ENDOMETRIOSIS

It is defined as the presence of endometrial tissue outside the endometrial cavity. Incidence is  10% in general and  20-50% in  infertile women.

Mostly located on the surface ovaries, fallopian tubes  and the abdominal membrane covering the back of the uterus. Besides it may attack intestines and other abdominal structures  and even distant organs such as eye and lung.  Although it is a benign disease, it can cause chronic and serious problems.

Painful menstruation, chronic pelvic pain, infertility and pain during  sex are the most common complaints.

Similiar hormonal changes ocur in these ectopic endometrial  tissues which may result in inflammation, bleeding and destruction of surrounding structures. Most of the complaints are due to either the mass effect or the irritaion  of the surrounding tissues.

Tiny bleeds over time get bigger within the ovary  and may result in cystic mass called endometrioma or chocolate cyst. The ultrasound image is quite typical.
     * Endometriosis in the uterine wall (myometrium) is called adenomyosis. It is more common in women aged 40-50 years with pain and bleeding disorder. It is one of the most important causes of uterine surgery  througout  the World following the fibroid. 
    * Treatment of endometriosis is evaluated and applied in a wide spectrum according to the patient's complaints, requests, stage of disease and clinical findings. Because the disease is dependent on the estrogen hormone, the exact solution is to take out both ovaries. But it is not possible in almost any of the patients of childbearing age. In patients with no clinical findings, follow-up without any medication is suitable.  But in symptomatic women; medications to supress the lesions and the ovaries and/or surgery may be advised accordingly