ENDOMETRIOSIS Introduction Endometriosis is a

This endometrial tissue may bleed during the menstrual period, responding to the hormones that the uterus responds to. This bleeding may cause cramps, pain, irritation and scar tissue. Endometriosis may result in pelvic pain, menstrual irregularities, and infertility. In some cases the pain is severe with only slight progression of the disease and in other severe cases, there may be no symptoms. Pain during menstruation from endometriosis may not occur until the disease has been present for several years. In some cases pain may be experienced during sexual intercourse prior or during menstruation. When the tissue is attached to the large intestine or bladder, there may be abdominal swelling, lower abdominal pain during urination, painful bowel movements, and rectal bleeding during menstruation. When the tissue attaches to an ovary or structure nearby, a blood-filled mass m

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larger than 2 inches, or obstructions, severe pain, or significant adhesions are present, surgery may be needed. In this case the tissue is removed. In many cases this tissue is removed during the diagnostic laparoscopy. Electrocautery or a laser are also used to remove endometrial tissue. Removal of the tissue is considered temporary since the disease recurs in most women. Although drugs may slow the growth rate and regrowth rate, only removal of both ovaries can prevent the return of the disease. Ovary and uterus removal is only performed for women with unrelieved pain who are not planning a pregnancy. After the removal, the endometrial tissue disappears; drugs may be needed to suppress delays (Merck, Ch. 237). Differential Diagnoses Diagnosis for endometriosis needs to rule out other possibilities that present pelvic pain and similar symptoms. Intrauterine & Extrauterine Pregnancy. Endovaginal ultrasound can be used to show intrauterine pregnancy or when an extrauterine pregnancy is present. Extrauterine pregnancy is also called ectopic pregnancy. Symptoms of ectopic pregnancy include cramping and spotting, with gradual bleeding, and pain and pressure in the lower abdomen. In cases of rapid bleeding, blood pr
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