Endometriosis, 1995--confusion or sense?
OBJECTIVE
To review current understanding of endometriosis.


METHODS
A review of etiology, pathogenesis, relationship with infertility, medical and surgical treatment.


RESULTS
It is likely that endometriosis occurs in most women at some stage in their reproductive years. Exposure to menstruation and estrogen are important etiologically. Current evidence suggests that implantation of menstrual endometrium is the commonest mechanism of pathogenesis. Clinical symptoms and signs are important in the diagnosis while laparoscopy remains the prime diagnostic technique. Treatment is not indicated for infertility but is for symptoms. Danazol and progestogens represent the best first-line therapy although gonadotropin-releasing hormone agonists are appropriate if economically justifiable. Both open and laparoscopic surgery are important especially in reconstructive work. The value of laser ablation in the treatment of infertility is unknown but it is effective in pain. The disease should be regarded as a recurrent problem and treatment strategies designed appropriately.


CONCLUSIONS
Endometriosis still represents an intellectual and therapeutic challenge but successful treatment is possible especially if it is individualized for each patient.
Thomas
E J
EJ
University of Southampton, Southampton University Hospital Trust, UK.
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood; D003613:Danazol / Q000627:therapeutic use; D004715:Endometriosis / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008487:Medical History Taking; D011372:Progestins / Q000627:therapeutic use; D012008:Recurrence
D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D018394:CA-125 Antigen; D011372:Progestins; D007987:Gonadotropin-Releasing Hormone; D003613:Danazol