endometriosis and adenomyosis

Understand the pathology of endometriosis and recognize its involvement in chronic pelvic pain
Recognize the association between endometriosis and subfertility.
• Understand how to diagnose and treat endometriosis.
defined as the presence of endometrial surface epithelium & or presence of endometrial glands & stroma outside the lining of the uterine cavity .
Endometriosis occurs in approximately 5–10% of women of reproductive age.
It is most commonly found in the pelvis , on the surface of the ovary , on pelvic endometrium , fallopian tubes & broad ligament .
It may be seen in remote sites such as skin , joint , lung.Typical peritoneal lesion is described as a powder burn .
These ectopic endometrial tissues respond to the clinical changes in ovarian hormones .It is a condition that is
oestrogen dependent and therefore it resolves after the menopause
or when treatment is directed towards
inducing a pseudomenopause.
1- Menstrual regurgitation& :
Sampson’s implantation theory:
endometriosis result from the retrograde menstrual reguargitation of viable endometrial glands & tissue within the menstrual fluid & subsequent implantation on the peritoneal surface .