Endometriosis Grand Rounds Presentation - Outline.docx -...

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Endometriosis Grand Rounds Presentation – Outline1.Introductiona.Pathophysiologyi.Endometriosis is an inflammatory disease, which is estrogen-dependent,that is identified with endometrial glands and tissue on areas outside of theuterus [ CITATION Mun15 \l 1033 ]. Most evidence regarding thepathophysiology of endometriosis has supported the hypothesis called“retrograde menstruation phenomenon” [ CITATION Ver14 \l 1033 ]. Thishypothesis states that pieces of endometrium travel through the fallopiantubes during uterine contractions during the menstrual cycle and escapethe interior of the uterus until they reach the peritoneal cavity [ CITATIONVer14 \l 1033 ]. Once in the cavity, they implant, grow, and furthermigrate to other tissues and organs also in the cavity [ CITATION Ver14 \l1033 ]. Certain risk factors have been linked to the likelihood of this eventhappening and include early age at menarche or long duration ofmenstrual flow, and can also have biological alterations that encouragecell implantation and growth at locations outside of the uterus[ CITATION Ver14 \l 1033 ]. These areas interact with the same hormonesof menses and cause extrauterine bleeding which is responsible for thepelvic pain associated with endometriosis [ CITATION Bon14 \l 1033 ].ii.Endometriosis has a long genetic etiology which requires that severalvariations in genetics and environmental factors interact for it to occur[ CITATION Ver14 \l 1033 ].iii.Other theories exist, but have less evidence at this point to support thehypotheses. Endometrial stem cell implantation, Mullerian remnantabnormalities, and Coelomic metaplasia are three other theories thought tolead to the development of endometriosis.b.Epidemiologyi.Endometriosis is a common condition which affects 10-15% of women ofreproductive age [ CITATION Kuk17 \l 1033 ].ii.Most endometrial deposits are found in the lower pelvis and the ovariesare found to be involved in approximately half of the cases [ CITATIONKuk17 \l 1033 ]. Other sites include broad ligaments, uterosacralligaments, rectovaginal septum, intestine, bladder, and the pouch ofDouglas [ CITATION Kuk17 \l 1033 ][ CITATION Bon14 \l 1033 ].c.Risk Factorsi.Risk factors can include any of the following: early menarche, latemenopause, delayed childbearing, long duration of menstrual flow, shortmenstrual cycles, defects found in the uterus or fallopian tubes, a historyof pelvic surgery, or family history of endometriosis [ CITATION Kuk17 \l1033 ].2.Clinical Assessment (4 assessment findings, in detail)a.Pelvic Pain [ CITATION Hic14 \l 1033 ]
i.Upwards of 58% of women with endometriosis reported abdominopelvicpain as a result of hormonal tissue stimulation of the endometrial tissueduring menses [ CITATION Hic14 \l 1033 ].

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Term
Spring
Professor
N/A
Tags
Endometrium, endometriosis, Chronic Pelvic Pain

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