

DIAGNOSIS

HISTORY

  • Dysmenorrhea (50–90% of cases) due to deep infiltrating endometrial implants

  • Dyspareunia due to lesions of the cul-de-sac, uterosacral ligaments, and posterior vaginal fornix

  • Dyschezia ...

TREATMENT

GENERAL MEASURES

Management is dependent on multiple factors: 
  • Age and reproductive desires of the patient

  • The certainty of the diagnosis

  • The degree of degradation on quality of life due to pain...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Routine gynecologic care 

Patient Monitoring

Symptomatic and asymptomatic pelvic masses (http://www.acog.org/

PROGNOSIS

  • Excellent, especially if diagnosis and treat...

REFERENCES

1
Practice bulletin no. 114: management of endometriosis. Obstet Gynecol.  2010;116(1):223–236. [View Abstract on OvidMedline]
2
Daraï C, Deboute O, Zacharopoulou C, et al. Impact of oste...

ADDITIONAL READING

  • Brown J, Farquhar C. Endometriosis: an overview of Cochrane Reviews. Cochrane Database Syst Rev.  2014;(3):CD009590. [View Abstract on OvidMedline]

  • Davis L, Kennedy SS, Moore J,...

CODES

ICD10

  • N80.9 Endometriosis, unspecified

  • N80.3 Endometriosis of pelvic peritoneum

  • N80.2 Endometriosis of fallopian tube

  • N80.4 Endometriosis of rectovaginal septum and vagina

  • N80.0 Endometriosis of uter...

CLINICAL PEARLS

  • Severe dysmenorrhea and dyspareunia are never normal. Failure to respond to NSAIDs and/or OCPs warrants further investigation.

  • A rectovaginal exam can be useful in patients suspected of...

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