It is the presence of endometrial tissue (uterine) located outside the uterus. This tissue can be added anywhere in the pelvis (the peritoneum, the ovaries, the recto vaginal) or even the body. It affects about 2% of women, mostly young women, aged 30-35 years.oldPhysiology of endometriosis is complex: the extra-uterine endometrial tissue behaves like the endometrium: it is painful and it bleeds during menstruation.
Clinical
The symptoms are varied and may be atypical according to the locations of endometriosis. It may be associated with::-des algies pelviennes chroniques-des dysménorrhées secondaires et en 2e partie de cycle (tardive)-chronic pelvic pain -Secondary dysmenorrhea and in the second part of the cycle (late) -infertility usually primary (never had children) -deep dyspareunia (pain during intercourse) -sometimes pain on urination (dysuria), a painful tension associated with a burning sensation at the anus (tenesmus)On physical examination, during a speculum examination, one can sometimes see purplish nodules sometimes at the cervico – vaginal. junction The vaginal examination may reveal a retroverted uterus (backwards), fixed,: nodules of the recto – vaginal, an adnexal mass in case of ovarian localization.
Paraclinical::
Several imaging tests may be needed:-Pelvic ultrasonography: looking for an ovarian cyst of endometriosis nature ... -Pelvic MRI: (the best test) is looking for different sites of endometriosis - Laparoscopy diagnostic : invasive test but allows an accurate inventory of lesions (bluish appearance of nodules).
Treatment::
The goal of treatment is to atrophy the ectopic endometrium (decrease the volume of the endometrium) by inhibiting the hormonal synthesis by antigonadotropic treatments antigonadotropic: :-Progestin -Agonists of LH-RH Sometimes it is necessary to resort to surgery to achieve excision of endometriotic lesions.
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Victor Hugo