Endometriosis Pathogenesis and Management
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 19, Issue 3
Abstract
Endometriosis has been described over 300 years ago [1-3]. It is a major cause of pain and infertility in 35-50% of women and chronic pelvic pain in 6-10% of women. It is a major cause of hospitalization and hysterectomy, with annual cost of 1.8 billion dollars in 2009 in Alberta and Quebec, Canada [4], 1.5 billion dollars in Germany, and 20 billion dollars in the United States [5]. Endometriosis is an estrogen dependent condition. On the other hand, this disease leads to defective response of Eutopic endometrium to progesterone and therefore implantation is difficult to occur thus leading to infertility or pregnancy loss. In addition, nerve fibers have been demonstrated in Eutopic endometrium of patients with endometriosis [6]. Infertility due to pelvic endometriosis may be caused by several factors. Ovulatory dysfunction may result from the high concentrations of prostoglandins and cytokines in the peritoneal fluid in these patients [7]. Prostaglandins also may lead to tubal dysfunction that will interfere with the pickup of the oocyte from the ovary, and also the motion of the sperm towards the oocyte with the result of failure of fertilization to take place. Furthermore, the endometrium of these patients has been shown to have aromatase that leads to high estradiol concentration and that might lead to defective response to progesterone, and the end result will be failure of implantation [8]. The first reference to endometriosis associated symptoms are found in the Ebers Papyrus (Tebas, Egypt, 500 BC) in which treatment for painful disorder of menstruation is described. In the 18th Century, scientists from England, Germany, Holland, and Scotland described endometriosis in autopsy studies [9]. Rokitansky (mid part of 19th Century-1885), suggested the presence of endometrial glands and stroma in ovarian and uterine neoplasia [10]. Cullen (1919) [11]: Was the first scientist to demonstrate histologically endometrial structures in the peritoneum of patients and called this process as adenomyoma of the peritoneum or adenomysis externa. Russel [12]: Published a report in 1899 of an ovaries containing uterine mucosa. Sampson (1927) [13]: The first to describe the menstrual reflux theory for the development of endometriosis. He also described the various types of the disease including chocolate cysts, and deep infiltrating disease in the pelvis.
Authors and Affiliations
Shawky ZA Badawy
Keywords
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- EP ID EP621753
- DOI 10.26717/BJSTR.2019.19.003299
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