Management Of Women With Endometriosis || A+ Grade
Management of women with endometriosis || A+ Grade
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Management of women with endometriosis || A+ Graded Already.
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Management of women with endometriosis || A+ Grade
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Management Of Women With Endometriosis || A+ Grade
Introduction correct answers Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induces a chronic, inflammatory reaction .
While some women with endometriosis can experience painful symptoms and/or infertility, others have no symptoms at all.
The e...
Management of women with endometriosis || A+ Graded
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Introduction correct answers Endometriosis is defined as the presence of endometrial-like tissue
outside the uterus, which induces a chronic, inflammatory reaction .
While some women with endometriosis can experience painful symptoms and/or infertility,
others have no symptoms at all.
The exact prevalence of endometriosis is unknown but estimates range from 2 to 10% of women
of reproductive age, to 50% of infertile women
Which symptoms are associated with or predictive of the diagnosis of endometriosis? correct
answers clinicians should consider the diagnosis of endometriosis:
-in the presence of gynaecological symptoms such as: dysmenorrhoea,
non-cyclical pelvic pain, deep dyspareunia, infertility and fatigue in the
presence of any of the above.
-in women of reproductive age with non-gynaecological cyclical symptoms (dyschezia, dysuria,
haematuria and rectal bleeding, shoulder pain).
What findings during clinical examination are predictive for the
presence and localization of pelvic endometriosis? correct answers -clinicians should perform
clinical examination in all women suspected of endometriosis, although vaginal examination
may be inappropriate for adolescents and/or women without previous sexual intercourse. In such
cases, rectal examination can be helpful for the diagnosis of endometriosis.
-Clinicians may consider the diagnosis of deep endometriosis in women with (painful) induration
and/or nodules of the rectovaginal wall found during clinical examination or visible vaginal
nodules in the posterior vaginal fornix .
-Clinicians may consider the diagnosis of ovarian endometrioma in women with adnexal masses
detected during clinical examination
-Clinicians may consider the diagnosis of endometriosis in women suspected of the disease even
if the clinical examination is normal
Can the diagnosis of endometriosis be made by application of specific medical technologies?
correct answers *Laparoscopy: The GDG recommends that clinicians:
-perform a laparoscopy to diagnose endometriosis, although evidence
is lacking that a positive laparoscopy 'without histology' proves the presence of disease.{A
negative diagnostic laparoscopy seems to be highly accurate for excluding endometriosis and
thereby useful to aid the clinician in decision-making.}
-confirm a positive laparoscopy by histology, since positive histology
, confirms the diagnosis of endometriosis even though negative histology
does not exclude it.
-The GDG recommends that clinicians obtain tissue for histology in
women undergoing surgery for ovarian endometrioma and/or deep infiltrating disease, to exclude
rare instances of malignancy.
*Ultrasound.
-In women with symptoms and signs of rectal endometriosis, (TVS) is useful for identifying or
ruling out rectal endometriosis.
-Clinicians are recommended to perform TVS to diagnose or to exclude
an ovarian endometrioma, base the diagnosis of ovarian endometrioma in premenopausal women
on the following ultrasound characteristics: ground glass echogenicity and no papillary structures
with detectable blood flow.
-Clinicians should be aware that the usefulness of 3D ultrasound to
diagnose rectovaginal endometriosis is not well established
**Magnetic resonance imaging.
-The usefulness of (MRI) to diagnose peritoneal endometriosis is not well
established
**Biomarkers.
-Clinicians are recommended NOT to use biomarkers from endometrial tissue, menstrual or
uterine fluids and/or immunological biomarkers, includingCA-125, in plasma, urine or serum, to
diagnose endometriosis.
Treatment of endometriosis-associated pain correct answers - counsel women with symptoms
presumed to be due to endometriosis thoroughly, and to empirically treat them with adequate
analgesia, combined hormonal contraceptives or progestagens.
-Clinicians are recommended to prescribe hormonal treatment
[hormonal contraceptives progestagens, anti-progestagens , or GnRH agonists] as one of the
options, as it reduces endometriosis-associated pain
-Clinicians can consider prescribing a combined hormonal contraceptive, as it reduces
endometriosis-associated dyspareunia, dysmenorrhoea and non-menstrual pain .
-Clinicians may consider the continuous use of a COCP in women suffering from endometriosis-
associated dysmenorrhoea .
-Clinicians may consider the use of a vaginal contraceptive ring or a
transdermal (oestrogen/progestin) patch to reduce endometriosis-associated dysmenorrhoea,
dyspareunia and chronic pelvic pain.
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