J Clin Outcomes Manage
Diagnosis and treatment of an ovarian endometrioma in a young woman with dysmenorrhea
Abstract Objective: To review the diagnosis and treatment of endometriosis in young women. Methods: Qualitative assessment of the literature. Results: Endometriosis is one of the most common conditions affecting young women and may result in considerable patient suffering. Primary symptoms include dysmenorrhea, dyspareunia, noncyclic pelvic pain, and subfertility. Diagnosis is reliably made only by laparoscopy, but extent of disease on laparoscopy often does not correlate with symptoms. Medical therapy emphasizes ovarian suppression, but large lesions respond poorly and recurrence is common following medication cessation. If endometriosis is diagnosed at the time of laparoscopy, laparoscopic surgery is the treatment of choice, particularly in reproductive-age women with endometriomata, in which excision should be performed. Recurrence of endometriosis following laparoscopic surgery is common. Further studies are needed to determine whether postoperative medical treatment is beneficial. Conclusion: Endometriosis may result in considerable patient suffering and should be suspected in any woman of reproductive age who presents with chronic dysmenorrhea or pelvic pain. Once a diagnosis is made, treatment goals include optimal pain management, preservation of fertility, and prevention of recurrence.
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