Scribd Logo
Upload

Welcome to Scribd!

  • 339 views

    Swatilekha Das (RN, MSN)

    Uploaded by

    sandeepv08
    Endometriosis is a condition where endometrial tissue grows outside the uterus, most often on the ovaries and tissues surrounding the uterus. It can cause painful periods, chronic pelvic pain, and infertility. Risk factors include genetics and environmental toxins. Diagnosis involves a medical history, physical exam, ultrasound or laparoscopy. Treatment options include hormonal birth control, NSAIDs, and in some cases surgery. Nursing care focuses on managing pain, anxiety about fertility issues, and ensuring patient education.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Swatilekha Das (RN, MSN)

    Uploaded by

    sandeepv08
    339 views20 pages
    Endometriosis is a condition where endometrial tissue grows outside the uterus, most often on the ovaries and tissues surrounding the uterus. It can cause painful periods, chronic pelvic pain, and infertility. Risk factors include genetics and environmental toxins. Diagnosis involves a medical history, physical exam, ultrasound or laparoscopy. Treatment options include hormonal birth control, NSAIDs, and in some cases surgery. Nursing care focuses on managing pain, anxiety about fertility issues, and ensuring patient education.

    Original Title

    endometriosis

    Copyright

    © © All Rights Reserved

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Endometriosis is a condition where endometrial tissue grows outside the uterus, most often on the ovaries and tissues surrounding the uterus. It can cause painful periods, chronic pelvic pain, and infertility. Risk factors include genetics and environmental toxins. Diagnosis involves a medical history, physical exam, ultrasound or laparoscopy. Treatment options include hormonal birth control, NSAIDs, and in some cases surgery. Nursing care focuses on managing pain, anxiety about fertility issues, and ensuring patient education.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    339 views20 pages

    Swatilekha Das (RN, MSN)

    Uploaded by

    sandeepv08
    Endometriosis is a condition where endometrial tissue grows outside the uterus, most often on the ovaries and tissues surrounding the uterus. It can cause painful periods, chronic pelvic pain, and infertility. Risk factors include genetics and environmental toxins. Diagnosis involves a medical history, physical exam, ultrasound or laparoscopy. Treatment options include hormonal birth control, NSAIDs, and in some cases surgery. Nursing care focuses on managing pain, anxiety about fertility issues, and ensuring patient education.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 20

    SWATILEKHA DAS

    (RN,MSN)
    INTRODUCTION
    Endometriosis is a condition in which cells similar
    to those in the endometrium, the layer of tissue that
    normally covers the inside of the uterus, grows
    outside of it. Most often this is on the ovaries,
    fallopian tubes, and tissue around the uterus and
    ovaries; however, in rare cases it may also occur in
    other parts of the body.
    DEFINITION
    The presence of functioning endometrium (glands &
    Stroma) in sites other than uterine mucosa is called
    endometriosis.
    RISK FACTORS
    Genetics- Genetic predisposition plays a role.
    Daughters or sisters of women with endometriosis are at
    higher risk of developing endometriosis themselves.
    Low progesterone levels may be genetic, and may
    contribute to a hormone imbalance.
    There is an about six-fold increased incidence in women
    with an affected first-degree relative.
    It has been proposed that endometriosis results from a
    series of multiple hits within target genes, in a
    mechanism similar to the development of cancer. In this
    case, the initial mutation may be either somatic or
    heritable.
    Environmental toxins- Some factors associated with
    endometriosis include:
    not having given birth (nulliparity)
    prolonged exposure to estrogen; for example, in
    late menopause or early menarche
    obstruction of menstrual outflow; for example,
    in Mülleriananomalies
    PATHOPHYSIOLOGY
    CLINICAL MANIFESTATIONS
    Dysmenorrhea – painful, sometimes disabling cramps
    during the menstrual period; pain may get worse over
    time (progressive pain), also lower back pains linked to
    the pelvis

    Chronic pelvic pain – typically accompanied by lower


    back pain or abdominal pain

    Dyspareunia – painful sex

    Dysuria – urinary urgency, frequency, and sometimes


    painful voiding
    • Infertility -About a third of women with infertility
    have
    endometriosis.
    Among women with endometriosis about 40% are infertile.
    The pathogenesis of infertility is dependent on the stage of
    disease: in early stage disease, it is hypothesised that this is
    secondary to an inflammatory response that impairs various
    aspects of conception, whereas in later stage disease distorted
    pelvic anatomy and adhesions contribute to impaired
    fertilisation.

