Diagnosis and treatment of endometriosis

Heeyon Kim; SiHyun Cho

doi:10.5124/jkma.2019.62.10.513

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Kim and Cho: Diagnosis and treatment of endometriosis

Focused Issue of this Month

J Korean Med Assoc 2019;62(10):513-518.

Published online: 17 October 2019

DOI: https://doi.org/10.5124/jkma.2019.62.10.513

Diagnosis and treatment of endometriosis

Heeyon Kim, MD, SiHyun Cho, MD

Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

Corresponding author: SiHyun Cho E-mail: sihyuncho@yuhs.ac

Received 28 August 2019 Accepted 4 September 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Endometriosis is a common gynecological condition characterized by chronic pelvic pain, dysmenorrhea and subfertility. However, the pathophysiology of the disease remains unclear and accurate non-invasive diagnostic methods are unavailable. Although clinical symptoms, serum biomarkers, and imaging studies, such as transvaginal ultrasonography and magnetic resonance imaging are useful diagnostic aids, laparoscopy remains the gold standard for the diagnosis of endometriosis. The treatment of endometriosis should be individualized and a multi-disciplinary approach is recommended based on degree of disease-associated symptoms, patient characteristics and preferences, reproductive plans, and desired quality of life. Surgical management is effective for subfertility, chronic pain, and ovarian endometriomas. The principle of surgery is removal of all ectopic endometrial lesions while ensuring that no lesions are missed. Currently, numerous medical treatment options are available to manage endometriosis-associated symptoms; however, all modalities are suppressive rather than curative. Further studies are needed to clarify the exact pathophysiology of endometriosis to enable the development of non-invasive diagnostic tools for early detection and to indicate potential therapeutic targets for this chronic and frustrating disease.

Keywords: Endometriosis, Pelvic pain, Dysmenorrhea, Subferfility

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