endometriosis部分知识点

岛民A

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Symptoms
deep dyspareunia （Interstitial cystitis also can cause dyspareunia）
Dysmenorrhea
Dyschezia
Chronic pelvic pain and back pain
Cyclic dysuria, hematuria
diarrhea, might due to rectovaginal endometriosis


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Physical examination
Immobile fixed uterus
Cervical motion tenderness
Adnexal mass
Rectovaginal septum, posterior cul-de-sac, uterosacral ligament nodules


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Diagnosis：Transvaginal ultrasound
Definitive diagnosis(gold standard)：
Laparoscopy : powder-burn or gunmetal lesions, red or clear vesicles, and fibrotic scars.

If implants on ovaries, Ovarian endometriomas (chocolate cysts) filled with old blood can be found ,along with dense adhesions that may distort pelvic anatomy, sometimes leading to a frozen pelvis.

Endometriomas ⟶ Unilocular adnexal mass with homogeneous, low-level echoes (blood)
Symptomatic cases ⟶ Surgical resection (e.g., cystectomy) ⟶ Pain relief, improved fertility, reduced risk of ovarian torsion


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Elevated CA-125 in a postmenopausal woman is concerning for cancer, whereas in premenopausal women, it can be elevated due to benign conditions such as endometriosis and fibroids. Instead, CA-125 levels are more useful for assessing response to therapy and detecting recurrence of endometriosis following surgical treatment.


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Not↑ endometrial cancer


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Thoracic endometriosis (TE) can lead to primary spontaneous pneumothorax (PSP), particularly catamenial pneumothorax (CP), through several mechanisms: (1) diaphragmatic defects allow air to pass into the pleural space; (2) cyclic bleeding of ectopic endometrial tissue causes inflammation and lung damage; (3) bronchopulmonary implantation leads to alveolar rupture; and (4) prostaglandins and enzymes weaken lung tissue. TE-related PSP is typically right-sided, recurrent, and linked to the menstrual cycle.

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