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Del Pozo Roselló Javier

Gynecology and Obstetrics

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What is endometriosis?

Endometriosis is a benign process characterized by the presence and proliferation of endometrial tissue that is normally found within the uterus, in other different areas outside of this cavity. There are different types:

Ovarian endometriosis: in the ovaries, giving rise to quite large size cysts - endometriomas. These contain a dark brown fluid, which accounts for their name of "chocolate cysts".
Recto-vaginal septum endometriosis: appears in the recto-vaginal space, the tissue found between the rectum and the vagina. Deep and very active.
Peritoneal endometriosis: affects the peritoneum, the tissue covering the internal organs. It frequently adopts different forms; reddish or brown-coloured patches or small cysts of a dark blue colour. These cysts are often found in the posterior wall of the uterus, but they can also occur in the bladder or intestines.

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¿Qué tipos hay?
Revestimiento endometrial normalExisten tres tipos distintos de endometriosis identificadas:
- Una de ellas se desarrolla en los ovarios, dando lugar a quistes que pueden alcanzar tamaños considerables; estos se conocen con el nombre de endometriomas. Dichos quistes contienen un líquido espeso de color marrón oscuro, lo que hace que se les denomine quistes de chocolate. Es la endometriosis ovárica.
- Otro tipo aparece en el tabique recto-vaginal, tejido que se encuentra entre el recto y la vagina. Es una endometriosis profunda y muy activa y recibe el nombre de endometriosis del septum recto-vaginal.
- Una tercera afecta al peritoneo, tejido que recubre los órganos internos. Esta suele adoptar distintas formas; manchas rojizas o marrones, o pequeños quistes de un color azul oscuro. Habitualmente se encuentran en la cara posterior del útero, pero también pueden localizarse en la vejiga urinaria o intestinos. Su principal característica es que puede crear grandes adherencias en diversos órganos. Es conocida como endometriosis peritoneal.
En ocasiones, el tejido endometrial posee una capacidad de crecimiento y diseminación similar a la de los tumores malignos, y por ello se le ha denominado el cáncer benigno.
What are the causes of endometriosis?

The real cause remains unknown. However, the most widely accepted theory is that of retrograde menstruation, the reflux of menstrual fluid to the abdominal cavity and the implantation of endometrial glands in the peritoneum or in the intra-abdominal organs. Most women suffer from it, although it does not result in endometriosis in all cases, thereby pointing to additional factors that lead to the proliferation of endometrial cells. This reflux may begin during puberty, although symptoms may not appear until later. Recent research suggests that certain environmental toxins, such as dioxin, could be responsible for what appears to be a modern epidemic: endometriosis.

As regards genetic predisposition, between 15-20 % of women suffer from this disease. Endometriosis runs in some families. If a mother or daughter have this disease, the chances of another family member developing it is increased seven-fold.
Predisposición genética
Entre un 15 y un 20% de las mujeres padecen esta enfermedad. Un dato curioso es que se encuentran lesiones en un 70% de autopsias efectuadas en la menopausia, habiendo pasado desapercibidas durante toda la vida. Se sabe que existen familias con endometriosis. Si una madre o hija la padecen, las posibilidades de que algún otro miembro de la familia desarrolle la enfermedad se incrementa unas siete veces.
What are the symptoms of endometriosis?
- Pain of highly variable intensity during menstruation or coitus; or back pains. Also generalized pelvic pain with abdominal distension. Although this is the most frequent symptom, some women do not suffer from it
- Chronic fatigue
- Sterility: between 30-50%
- Polycystic ovary disease, uterine miomas, ovarian cysts or congenital or acquired genital malformations.
Endometrosis-4
How is endometriosis diagnosed?
Determined by the presence of pelvic pain, a palpable lump in the pelvis or sterility.Suspects of endometriosis can be confirmed by a surgical laparoscopic procedure. Laparoscopy is the most common surgical procedure for the diagnosis and treatment of endometriosis. This type of operation may also be known as key-hole surgery and is one of the lesser forms of invasive surgical treatment available today.

During this surgical operation under general anaesthetic, a fine endoscope photo-transmitter (laparoscope) is inserted through a tiny incision in the abdomen, just below the navel, it is equipped with lens for a clear view. During a laparoscopic procedure, endometrial implants can be easily seen once these implants have reached a reasonable size. The implants that are still tiny cannot be seen by the naked eye. The surgeon is able to examine the condition of the abdominal organs and verify the size and magnitude of the endometrial tumours, remove endometrial implants, separate any adhesions, also drain and treat or remove large cysts. This method enables other problems presenting similar symptoms to be ruled out.

Other techniques such as ecography, scanning or magnetic resonance may detect the presence of endometriosic lesions in other locations. However, only laparoscopy has so far been able to provide early diagnosis of this disease in women of child-bearing age.

Diagnostic laparoscopy is recommended in the following cases:
- Sterile woman under study
- Sterility of unknown origin
- Abnormalities found during examination of the Fallopian tubes: hysterosalpingography
- Patients with pelvic pain
- Anomalies in pelvic examination
Laparoscopia diagnóstica
La laparoscopia diagnóstica para descartar una endometriosis está indicada en los siguientes casos:
- Mujer estéril en fase de estudio
- Esterilidad de origen desconocido
- Cuando hay hallazgos anormales en la exploración de las trompas: "histerosalpingografía"
- Pacientes con dolor pélvico
- Anomalías en el examen pélvico

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Centro Médico Teknon

Del Pozo Roselló Javier

Doctor's Office 25

Marquesa de Vilallonga, 12

08017 Barcelona

93 290 64 25

info@clinicaginecologica.org

www.clinicaginecologica.org

Schedules

	Morning	Afternoon
Monday	10.00 - 20.00 h	-
Tuesday	10.00 - 20.00 h	-
Wednesday	10.00 - 20.00 h	-
Thursday	10.00 - 20.00 h	-
Friday	09.00 - 14.00 h	-

Carrer de Vilana, 12, 08022 Barcelona

932 906 200