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hanin muhsen

on 17 December 2014

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Transcript of Endometriosis

what is it?
Endometriosis is a condition resulting from the appearance of endometrial tissue outside the uterus.
late into medical knowledge
symptoms were poorly understood because of the condition being internal
endometriosis could only be studied through the performing of autopsies and anatomic dissections
these occurred in ancient Egypt and southern Italy before the time of christ
What is its history?
What causes it?
Retrograde menstruation
- when menstral fluid flows backward into the fallopian tubes instead of the vagina
- this backflow spills into the pelvic cavity because the fallopian tubes are open ended
- this leads to the transfer of the endometrial cells to other tissues of the pelvis
genetic defects
immunological abnormalities
ovarian steroids oestrogen and progesterone are intimately involved in the development of endometriosis
How is it
A doctor will...
step: 1
take medical history
step: 2
conduct a pelvic exam
internally check for lumps and bumps
ask about any occurrence of symptoms associated with endometriosis
step: 3
may request an ultrasound of the pelvis to look for cysts on the ovary
Other forms of diagnosis
Biopsy: a procedure where tissue samples are removed (with a needle or during surgery) taken from the body (often during a laparoscopy) to be examed under a microscope to help determine if cancer or other abnormal cells are present
Ultrasound: an diagnostic imaging technique that creates an image of the internal organs with the use of high-frequency sound waves
Computed tomography (CT scan): a diagnostic imaging procedure, which by using a combination of X-rays and computer technology to produce of the body to find any abnormalities that may not show up on an ordinary X-ray
Magnetic resonance imaging (MRI): A noninvasive procedure which creates a two-dimensional view of an internal organ or structure
what are the
pelvic pain
changes in menstruation
pain and cramps during menstruation (Dysmenorrhea)
Dyspareunia (painful intercourse)
(Dysuria) painful urination during periods
painful bowel movements during periods
no symptoms
affects an estimated 1 in 10 women during their reproductive years (i.e most often the ages between 15 and 49), which is approximately 176 million women in the world
even after menopause the symptoms of endometriosis may not resolve if the woman has scar tissue or adhesions from the disease and/or treatment especailly
can affect physical, mental and socail well being
How is it
a laparoscopy (can also be used for diagnosis) , uses laser or thermal techniques to burn off the endometrial tissue
a Hysterectomy with salpingo-oophorectomy (abdominal incisions to remove the uterus and ovaries) can be performe
" Watchful waiting" (to observe the course of the disease)
Pain medication (nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen)
Hormone therapy, including:
Gonadotropin-releasing hormone agonist (GnRH agonist), which stops ovarian hormone production "medical menopause"
to prevent ovulation and reduce the menstral flow oral contraceptives can be taken, consisting of combined estrogen and progestin (a synthetic form of progesterone) hormones
only Progestins
If the history and pelvic exam suggest endometriosis, the next step may involve a procedure called laparoscopy. With this procedure, a tiny cut is made near the navel and a thin tube inserted. This tube (the laparoscope) is an illuminated microscope that enables the doctor to clearly see the endometriosis on the outer surfaces of the pelvic organs. The doctor may take a tissue sample during a laparoscopy and a pathologist examines the tissue sample to confirm if endometriosis was found. Laparoscopy can also be used to treat endometriosis, using a laser or electricity to burn off the endometrial tissue.
is being conducted to influence the
future outlook
five years following surgery or medical treatment, 20-50% of women will have a recurrence
Long-term medical treatment (with or without surgery) can potentially reduce recurrence, however there is no clear evidence for this
endometriosis may or may not be progressive because of its unclear natural course
- two studies following the natural history of endometriosis were conducted over 6-12 months, in the study
endometrial deposits resolved spontaneously in a third of women, deteriorated in nearly half, and were unchanged in the remainder
very commonly patients relapse after being surgically treated Surgical cohort studies report a 20% recurrence rate at two years and 40-50% at five years
very few risk factors for recurrence have been identified in consistance
the use of biomarkers to identify recurrences is under investigation
increasingly, the interactions of sex steroids(i.e estrogen and progesterone with the inflammatory cascades of endometriosis are being studied at a molecular level for a better future outlook in terms of progressive treatments or even a cure
the Juneau Biosciences team of researchers is applying a population-based gene mapping approach, this form of genetic research requires DNA samples from thousands of women with and without the disease. Each sample is accompanied by a questionnaire completed by the participant as well as a review of their medical record. No personally identifying information is provided to the laboratory or scientific personnel for the privacy of the patient. Each DNA sample is processed with state-of-the-art equipment, it makes comparisons across the entire genome with other samples
Statistical programs are then used to find trends in the genetic information to then match these trends with the clinical information. Gradually, a picture of the genes emerges, which consistently play a part in the development of these disorders.
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