What is endometriosis?

Abstract:

Objectives:

To compare histologically and stereologically the endometriotic nodule of the rectovaginal septum to peritoneal endometriosis.

Design:

Morphometric investigation, cytokeratin and vimentin content, and steroid receptor evaluation were performed on endometriotic tissue from the peritoneum (n = 52) and rectovaginal nodules (n = 68).

Setting:

An academic teaching hospital.

Patients:

Biopsies were taken from 120 patients undergoing a laparoscopy for infertility and/or pelvic pain (52 from typical black peritoneal endometriotic implants and 68 from endometriotic nodule of the rectovaginal septum). None of the patients were treated.

Results:

Mitotic activity was found to be significantly different in peritoneal and rectovaginal endometriosis. The evaluation suggested that the stroma is not mandatory for the invasion of glandular epithelium in the rectovaginal nodule, which is, like a adenomyoma, a circumscribed nodular aggregate of smooth muscle and glandular elements. Cytokeratin and vimentin content as well as the estrogen receptor (ER) and P receptor (PR) content were significantly lower in both types of lesion when compared with eutopic endometrium. But vimentin immunoreactivity in epithelium, as well as the ER and PR content, were significantly lower in nodules when compared with black peritoneal lesions.

Conclusion:

It is suggested that the rectovaginal endometriotic nodule is a different disease from peritoneal endometriosis and must be called rectovaginal adenomyosis or rectovaginal adenomyoma. Its histopathogenesis probably is not related to the implantation of regurgitated endometrial cells but to the metaplasia of Mullerian rests.

Please click on the required question.

• 1 Pelvic Pain. Is this a common problem?
• 2 What are the common causes of pelvic pain in women?
• 3 What are the more common gynaecological causes of pelvic pain?
• 4 What are the more common non-gynaecological causes of pelvic pain?
• 5 What are primary and secondary dysmenorrhoea - painful periods?
• 6 What is retrograde menstruation?
• 7 How can dysmenorrhoea - painful periods be treated?
• 8 What are ovarian cysts?
• 9 How do ovarian cysts cause pain?
• 10 How are ovarian cysts diagnosed?
• 11 How are ovarian cysts treated?
• 12 I think I may be pregnant and I have some pelvic pain. What should I do?
• 13 What is pelvic inflammatory disease and how can it be treated?
• Mittelschmertz

FIBROIDS

•  What are fibroids?
•  I have fibroids. What difficulties might they cause for me?
•  How are fibroids diagnosed?
•  How could my fibroids be treated?

  ENDOMETRIOSIS

•  What is endometriosis?
•  How prevalent is endometriosis?
•  What causes endometriosis?
•  How can my endometriosis be treated?
•  How can my doctor determine the cause of my pelvic pain?
•  What investigations might be recommended by my gynaecologist to investigate my pelvic pain?
•  What is laparoscopy?
•  What are pelvic adhesions?
•  I have chronic pelvic pain. Could this be related to adhesions?
•  What is uterine retroversion (retroverted uterus)
•   Does a retroverted uterus (backward tilted uterus) cause symptoms?
•  How is a retroverted uterus - backward tilted uterus - treated?
•  What is pelvic congestion?
•  What causes pain associated with sexual intercourse (dyspareunia)
•  How can painful sexual intercourse (dyspareunia) be treated?
•  What is a pelvic mass?

  IRRITABLE BOWEL SYNDROME - IBS

•  What is irritable bowel syndrome?
•  How can we find out if I have irritable bowel syndrome?
•  Is irritable bowel syndrome (IBS) a common condition?
•  What causes IBS?
•  What is the pain associated with IBS like?
•  Can IBS be mistaken for gynaecological problems?
•  How can my IBS be treated?
•  What other treatments are available for IBS?
•  What can be done to reduce the amount of bowel gas(flatus)
•  What is constipation?
•  What causes constipation?
•   How can constipation be treated?
•  How could we summarise the treatments that are available for my pelvic pain?
•  Where can I obtain more information?
•  Pelvic Pain Support Groups.
•  Endometriosis Support Groups.
•  IBS Support Groups.




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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.