1. Endometriosis Sanja Načinović Mentor: A. Žmegač Horvat

2. Definition endometrial-like cells appear in areas outside the uterine cavity endometrial-like cells appear in areas outside the uterine cavity endometrial-like cells are influenced by hormonal changes endometrial-like cells are influenced by hormonal changes

3. Epidemiology typically seen during the reproductive years typically seen during the reproductive years occurs in roughly 5-10% of women occurs in roughly 5-10% of women

4. Sings and symptoms Pelvic pain Dysmenorrhea Chronic pelvic pain Dyspareunia

5. Infertility link between infertility and endometriosis remains enigmatic link between infertility and endometriosis remains enigmatic

6. Other symptoms constipation constipation chronic fatigue chronic fatigue mild to severe fever mild to severe fever headaches headaches depression depression hypoglycemia (low blood sugar) hypoglycemia (low blood sugar) anxiety anxiety

7. Causes the exact cause of endometriosis remains unknown the exact cause of endometriosis remains unknown Retrograde menstruation Retrograde menstruation Coelomic metaplasia Coelomic metaplasia Genetics Genetics Transplantation Transplantation Environment Environment

8. How to diagnose it? laparotomy laparotomy laparoscopy laparoscopy ultrasound ultrasound

9. Co-morbidity ovarian cancer ovarian cancer non-Hodgkin's lymphoma non-Hodgkin's lymphoma leiomyoma leiomyoma autoimmune disorders autoimmune disorders hypothyroidism hypothyroidism

10. Possible locations ovaries ovaries fallopian tubes fallopian tubes back of the uterus back of the uterus front of the uterus front of the uterus uterine ligaments uterine ligaments pelvic and back wall pelvic and back wall intestines intestines urinary bladder and ureters urinary bladder and ureters

11. Staging Stage I (minimal) Stage I (minimal) Stage II (mild) Stage II (mild) Stage III (moderate) Stage III (moderate) Stage IV (severe) Stage IV (severe)

12. Markers high levels of estrogen high levels of estrogen low levels of progesterone low levels of progesterone antigen C-125 antigen C-125

13. Treatments 1. hormonal medications - progestins, oral contraceptives, Danazol, aromatase inhibitors 2. other medications - NSAID, Diclofenac

14. surgery- excision, hysterectomy, presacral neurectomy surgery- excision, hysterectomy, presacral neurectomy