NURSING

1. PRESENTATION ON
ENDOMETRIOSIS
SUBMITTED TO:- SUBMITTED BY:-
Mrs. Snehlata Parashar Govind Dayma
(Lecturer OBG) B.sc Nursing 4th Year

2. ENDOMETRIOSIS
DEFINATION:
 Presence of Functioning endometrium (gland and
stroma) in site other than uterine mucosa is called
endometriosis.
 It is mot neoplastic condition, although malignant
transformation is possible.

3. PREVALENCE
The prevalence is about 10% of all
women between menarche and
menopause
The prevalence increase both in term of
real and apparent.

4. SITE
 ABDOMINAL: it can occur at any site but mainly
confined to the abdominal structure below the level of
umblicus.
 EXTRA-ABDOMINAL:- the common site are
abdominal scar of hysterotomy, CS, espisiotomy scar,
vagina and cervix.
 REMOTE:- umblicus, lungs, pleura, ureter, kidney,
arms, legs, nasal mucosa

5. RISK FACTOR
Low parity
Delayed child bearing
Family history
Genital tract obstruction

6. AETILOGY: THEORIES
1. Sampson’s theory of menstrual reguragitation and
implantion (metastatic theory)
2. Coelomic metaplasia theory
3. Lymphatic & vascular meastases theory
4. Genetic factors
5. immunological factors
6. inflammation

7. SIGNS & SYMPTOMS
SYMPTOMS
 Dysmenorrhoea
 Dyspareunia
 Deep seated pelvic
pain
 Dysuria
 Hematuria
 Infertility
SIGNS
•Tenderness in cul-de-sac
•Nodularity in cul-de-sac
•Fixed retroverted uterus
•Adnexal tenderness
•Adnexal masses

8. INVESTIGATIONS
 CT & MRI: identical picture as in USG
 COLOUR DOPPLER FLOW: Increased Vascularity
 CYTOSCOPY: involvement of bladder
 SIGMOIDOSCOPY: if the women develops bowel
symptoms

9. DIAGNOSIS
EXAMINATION
on bimanual pelvic examination, fixed
retroverted uterus, bilateral pelvic tenderness,
fixed or enlarged ovaries and painful
uterosacral nodularity

10. DRUG TREATMENT
 Combined oral contraceptives
 Oral progestogens
 Danazol
 Aromatase inhibitors
 Gonadotropin releasing hormone
 RU-486

11. SURGERY
 Laparotomy:
 In advcanced & larger lesions if medical therapy fails
 Inspect the letral side wall, all ovarian surface, both side of
the broad ligament, the bladder, bowel serosa, inferior
aspect of cul-de-sac
 Total hysterectomy & B/L oophorectiomy:
 Women with severe symptoms & those with fertility is not a
problems.

12. COMPLICATIONS
Malignant transformation
Endometrioma rupture
Endomtrioma infection

13. BIBLIOGRAPHY
Text book of obstetrics, D.C
DUTTA( page 113-115)
www.google.com
www.wikipedia.org

14. THANK
YOU