Endometriosis
Endometriosis
Definition Endometriosis is usually defined as the pg resence of endometrial like tissue that is lands and stroma outside the endometrium in uterine cavity and myometrium
Definition Endometriosis is usually defined as the presence of endometrial-like tissue, that is, glands and stroma, outside the endometrium in uterine cavity and myometrium
Common sites of endometriosis The most comimon sites .uterosacral ligarrerit rectouterine pouch ovary others: Fallopian tube o uterine serosa Endometrial plants Ns fallopian tube sigmoid colon(乙状结肠) bEndometnal outside of the pelvis Rectum Bladder Umbilicus(r) bladder, kidney
Common sites of endometriosis The most common sites： • uterosacral ligament • rectouterine pouch • ovary Others： • uterine serosa • fallopian tube • sigmoid colon (乙状结肠) outside of the pelvis : • Umbilicus(脐) , bladder, kidney
Prevalence present in 10/% of women in reproductive age group especially from age 25 to 45 normally not seen before age 15 or after menopause less and late childbearing latest study, more frequent menses(cycle length s 27 days)and prolonged menstrual flow(e 1 week)2 times risk
Prevalence • present in 10%-15% of women in reproductive age group, especially from age 25 to 45 • normally not seen before age 15 or after menopause • less and late childbearing • latest study: more frequent menses (cycle length ≤ 27 days ) and prolonged menstrual flow (≥ 1 week) 2 times risk
Pathogenesis Theories of sources of ectopic endometrium Implantation theory(种植学说)— -samps0n1921 endometriurn transfer→ implant→grow etrograde menstruation(经血逆流) theory 2 iatrogenic(医源性的) implantation 3. transport by lymph and vein
Pathogenesis Theories of sources of ectopic endometrium • Implantation theory (种植学说) ——Sampson 1921 endometrium transfer → implant →grow ⒈retrograde menstruation (经血逆流) theory ⒉iatrogenic (医源性的) implantation ⒊ transport by lymph and vein
Pathogenesis Theories of source of ectopic endometrium metaplasia theory of coelomic epithelium(体腔上皮 化生学说) induction theory(诱导学说)
Pathogenesis Theories of source of ectopic endometrium • metaplasia theory of coelomic epithelium(体腔上皮 化生学说) • induction theory（诱导学说）
Pathogenesis 用C0 related的en0met10s5 Genetic Factors: high risk in first-degree relatives Immunologic Factors o Inflammation Character of uterine eutopic endometrium
Pathogenesis Factors related with endometriosis • Genetic Factors ：high risk in first-degree relatives • Immunologic Factors • Inflammation • Character of uterine eutopic endometrium
Pathology ectopIc endorretrlum hemorrhage proliferation of fibrous tissue adhesions dark blue or dark brown spots scarring nodules or cysts
Pathology ectopic endometrium ↓ hemorrhage ↓ proliferation of fibrous tissue ＆ adhesions ↓ dark blue or dark brown spots ↓ scarring nodules or cysts
Pathology Ovarian endometriosis Peritoneal endometriosis Deep infiltrating endometriosis others
Pathology • Ovarian endometriosis • Peritoneal endometriosis • Deep infiltrating endometriosis • others
Gross appearance ovarian engoneirjosis red blue or brown spots endometriomas chocolate cysts aspIng forceps ovary
Gross appearance : ovarian endometriosis • red, blue, or brown spots • endometriomas —— chocolate cysts