Endometriosis ; Endometrioza

Endometriosis is a gynecologic chronic inflammatory disease branded by the presence of ectopic endometrial tissue outside the uterus, frequently in the pelvis. Core symptoms of endometriosis are chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. John Sampson first described it and named it in 1920is. Endometriosis is a complex disease with an unknown correct origin. There are several mentioned theories with retrograde menstruation from fallopian tubes as the main one. Endometriosis has a heavy burden on patients and their relatives, as they lose capacity for work and coitus due to severe pain. It is believed that endometriosis is present in 5-10% of women of reproductive age. Diagnosis of endometriosis is by thorough patient history, clinical exam, and diagnostic workup (Ultrasound, MR). Unfulfilled diagnosis leads to investigative laparoscopy plus endometrial tissue biopsy which was once considered a “gold standard” for diagnosis. Investigative laparoscopy and visualization of the location and size of endometrial lesions is the only definitive diagnosis. Endometriosis treatment modalities include pharmacological, surgical, or combined treatment. Infertile women have the additional option of assisted reproductive technology. Treatment is not curative; it is usually suppressive (symptomatic) and tries to reduce the pain and burden. Pharmacological treatment relies on hormones that create a state of hypoestrogenism. These include progestogens, oral hormonal contraceptives, and gonadotropin-releasing hormone analogs, they suppress the size of the lesion and symptoms. Drugs currently under exploration as potential therapies, including aromatase inhibitors, gonadotropin-releasing hormone antagonists, and selective modulators of progesterone and estrogen receptors, have demonstrated value in reducing endometriotic lesions in experimental models. Surgical therapy is usually done laparoscopically when the first line pharmacologic treatment fails when the lesions are too big or when endometriosis is severe. ...