The Modern Management of Endometriosis. Malcolm Padwick. What is it ?. The presence of endometrial tissue outside of the uterine cavity cul-de-sac rectovaginal septum surface of rectum fallopian tubes and ovaries uterosacral ligaments bladder pelvic side wall. Is it inherited?.
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The presence of endometrial tissue outside of the uterine cavity
Clear mean age 21.5
Black mean age 31.9
disease is progressive in 47 - 64% of women and in 20% of treated women (Redwine)
Management options 1
Hormonal or antihormonal therapy has no beneficial effect
on fertility either alone or as an adjunct to surgery ( RCOG recommendation)
only surgical ablation or excision of disease will restore fertility ( RCOG recommendation)
Management option 2
CO 2 LASER Vs Diathermy
Del Pozo 1997
Endometriosis on the caecum
Endometriosis should be treated early and aggressively by surgical destruction or excision, ideally at laparoscopy. Drug therapy which is expensive, largely ineffective and has significant side-effects should be reserved for selected cases requiring post surgical maintenance therapy.