Endometriosis |
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| Authors: | HENRIKSEN E |
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| Affiliation: | 1. Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States;2. Department of Obstetrics and Gynecology, University of Wisconsin Hospital and Clinics, Madison, WI, United States;1. Biostatistics and Epidemiology, Graduated School of Public Health, Seoul National University, South Korea;2. School of Forestry & Environmental Studies, Yale University, 195 Prospect Street, New Haven, CT 06511, USA;3. Asian Institute for Energy, Environment, and Sustainability, Seoul National University, South Korea;1. Department of Obstetrics and Gynecologic, Division of Gynecologic Oncology, University of Virginia, Charlottesville, VA, United States;2. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States;1. CHU Clermont-Ferrand, Service de Chirurgie Gynécologique (Drs. Comptour, Chauvet, Grémeau, Pouly, Canis, and Bourdel);2. Unités de Biostatistiques Direction de la Recherche Clinique et de l''Innovation (DRCI) (Drs. Pereira and Lambert), Clermont-Ferrand, France;1. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy;2. Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy |
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| Abstract: | - 1.1. Observations based on review of 1,000 cases of proved endometriosis are presented.
- 2.2. The so-called characteristic sign-symptom pattern was present in 43 per cent of the cases.
- 3.3. The disease is diagnosed on an awareness of the possibility of the disease, a careful history and a thorough rectopelvic examination.
- 4.4. Although the disease tends to regress following surgical or physiologic castration, twenty-nine patients exhibited clinical and histologic evidence of continued activity following ovariectomy. Active endometriosis was proved in thirty-seven patients in the postmenopausal group.
- 5.5. Involvement of the bowel is frequent enough to warrant the acceptance of endometriosis as an important possible factor in the problems affecting both the small and large bowel.
- 6.6. An acute condition of the abdomen followed the spontaneous rupture of an ovarian cyst of endometrial origin in eight cases; a perforation of an extensive endometrioid lesion of the sigmoid in one case.
- 7.7. Proper management is based on the surgeon's appreciation of the natural history of the disease, the evaluation of such factors as age, severity of symptoms, extent of disease, desire for children, and the patient as a whole. Fortunately the value of conservatism in the surgical management of the disease is becoming more widely accepted.
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