Endometriosis: A Disease That Remains Enigmatic

Abstract

Endometriosis, a gynecologic pathology, is defined by the presence of a tissue similar to uterine endometrium, which is located in places other than physiologically appropriate. These endometrial heterotopic islets contain glands and stroma and are functionally capable of responding to exogenous, endogenous, or local hormonal stimuli. Endometriosis affects 8%–10% of women of reproductive age; in 30% of the women, the condition is associated with primary or secondary infertility. In several instances, endometriosis persists as a minimal or mild disease, or it can resolve on its own. Other cases of endometriosis show severe symptomatology that ends when menopause occurs. Endometriosis can, however, reactivate in several postmenopausal women when iatrogenic or endogenous hormones are present. Endometriosis is occasionally accompanied by malignant ovarian tumors, especially endometrioid and clear cell carcinomas. Its pathogenesis is widely debated, and its variable morphology appears to represent a continuum of individual presentations and progressions. Endometriosis has no pathognomonic signs or symptoms; it is therefore difficult to diagnose. Because of its enigmatic etiopathogenesis, there is currently no satisfactory therapy for all patients with endometriosis. Treatments include medications, surgery, or combined therapies; currently, the only procedures that seem to cure endometriosis are hysterectomy and bilateral salpingo-oophorectomy. In this paper, we review the most controversial and enigmatic aspects of this disease.

Fatores ambientais e endometriose: um ponto de vista

“…Em países industrializados, essa é uma das principais causas de hospitalização ginecológica 3 . Apesar de ser uma das doenças mais estudadas em ginecologia 4 , alguns aspectos continuam sendo alvo de pesquisa, destacando-se a busca pela sua etiopatogenia [5][6][7] . Muitos estudos têm sido realizados na tentativa de se identificar as alterações imunológicas, genéticas, ou mesmo as respostas a contaminantes ambientais que podem estar presentes em pacientes com endometriose.…”

Identical Ovarian and Deep Pelvic Endometriosis with Colorectal Involvement in Monozygotic Twins: A Case Report and Review of the Literature

“…Both superficial peritoneal and ovarian endometriomas may be found in association with DIE in variable percentages, thus contributing to the intensity of painful stimuli, as well as to infertility [18]. Thisraises the question of whether DIE is an independent form of the disease, or whether it represents its most severe clinical representation [19]. Nisolle and Donnez have argued that peritoneal endometriosis, ovarian endometriosis and adenomyotic nodules of the rectovaginal septum are three different entities [20].…”

Chocolate cyst became ovarian abscess following IVF: a serious surgical emergency

“…In the ovary, endometriosis is called as endometrioma or chocolate cyst. 1 Endometriosis is commonly occurred in the reproductive age group distributed from 14 years to 49 years of age. Patients of endometriosis commonly remain asymptomatic but symptomatic patient's presents in a classical triad dysmenorrhoea, dyspareunia and infertility.…”