Endometriosis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]
Overview
Endometriosis affects females in the reproductive age group. Endometriosis has a wide spectrum of presentations. It can be asymptomatic, present with premenstrual spotting and cyclical abdominal pain, present with infertility or chronic pelvic pain, or present as deep endometriosis with dyspareunia, dyschezia, and cyclical rectal bleeding. Complications of endometriosis include infertility, fibrosis, chocolate cyst, and rarely, other organs such as the lungs can be affected.
Natural History, Complications and Prognosis
Natural History
Endometriosis is a condition affecting females in the reproductive age group. Endometriosis has a wide spectrum of presentations; it may be asymptomatic or present with premenstrual spotting and cyclical abdominal pain. Endometriosis may also present with infertility or chronic pelvic pain, or as deep endometriosis presenting with dyspareunia, dyschezia, and cyclical rectal bleeding. The progression of the disease, if left untreated, is variable. It can progress to a severe disease or regress or remain the same. Severe disease is called deep endometriosis. It presents with chronic pelvic pain, infertility, and other complications due to the extensive fibrosis of the pelvic structures.[1][2]
Complications
The major complication of endometriosis is infertility; endometriosis accounts for 17% of all the cases of infertility.
Common Complications
Common complications of endometriosis include:[3][4]
- Internal abdominal organ scarring
- Adhesions
- Pelvic cysts
- Chocolate cysts
- Ruptured cyst
Less Common Complications
Less common complications of endometriosis include:
- Bowel and ureteral obstruction resulting from pelvic adhesions
Prognosis
Prognosis of endometriosis varies with medical therapy. The majority of patients improve with medical therapy, but symptoms may recur in 30-40% of patients after the completion of treatment.[5]
References
- ↑ Wenger JM, Loubeyre P, Marci R, Dubuisson JB (2009). "[Endometriosis: review of the literature and clinical management]". Rev Med Suisse. 5 (222): 2085–6, 2088–90. PMID 19947450.
- ↑ Brawn J, Morotti M, Zondervan KT, Becker CM, Vincent K (2014). "Central changes associated with chronic pelvic pain and endometriosis". Hum Reprod Update. 20 (5): 737–47. doi:10.1093/humupd/dmu025. PMC 4501205. PMID 24920437.
- ↑ Donnez J, Donnez O, Orellana R, Binda MM, Dolmans MM (2016). "Endometriosis and infertility". Panminerva Med. 58 (2): 143–50. PMID 26837776.
- ↑ Karaman Y, Uslu H (2015). "Complications and their management in endometriosis surgery". Womens Health (Lond). 11 (5): 685–92. doi:10.2217/whe.15.55. PMID 26315050.
- ↑ Leone Roberti Maggiore U, Ferrero S, Mangili G, Bergamini A, Inversetti A, Giorgione V; et al. (2016). "A systematic review on endometriosis during pregnancy: diagnosis, misdiagnosis, complications and outcomes". Hum Reprod Update. 22 (1): 70–103. doi:10.1093/humupd/dmv045. PMID 26450609.