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Medicina Legal de Costa Rica
On-line version ISSN 2215-5287Print version ISSN 1409-0015
Abstract
DURON GONZALEZ, Rodrigo and BOLANOS MORERA, Pamela. Endometriosis. Med. leg. Costa Rica [online]. 2018, vol.35, n.1, pp.23-29. ISSN 2215-5287.
Endometriosis is a benign, estrogen dependent, inflammatory disease, which is characterized by the presence of endometrial glands and stroma in a site different from the uterine cavity. The main theories about it’s pathogenesis involve retrograde menstruation, metaplasia of the germinal epithelium, and metastatic spread. The lesions are typically located in the pelvis; in ovaries, utero sacral ligaments and Douglas pouch, but can also have an extra pelvic location. This disease has a variable clinical presentation that involves dysmenorrhea, dyspareunia, pelvic pain and infertility.
It’s definitive diagnosis is surgical. Medical treatment is only symptomatic and non-curative, while the surgical treatment despite being curative has important recurrence rates. Assisted reproduction techniques are very useful to improve birth rates in case of infertility associated with the disease.
Keywords : Endometriosis; pelvic pain; endometrioma; infertility; dysmenorrhea; aromatase inhibitors; GnRH agonists.