    • Others- diarrhea or constipation , chronic fatigue, nausea


    and vomiting, headaches, low-grade fevers, heavy and/or
    irregular periods, and hypoglycemia
    POSSIBLE LOCATIONS OF ENDOMETRIOSIS
    DIAGNOSTIC TESTS
    A health history and a physical examination
     Visual analogue scale (VAS); VAS and
    numerical rating scale (NRS) were the best
    adapted pain scales for pain measurement in
    endometriosis.
    Vaginal Ultrasound
    Laparoscopy
    Immunohistochemistry-Immunohistochemistry
    has been found to be useful in diagnosing
    endometriosis as stromal cells have a peculiar
    surface antigen, CD10.
    Staging-
    Surgically, endometriosis can be staged I–IV by the
    revised classification of the American Society of
    Reproductive Medicine from 1997.
    Stage I (Minimal)Findings restricted to only superficial
    lesions and possibly a few filmy adhesions
    Stage II (Mild)In addition, some deep lesions are
    present in the cul-de-sac
    Stage III (Moderate)As above, plus the presence of
    endometriomas on the ovary and more adhesions.
    Stage IV (Severe) As above, plus large endometriomas,
    extensive adhesions.
    MEDICAL MANAGEMENT
    Hormonal birth control therapy
    Progestogens
    Danazol(Danocrine) and Gestrinone (Dimetrose,
    Nemestran) ,suppressive steroids inhibit the growth
    of endometriosis but their use remains limited as
    they may cause masculinizing side effects such as
    excessive hair growth and voice changes.
    Gonadotropin-releasing hormone (GnRH)
    modulators
    Aromatase inhibitors
    OTHER MEDICATIONS-
    NSAIDs (Anti-inflammatory)-They are commonly
    used in conjunction with other therapy. For more
    severe cases narcotic prescription drugs may be
    used. NSAID injections can be helpful for severe
    pain or if stomach pain prevents oral NSAID use.
    Examples of NSAIDs include ibuprofen and naproxen.
    Opioids: Morphine sulphate
    Pentoxifylline, an immunomodulating agent,
    Angiogenesis inhibitors
    SURGICAL MANAGEMENT
    Conservative treatment consists of the excision of the
    endometrium, adhesions, resection of endometriomas,
    and restoration of normal pelvic anatomy as much as is
    possible.

    A hysterectomy (removal of the uterus) can be used to treat


    endometriosis in women who do not wish to conceive.

    For women with extreme pain, a presacral neurectomy may


    be very rarely performed where the nerves to the uterus are
    cut. However, this technique is almost never used due to
    the high incidence of associated complications including
    presacral hematoma and irreversible problems with
    urination and constipation
    TREATMENT OF INFERTILITY
    Surgery is more effective than medicinal intervention
    for addressing infertility associated with
    endometriosis. Surgery attempts to remove
    endometrial tissue and preserve the ovaries without
    damaging normal tissue. In-vitro fertilization (IVF)
    procedures are effective in improving fertility in many
    women with endometriosis.

    During fertility treatment, the ultralong pretreatment


    with GnRH-agonist has a higher chance of resulting in
    pregnancy for women with endometriosis, compared
    to the short pretreatment.
    COMPLICATIONS
    Internal scarring, adhesions, pelvic cysts, chocolate
    cysts of ovaries, ruptured cysts, and bowel and ureter
    obstruction resulting from pelvic adhesions.
    Endometriosis-associated infertility can be related to
    scar formation and anatomical distortions due to the
    endometriosis.
    Ovarian endometriosis may complicate pregnancy by
    decidualization, abscess and/or rupture.
    Thoracic endometriosis is associated with recurrent
    pneumothoraces at times of a menstrual period,
    termed catamenial pneumothorax.
    NURSING DIAGNOSES
    Chronic pain related to endometrial pelvic implants

    Anxiety related to effect of endometriosis on fertility

    Deficient knowledge related to diagnosis


    and treatment options

    Ineffective sexuality patterns related to


    the manifestations of endometriosis

    You might also like