Endometriosis: an enigmatic disease with many faces

Dipak J. Limbachiya; Grishma P. Agrawal

doi:10.18203/2320-1770.ijrcog20170414

Authors

Dipak J. Limbachiya Department of Obstetrics and Gynecology, EVA Endoscopy Training Institute, Ahmedabad, Gujarat, India
Grishma P. Agrawal Department of Obstetrics and Gynecology, EVA Endoscopy Training Institute, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20170414

Keywords:

Bladder endometriosis, Endometriosis, Hydroureter, Infertility, Laparoscopy, Post caesarean scar, Vault endometriosis

Abstract

Endometriosis is a benign disease defined by the presence of the endometrial glands and stroma outside of the uterus, both at pelvic and extra pelvic sites. We are reporting 4 unusual cases of endometriosis that are unique on their own due to site of endometriosis, presenting symptoms, complications and treatment. Endometriosis was present at post caesarean scar site in one case, at vault site in another case, in bladder in third case and in the last case it caused frozen pelvis with hydroureter, hydronephrosis and possibly infertility. All four patients have been treated laparoscopically and have been following up with no recurrence of its symptoms. The purpose of this article is to create awareness among Doctors about endometriosis, which is more common than previously thought as. Endometriosis has been rightly summed up in the phrase “The clock is definitely ticking, as we know millions of women still live lives awash in anguish, just as they did thousands of years ago and just as they will centuries from now unless we steer ourselves faster toward the long-elusive cure. Four thousand years is long enough; the time has come to end the empire of endometriosis”.

Metrics

Metrics Loading ...

References

Endometriosis. In Fritz MA, Speroff L Clinical gynecologic Endocrinology and Infertility.8th ed.Wolters Kluwer: Lippincott Williams and Wilkins; 2011:1221-1248.

Acién P, Velasco I. Endometriosis: A Disease That Remains Enigmatic. ISRN Obstetrics and Gynecology. 2013; Article ID 242149, 12 pages.

Jubanyik KJ, Comite F. Extrapelvic endometriosis. Obstet Gynecol Clin North Am. 1997;24:411-40.

Heaps JM, Nieberg RK, Berek JS. Malignant neoplasms arising in endometriosis. Obstet Gynecol. 1990;75:1023-8.

Teng CC, Yang HM, Chen KF, Yang CJ, Chen LS, Kuo CL. Abdominal wall endometriosis: an overlooked but possibly preventable complication. Taiwan J Obstet Gynecol. 2008;47:42-8.

Endometriosis. In: Fritz MA, Speroff L Clinical gynecologic Endocrinology and Infertility.8th ed.Wolters Kluwer: Lippincott Williams and Wilkins; 2011:1221-1248.

Sengul I, Sengul D, Kahyaoglu S, Kahyaoglu I. Incisional endometriosis: A report of 3 cases. Can J Surg. 2009;52:444-5.

Acien P, Acien M. The cavitated accessory uterine mass. A Mullerian anomaly in women with an otherwise normal uterus. Obstetrics and Gynecology. 2010;116:1101-9.

Acien P, Bataller A. New cases of accessory and cavitated uterine masses (ACUM): a significant cause of severe dysmenorrhea and recurrent pelvic pain in young women. Human Reproduction. 2012;27(3):683-94.

Koninckx PR, Martin DC. Deep endometriosis: a con- sequence of infiltration or retraction or possibly adenomyosis externa? Fertility and Sterility. 1992;58(5):924-8.

Koninckx PR, Martin D. Treatment of deeply infiltrating endometriosis. Current Opinion in Obstetrics and Gynecology. 1994;6(3):231-41.

Ridley JH. The histogenesis of endometriosis: a review of facts and fancies. Obstetrical and Gynecological Survey. 1968;23(1).

Francica G, Giardiello C, Angelone G, Cristiano S, Finelli R, Tramontano G. Abdominal wall endometriosis near cesarean delivery scars. J Ultrasound Med. 2003;22:1041-7.

Kaloo P, Reid G, Wong F. Caesarean section scar endometriosis: Two cases of recurrent disease and a literature review. Aust NZ J Obstet Gynaecol. 2002;42:218-20.

Meirelles M, Losano R, Viana AT. Scar endometriosis: study of 14 cases. Arq Med Hosp Fac Cienc Med Santa Casa Sao Paulo. 2005;50(3):92-6.

Blanco RG, Parithivel VS, Shah AK, Gumbs MA, Schein M, Gerst PH. Abdominal wall endometriomas. Am J Surg. 2003;185:596-8.

Zhao X, Lang J, Leng J, Sun D, Zhu L. Abdominal Wall Endometriomas. International Journal of Gynecology and Obstetrics. 2005;90:218-22.

Gunes M, Kayikcioglu F. Incisional endometriosis after cesarean section, episiotomy and other gynecologic procedures. Journal of Obstetrics and Gynaecology Research. 2005;31(5):471-5.

Scott RB, Telinde RW. Clinical external endometriosis; probable viability of menstrually shed fragments of endometrium. Obstetrics and gynecology. 1954;4(5):502-10.

