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Endometriosis externa and interna: endoscopic diagnosis
L Muzii1, G F Catalano, R Marana
1Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Policlinico A. Gemelli, Roma, Italy.
Rays
|April 7, 1999
Summary
Endometriosis involves uterine lining tissue outside the uterus. Diagnosis of pelvic endometriosis requires invasive surgery, while adenomyosis diagnosis relies on hysterectomy specimen histology for accuracy.
Area of Science:
- Gynecology
- Surgical Pathology
Background:
- Endometriosis is characterized by endometrium outside the uterine cavity.
- Endometriosis interna (adenomyosis) occurs within the endometrium.
- Endometriosis externa (pelvic endometriosis) is located outside the uterus.
Purpose of the Study:
- To describe the diagnostic methods for endometriosis.
- To differentiate between pelvic endometriosis and adenomyosis.
- To outline the staging and prognostic factors for pelvic endometriosis.
Main Methods:
- Diagnosis of pelvic endometriosis involves invasive procedures like laparoscopy or laparotomy.
- Histologic confirmation from surgical specimens is required for diagnosis.
- Adenomyosis diagnosis is primarily based on hysterectomy specimen histology due to limitations in endoscopic diagnosis.
Main Results:
- Laparoscopy enables visualization of superficial implants, deep lesions, and adhesions in pelvic endometriosis.
- Histology remains the gold standard for confirming both types of endometriosis.
- A staging system based on lesion scoring aids in prognosis for reproductive outcomes.
Conclusions:
- Accurate diagnosis of endometriosis, particularly pelvic endometriosis, relies on invasive surgical techniques and histological analysis.
- Adenomyosis diagnosis is best achieved through post-hysterectomy histology.
- Staging of pelvic endometriosis provides prognostic information regarding reproductive performance.