Ovaryen Endometriozis
Synopsis
Ovaryen endometriozis, doğurganlık çağındaki kadınların %10’unda görülen ve dünya genelinde 176 milyon kadını etkileyen yaygın bir jinekolojik hastalıktır. Endometriozis vakalarının %17-44’ü overlerde yerleşir ve endometrioma adı verilen kistik yapılar oluşturur. Hastalık, şiddetli ağrı ve kronik pelvik inflamasyon ile karakterizedir ve infertiliteye neden olabilir. Tanı genellikle geç konur, ortalama tanı gecikmesi 6-10 yıl arasındadır. Patogenez teorileri arasında retrograd menstrüasyon, coelomik metaplazi, immünolojik disfonksiyon, genetik yatkınlık ve vasküler yayılım yer alır. Klinik belirtiler arasında kronik pelvik ağrı, dismenore, disparoni ve anormal uterin kanama bulunur. Tanı, fizik muayene, laboratuvar testleri, görüntüleme yöntemleri ve laparoskopi ile konur. Tedavi seçenekleri arasında hormonal tedaviler, cerrahi müdahale ve infertilite tedavileri yer alır. Laparoskopi, tanı ve tedavide altın standart olarak kabul edilir. Endometriozisli kadınların %30-50’si infertilite ile karşı karşıya kalmaktadır ve IVF gibi asistif üreme teknikleri bu hastalar için önerilmektedir.
Ovarian endometriosis is a common gynecological disease affecting 10% of women of reproductive age and an estimated 176 million women worldwide. Approximately 17-44% of endometriosis cases are located in the ovaries, resulting in cystic structures called endometriomas. The disease is characterized by severe pain and chronic pelvic inflammation, and it can lead to infertility. Diagnosis is often delayed, with an average delay of 6-10 years. Theories of pathogenesis include retrograde menstruation, coelomic metaplasia, immunological dysfunction, genetic predisposition, and vascular dissemination. Clinical features include chronic pelvic pain, dysmenorrhea, dyspareunia, and abnormal uterine bleeding. Diagnosis is made through physical examination, laboratory tests, imaging methods, and laparoscopy. Treatment options include hormonal therapies, surgical intervention, and infertility treatments. Laparoscopy is considered the gold standard for diagnosis and treatment. Between 30-50% of women with endometriosis face infertility, and assisted reproductive techniques such as IVF are recommended for these patients.
References
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