medical notes

Apr 17th, 2015
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ENDOMETRIOSISDefinitionEndometriosis, the presence of endometriumlike glands and stroma outside the uterusAdenomyosis is the invasion of the myometrium by endometrial tissueEpidemiologyEndometriosis occurs in 7-10% of women in the general population.It is an estrogen-dependent disease and, thus, usually affects reproductive-aged women. Endometriosis has a prevalence rate of 20-50% in infertile women and as high as 80% in women with chronic pelvic pain. A familial association exists, with a 10-fold increased incidence in women with an affected first-degree relative. Monozygotic twins are markedly concordant for endometriosisEtiologyTheories of causation include the following:Retrograde menstruation: Retrograde flow of endometrial tissue through the fallopian tubes into the peritoneal cavity is believed to cause endometriosis. Various animal experiments and clinical observations support this theory. Lymphatic and vascular spread: These pathways may explain the occurrence of endometriosis at distant, noncontiguous sites. Ovarian endometriosis is also believed to be caused by lymphatic spread, although superficial ovarian endometriosis may also be due to implantation via retrograde menstruation.Coelomic metaplasia: Transformation of coelomic epithelium into endometrial-type glands in response to as yet unknown stimuli could explain endometriosis in unusual sites. Coelomic metaplasia is also believed to explain the occurrence of endometriosis in women who ha

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