endometriosis sanja načinović mentor: a. Žmegač horvat
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EndometriosisEndometriosis
Sanja Sanja NačinovićNačinović
Mentor: A. Žmegač Mentor: A. Žmegač HorvatHorvat
DefinitionDefinition
• endometrial-like cells appear in areas endometrial-like cells appear in areas outside the uterine cavityoutside the uterine cavity
• endometrial-like cells are influenced endometrial-like cells are influenced by hormonal changes by hormonal changes
Epidemiology Epidemiology
• typically seen during the typically seen during the reproductive years reproductive years
• occurs in roughly 5-10% of women occurs in roughly 5-10% of women
InfertilityInfertility
• link between infertility and link between infertility and endometriosis remains enigmatic endometriosis remains enigmatic
Other symptomsOther symptoms
• constipationconstipation
• chronic fatigue chronic fatigue
• mild to severe fever mild to severe fever
• headaches headaches
• depression depression
• hypoglycemia (low blood sugar) hypoglycemia (low blood sugar)
• anxiety anxiety
CausesCauses
• the exact cause of endometriosis the exact cause of endometriosis remains unknown remains unknown
• Retrograde menstruationRetrograde menstruation
• Coelomic metaplasiaCoelomic metaplasia
• GeneticsGenetics
• TransplantationTransplantation
• EnvironmentEnvironment
How to diagnose it?How to diagnose it?
• laparotomylaparotomy
• laparoscopylaparoscopy
• ultrasoundultrasound
Co-morbidityCo-morbidity
• ovarian cancerovarian cancer
• non-Hodgkin's lymphoma non-Hodgkin's lymphoma
• leiomyomaleiomyoma
• autoimmune disorders autoimmune disorders
• hypothyroidismhypothyroidism
Possible locationsPossible locations
• ovariesovaries
• fallopian tubes fallopian tubes
• back of the uterus back of the uterus
• front of the uterus front of the uterus
• uterine ligaments uterine ligaments
• pelvic and back wall pelvic and back wall
• intestines intestines
• urinary bladder and ureters urinary bladder and ureters
StagingStaging
• Stage I (minimal) Stage I (minimal)
• Stage II (mild) Stage II (mild)
• Stage III (moderate) Stage III (moderate)
• Stage IV (severe) Stage IV (severe)
MarkersMarkers
• high levels of estrogen high levels of estrogen
• low levels of progesterone low levels of progesterone
• antigen C-125antigen C-125
TreatmentsTreatments
1.1. hormonal medications - progestins, hormonal medications - progestins, oral contraceptives, Danazol, oral contraceptives, Danazol, aromatase inhibitorsaromatase inhibitors
2.2. other medications - NSAID, other medications - NSAID, DiclofenacDiclofenac