The Clinical Anatomy of Endometriosis: A Review

Abstract

Endometriosis is a gynecological disorder identified by the presence of ectopic endometrial tissue outside the uterus. Largely, it affects reproductive-aged women and is a major cause of infertility. Clinical manifestations of endometriosis include dyspareunia, cyclic menstrual pain, chronic pelvic pain, and dyschezia, all of which can affect the patient’s quality of life and health severely; therefore, it is paramount that medical treatment is initiated as soon as endometriosis is suspected clinically. In this review, we examine the known anatomic principles of endometriosis in the literature and outline ways to manage patients with this condition better.

The Healthy and Diseased Equine Endometrium: A Review of Morphological Features and Molecular Analyses

“…The retrospective study of Ebert et al [62] on 9120 biopsies submitted for routine diagnostic evaluation show the following age dependency of endometrosis: 32% in ≤5 year old mares, 66% in 6-10 year old mares, 84% in mares with an age from 11-15 years, 90% in mares aging 16-20 years, and 92.5% in >20 year old mares. Equine endometrosis has to be distinguished from endometriosis, a disease that occurs in women and menstruating primates and that is characterized by the implantation of dispersed endometrial tissue within the pelvic or abdominal cavities [63].…”

Endometriosis Associated Infertility: A Critical Review and Analysis on Etiopathogenesis and Therapeutic Approaches

“…Diagnosing endometriosis requires a vast array of tools related not only to clinical assessment but also to biological clues as well as imaging techniques, whether non-invasive such as ultrasonography or surgical methods for direct visualization. Evaluating the presence of symptoms and performing a physical examination represent the first steps in diagnosing endometriosis [ 51 , 52 ]. As mentioned, before, symptoms of endometriosis correlate with the site of anatomical involvement, thus, women are complaining most frequently of cyclic pelvic pain in the form of dysmenorrhea, intermenstrual pain, and dyspareunia.…”

“…Physical examination, while executing the bimanual pelvic maneuver, points toward diagnosing endometriosis when several criteria are met such as palpable nodularity and abnormal pelvic anatomy, especially when located in the vagina and the rectovaginal space, the pouch of Douglas, the rectosigmoid, as well as the posterior wall of the urinary bladder [ 44 , 51 , 52 ]. Other signs such as tenderness, decreased mobility, and a retroverted uterus, evidenced while palpating, might also indicate signs of endometriosis [ 53 ].…”

Appendicitis Caused by Endometriosis Within the Bowel Wall

“…Acute appendicitis is the most common surgical diagnosis of abdominal pain in the right lower quadrant [1]. Endometriosis in the right lower quadrant can mimic acute appendicitis and can deposit into the nearby tissue such as the ovary, fallopian tube, and the appendix [2,3]. Endometrial tissue is in the appendix in 0.4% of the general population and 2.8% of patients with previously diagnosed endometriosis [4].…”