Title Endometriosis Title (croatian) Endometrioza Author Miro Kerner Mentor Vladimir Banović (mentor)Committee member Vladimir Banović (predsjednik povjerenstva)Committee member Držislav Kalafatić (član povjerenstva)Committee member Dinka Pavičić Baldani (član povjerenstva)Granter University of Zagreb Defense date and country 2024-07-12, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Endometriosis is a gynecologic chronic inflammatory disease branded by the presence of ectopic endometrial tissue outside the uterus, frequently in the pelvis. Core symptoms of endometriosis are chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. John Sampson first described it and named it in 1920is. Endometriosis is a complex disease with an unknown correct origin. There are several mentioned theories with retrograde menstruation from fallopian tubes as the main one. Endometriosis has a heavy burden on patients and their relatives, as they lose capacity for work and coitus due to severe pain. It is believed that endometriosis is present in 5-10% of women of reproductive age. Diagnosis of endometriosis is by thorough patient history, clinical exam, and diagnostic workup (Ultrasound, MR). Unfulfilled diagnosis leads to investigative laparoscopy plus endometrial tissue biopsy which was once considered a “gold standard” for diagnosis. Investigative laparoscopy and visualization of the location and size of endometrial lesions is the only definitive diagnosis. Endometriosis treatment modalities include pharmacological, surgical, or combined treatment. Infertile women have the additional option of assisted reproductive technology. Treatment is not curative; it is usually suppressive (symptomatic) and tries to reduce the pain and burden. Pharmacological treatment relies on hormones that create a state of hypoestrogenism. These include progestogens, oral hormonal contraceptives, and gonadotropin-releasing hormone analogs, they suppress the size of the lesion and symptoms. Drugs currently under exploration as potential therapies, including aromatase inhibitors, gonadotropin-releasing hormone antagonists, and selective modulators of progesterone and estrogen receptors, have demonstrated value in reducing endometriotic lesions in experimental models. Surgical therapy is usually done laparoscopically when the first line pharmacologic treatment fails when the lesions are too big or when endometriosis is severe. Surgery is carefully elected to preserve the patient’s fertility and ovarian reserves.
Abstract (croatian) Endometrioza je kronična upalna bolest obilježena prisutnošću ektopičnog endometrijskog tkiva izvan maternice, najčešće u zdjelici. Glavni simptomi endometrioze su kronična zdjelična bol, dismenoreja, dispareunija i neplodnost. John Sampson je prvi opisao i imenovao ovu bolest. Endometrioza je kompleksna bolest nepoznatog točnog podrijetla. Postoji nekoliko teorija koje objašnjavaju njezin nastanak, s retrogradnom menstruacijom iz jajovoda kao glavnom teorijom. Endometrioza predstavlja veliko opterećenje za pacijentice i njihove obitelji, jer gube radnu sposobnost i sposobnost za spolne odnose zbog jake boli. Vjeruje se da je endometrioza prisutna kod 5-10% žena reproduktivne dobi. Dijagnoza se postavlja temeljem detaljne anamneze pacijentice, kliničkog pregleda i dijagnostičkih pretraga (ultrazvuk, MR). Kada ove metode ne daju zadovoljavajuću dijagnozu, provodi se istražna laparoskopija i biopsija endometrijskog tkiva, što je nekada smatrano "zlatnim standardom" za dijagnozu. Istražna laparoskopija i vizualizacija mjesta i veličine endometrijskih lezija jedina je konačna dijagnoza. Metode liječenja endometrioze uključuju farmakološko, kirurško ili kombinirano liječenje. Neplodne žene imaju dodatnu mogućnost asistirane reproduktivne tehnologije. Liječenje nije kurativno, obično je supresivno, s ciljem smanjenja boli i opterećenja bolesti. Farmakološko liječenje uglavnom se oslanja na hormone koji smanjuju stvaranje estrogena. To uključuje gestagene, oralne hormonske kontraceptive i analoge gonadotropin-otpuštajućeg hormona, koji suprimiraju veličinu lezija i simptome. Trenutno se istražuju lijekovi kao potencijalne terapije, uključujući inhibitore aromataze, antagoniste gonadotropin-otpuštajućeg hormona i selektivne modulatore progesteronskih i estrogenskih receptora, koji su pokazali učinkovitost u smanjenju endometrijskih lezija u eksperimentalnim modelima. Kirurško liječenje obično se provodi laparoskopijom kada prvi red farmakološkog liječenja ne uspije, kada su lezije prevelike ili kada je endometrioza teška. Kirurški zahvati pažljivo se biraju kako bi se očuvala plodnost pacijentice i rezerva jajnika.
Keywords
endometriosis
epidemiology
diagnosis
classification
treatment
Keywords (english)
endometrioza
epidemiologija
dijagnoza
klasifikacija
liječenje
Language croatian URN:NBN urn:nbn:hr:105:439727 Study programme Title: Medicine (in English language) Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2024-10-18 07:46:03
