Endometriosis [antikvár]

Introduction Endometriosis, since Sampson first coined its name in the 1920s, has remained a perplexing, poorly understood disease of the female reproductive system. It affects women in the reproductive years, limits their fertility, and seriously impairs their health, although it is not life-threatening. It is not known why some women acquire this disease, but it is well established that its persistence and spread are stimulated by the cyclic secretion of ovarian hormones. Retrograde tubal transport of shed endometrial fragments, postulated by Sampson to be the etiologic factor, probably plays a role in the development of endometriosis, but the pathogenesis of this disease is much more complex and remains unclear. The development of effective diagnostic and therapeutic methods has been hindered by the unknown etiology of endometriosis. Endometriosis can be diagnosed only by laparoscopy or laparotomy; noninvasive diagnostic techniques are not available. However, new basic research developments, primarily in the field of reproductive immunology, are promising. Several studies strongly suggest that the immune system may play a significant role in the pathophysiology of endometriosis and that the disease may be a systemic disorder. This monograph is a review of the pathophysiology of endometriosis, clinical features, and characteristic laparoscopic findings, relationship to infertility, and methods of treatment, with specific attention to newer developments in hormonal therapy using GnRH agonists.