Definition extension of areas of endometrial glands and stroma into the myometrium also known as ìendometriosis internaî en...
Definition
- extension of areas of endometrial glands and stroma into the myometrium
- also known as ìendometriosis internaî endometrium often remains unresponsive to ovarian hormones uterine wall may be diffusely involved
Incidence
- 15% of females > 35 years old
- 20-40% of hysterectomy specimens
- older parous age group 40-50 years (in contrast to endometriosis)
Symptoms
- menorrhagia
- dysmenorrhea (secondary)
- pelvic discomfort
- dyspareunia
- dyschezia
Diagnosis
- uterus symmetrically bulky
- uterus size is rarely greater than 2-3 times normal
- Halban sign: tender, softened uterus on premenstrual bimanual
- definitive diagnosis made at time of pathological examination
Treatment
- iron supplements as necessary
- D&C to rule out other pathology
- analgesics/NSAIDs
- low dose danazol 100-200 mg daily for 4 months
- GnRH agonists
- hysterectomy
