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Endometriose

Sist revidert:
Sist revidert av:
Definisjon:
Endometrieliknendevev utenfor uterinhulen. Inflammatorisk tilstand. Sykdomsaktivitet stimuleres av østrogen
Forekomst:
6-10% i den generelle fertile kvinnelige befolkningen.
Symptomer:
Dysmenore, lave magesmerter og kraftig mensblødning. Ev. dysuri og/eller defekasjonssmerter under menstruasjon, obstipasjon, diare, dyp dyspareuni, kvalme
Funn:
Klinisk undersøkelse er ofte normal. Viktige funn ved bimanuell palpasjon er øm oppfylning over adnex/bak cervix, nedsatt mobilitet av uterus
Diagnostikk:
Effekt av empirisk hormonell behandling og NSAID (primærhelsetjenesten). Ev. transvaginal UL og ev. laparoskopi.
Behandling:
Symptomatisk behandling med NSAIDs, empirisk hormonell behandling.Kirurgi ved manglende effekt av hormoner eller funn av omfattende endometriose. Ev. assistert befruktning ved infertilitet
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  9. Vercellini P, Bracco B, Mosconi P et al. Norethindrone acetate or dienogest for the treatment of symptomatic endometriosis: a before and after study. Fertil Steril. 2016 Mar;105(3):734-743.e3. Epub 2015 Dec 8. PMID: 26677792. PubMed  
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  14. Banerjee SK, Ballard KD, Wright JT. Endometriomas as a marker of disease severity. J Minim Invasive Gynecol. 2008 Sep-Oct;15(5):538-40. Epub 2008 Jul 10. PMID: 18619924. PubMed  
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  16. Johnson NP, Hummelshoj L. Reply: consensus on current management of endometriosis. Hum Reprod. 2013 Nov;28(11):3163-4. Epub 2013 Sep 5. PMID: 24014602. PubMed  
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  18. Chen YJ, Hsu TF, Huang BS, et al. Postoperative maintenance levonorgestrel-releasing intrauterine system and endometrioma recurrence: a randomized controlled study. Am J Obstet Gynecol 2017; 216: 582.e1-582.e9. pmid:28209488 PubMed  
  19. Zhu X, Hamilton KD, McNicol ED. Acupuncture for pain in endometriosis. Cochrane Database of Systematic Reviews 2011; 9: CD007864. Cochrane (DOI)  
  20. Hickey M, Ballard K, Farquhar C. Endometriosis. BMJ. 2014 ;348:g1752. doi: 10.1136/bmj.g1752 DOI  
  21. Schwartz A, Wölfler MM, Mitter V et al. Endometriosis espesially mild disease a risk factor for misscarriages. Fertil Steril 2017;108:5:806-14. PMID: 29079275 PubMed  
  • Ingrid Marie Ringen, spesialist i kvinnesykdommer og fødselshjelp, overlege, seksjon for generell gynekologi, Kvinneklinikken, St. Olavs hospital Trondheim
  • Silje Folven Barlindhaug, spesialist i allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Mette Haase Moen, førsteamanuensis ved Norges teknisk-naturvitenskapelige universitet og overlege ved Kvinneklinikken St. Olavs Hospital, Trondheim