Chatterjee SK. Scar endometriosis: A Clinicopathological study of 17 cases. Obstet Gynecol. 1980;56:81-84.

Green TH Jr, Meigs JV. Pseudo menstruation from post hysterectomy vaginal vault endometriosis. Obstet Gynecol. 1954;4:622-34.

Judd ES. Adenomyoma presenting as a tumor of the bladder. Surg Clin North Am. 1920;1:1271-3.

Muller J. Endometrioide adenomatose (denomyosis) and cystadenomatose Arch F Klin Chir. 1927;145:394-434.

Umaria N, Olliff JF. MRI appearances of bladder endometriosis. The British J Radiol. 2000;73:733-6.

Vercellini P, Frontino G, Pisacreta A, De Giorgi O, Cattaneo M, Crosignani PG. The pathogenesis of bladder endometriosis. Am J Obstet Gynecol. 2002;187:538-42.

Agarwal N, Kriplani A. Intramural bladder endometriosis after caesarean section: diagnostic and therapeutic aspects. J Gynecol Surg. 2002;18:69 -73.

Mettler L. Manual of New Hysterectomy Techniques. New Delhi, India: Jaypee Brothers Medical Publishers (P) Ltd; 2007.

Chen WM, Yang CR. Vesical endometriosis: a case report. JTUA. 2000;14(4):183-6.

Westney OL, Amundsen CL, McGuire EJ. Bladder endometriosis: conservative management. J Urol. 2000;163:1814-7.

Bogart LM, Berry SH. Symptoms of interstitial cystitis, painful bladder syndrome and similar diseases in women: a systematic review. J Urol. 2007;177(2):450-6.

Stillwell TJ, Kramer SA, Lee RA. Endometriosis of ureter. Urology. 1986;28:81-5.

Jubanyik KJ, Comite F. Extrapelvic endometriosis. Obstet Gynecol Clin North Am. 1997;24:411-40.

Leonhartsberger N, Zelger B. Intrinsic Endometriosis of Ureter and Bladder in Young Women without Gynaecological Symptoms. Urol Int. 2008;80:222-4.

Horn LC, Do Minh M, Stolzenburg JU. Intrinsic form of ureteral endometriosis causing ureteral obstruction and partial loss of kidney function. Urol Int. 2004;73:181-4.

Rani AK, Kapoor D. Ruptured ovarian endometrioma with an extreme rise in serum CA 125 level - A case report: Ovarian endometrioma with very high CA‐125 level. Gynecologic Oncology Case Reports. 2012;2(3):100-1.

Verkauf BS. The incidence, symptoms, and signs of endometriosis infertile and infertile women. J Fla Med Assoc. 1987;74(9):671-5.

Milburn A, Reiter RC, Rhomberg AT. Multidisciplinary approach to chronic pelvic pain. Obstet Gynecol Clin North Am. 1993;20:643-61.

American College of Obstetricians and Gynecologists. Washington DC; Endometriosis. ACOG technical bulletin no. 184. ACOG; 1993.

Acién P, Velasco I. Endometriosis: A Disease That Remains Enigmatic. ISRN Obstetrics and Gynecology, 2013; Article ID 242149, 12 pages.

Hsu AL, Khachikyan I, Stratton P. Invasive and non-invasive methods for the diagnosis of endometriosis. Clinical obstetrics and gynecology. 2010;53(2):413-9.

Medical Management of Endometriosis. ACOG Practice Bulletin #11. 1999

Kennedy S, Bergqvist A, Chapron C, D’Hooghe T, Dunselman G, Greb R, et al. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod. 2005;20:2698-704.

Rivlin ME, Das SK, Patel RB, Meeks GR. Leuprolide acetate in the management of cesarean scar endometriosis. Obstet Gynecol. 1995;85:838-9.

Crosignani PG, Vercellini P, Biffignandi F, Costantini W, Cortesi I, Imparato E, et al. Laparoscopy versus laparotomy in conservative surgical treatment for severe endometriosis. Fertil Steril. 1996;66:706-11.

Patterson GK, Winburn GB. Abdominal wall endometriomas: Report of eight cases. Am J Surg. 1999;65:36-9.

Maccagnano C, Pellucchi F, Rocchini L, Ghezzi M, Scattoni V, Montorsi F, et al. Diagnosis and Treatment of Bladder Endometriosis: State of the Art. Urol Int. 2012;89:249-58.

Nezhat C, Paka C, Gomaa M, Schipper E. Silent Loss of Kidney Secondary to Ureteral Endometriosis. JSLS : Journal of the Society of Laparoendoscopic Surgeons. 2012;16(3):451-5.

Tang Y, Chen SL. Ovarian damage after laparoscopic endometrioma excision might be related to the size of cyst. Fertility and Sterility. 2013;100(2):464-9.

de Ziegler. Endometriosis and infertility: pathophysiology and management. The Lancet. 2012;376(9742):730-8.

Chatterjee SK. Scar endometriosis: A clinicopathologic study of 17 cases. Obstet Gynecol. 1980;56:81-4.