DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20184532

Diagnostic and therapeutic laparoscopy in the management of endometriosis

Sujata Swain, Paresh Kumar Jena

Abstract


Background: Endometriosis associated with a variety of symptoms, primarily produces dysmenorrhea and infertility. Three classes of techniques have been used to diagnose women with endometriosis beside the history and the clinical picture: biochemical markers, radiological imaging and laparoscopic examination of peritoneal cavity.

Methods: All 52 patients were evaluated clinically, biochemically, and radiologically and laparascopically to find out the abnormalities.

Results: Most common complaint in a patient with endometriosis is dysmenorrhea affecting 67.6% population in this study group. 20% patients presented with infertility. Diagnostic laparoscopy of the patients in the study group show ovarian endometrioma in 67.3% population. Stage II endometriosis was seen in maximum number of cases in the study group comprising 46.2% patients. Ovarian cystectomy was the most common therapeutic procedure done in 51.9% of patients, out of which 40.4% cases treated with unilateral cystectomy and rest by bilateral cystectomy.

Conclusions: This study concludes that endometriosis predominantly affects the women of reproductive age group and causes dysmenorrhea and infertility in majority of the patients. A laparoscopic finding marks as a standard tool in diagnosis and treatment of endometriosis.


Keywords


Diagnostic laparoscopy, Dysmenorrhea, Endometriosis, Infertility, Ovarian cystectomy

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References


Andrew S. Cook. Pathophysiology of endometriosis-associated infertility. Clin Obstet Gynecol. 2017;42(3):586-610.

Healey M, Ang WC and Cheng C. Surgical treatment of endometriosis: a prospective randomized double blinded trial comparing excision and ablation. Fertil Steril. 2010;94(7):2536-40.

Hart RJ, Hickey M, Maouris P and Buckett W. Excisional surgery versus ablative surgery for ovarian endometriomata. Cochrane Database Syst Rev 2008(2).

Rajeswari M, Ramanidevi T, Kadalmani B. Cohort study of endometriosis in south Indian district. Int J Reprod Contracept Obstet Gynecol. 2016;5(11):3883-8.

Sahu L, Tempe A. Laparoscopic management of endometriosis in infertile women and outcome. Int J Reprod Contracept Obstet Gynecol. 2016;2(2):177-81.

Arumugam K, Lim JM. Menstrual characteristics associated with endometriosis. BJOG: An International Journal of Obstetrics and Gynaecology. 1997 Aug;104(8):948-50.

Giudice LC. Clinical practice. Endometriosis. N Engl J Med. 2010;362(25):2389-98.

Mishra VV, Gaddagi RA, Aggarwal R, Choudhary S, Sharma U, Patel U. Prevalence; characteristics and management of endometriosis amongst infertile women: a one-year retrospective study. J Clinic Diagnos Res: JCDR. 2015;9(6):QC01.

Koninckx PR, Meuleman C, Demeyere S, Lesaffre E, Cornillie FJ. Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril. 1991;55(4):759-65.

Matalliotakis IM, Goumenou AG, Matalliotakis M, Arici A. Uterine anomalies in women with endometriosis. J Endomet. 2010;2(4):213-7.

Davil GW, Estape R. Gynecologic laparoscopy surgical oncology. Clinic North Am. 2001;10(3):557-70.