Endometriosis

Abstract

Endometriosis is characterized by the dissemination of glands and endometrial stroma to ectopic sites in the uterine cavity and musculature. It is a contrasting disease that presents no association between clinical status and quantity of lesions. Some of the patients present asymptomatic, whereas others present diverse manifestation of clinical status characterized by pelvic pain, infertility, dysmenorrhea, and dyspareunia. The etiopathogeny of endometriosis is uncertain, and the most widely known hypotheses are related to celomic metaplasia, to transplantation, and to induction. The diagnosis of endometriosis is usually carried out through laparoscopy, in which case the identification of typical lesions confirms the diagnosis. Treatment for endometriosis includes induction of a pseudopregnancy state. There are many drugs that can be used to induce pregnancy, such as progestational hormones, derived forms of androgen, birth-control medication, and analogous forms of the gonadotropin-releasing hormone (GnRH). Endometriosis can also be surgically treated with a conservative procedure of cauterization and/or resection of the lesions. Cases of endometriosis that are more resistant or that occur in patients who are not worried about their fertility can be managed with more aggressive surgical procedures such as hysterectomy, for example. Infertility is treated with techniques of assisted reproduction in cases associated with anatomical factors. In all forms of treatment there is a relatively high incidence of recurrence and failure, in which case different therapeutic options should be employed.