Publication: La endometriosis: formas de presentación y manejo. Todo un mundo de posibilidades
Loading...
Official URL
Full text at PDC
Publication Date
2017-10-04
Authors
Advisors (or tutors)
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
Universidad Complutense de Madrid
Citations
Exportar
Abstract
La endometriosis se define como la presencia de glándulas endometriales y estroma en localizaciones extrauterinas. Estos implantes endometriales ectópicos son generalmente ubicados en la pelvis, pero pueden ocurrir casi en cualquier parte del organismo. Se trata de una enfermedad benigna estrógeno dependiente y de evolución crónica. Su etiopatogenia, permanece aún hoy en día no del todo aclarada, manejándose varias teorías que podrían explicar de diversas formas el mecanismo de aparición de los implantes de tejido endometrial más allá de su sitio habitual que es la cavidad endometrial, y que junto con diversos factores predisponentes, hacen que determinadas pacientes tengan más predisposición a padecer la enfermedad. Como decimos en el título de nuestro trabajo, la Endometriosis puede manifestarse de muy diversas maneras, y aunque la sintomatología más frecuente, se manifiesta en forma de dismenorrea, dolor pélvico, los problemas reproductivos, no es raro encontrarnos desde pacientes totalmente asintomáticas hasta pacientes con gran sintomatología y gran deterioro de su calidad de vida junto con pacientes que cuya expresión clínica depende del órgano afectado. Todo esto hace que el diagnóstico en ocasiones pueda pasar desapercibido, y que se produzcan retrasos en el mismo hasta de 8-10 años lo cual condiciona que cuando llegamos a saber lo que realmente le ocurre a la paciente, la enfermedad está en fase avanzada con secuelas a veces irreversibles. En la misma línea de una amplia gama de posibilidades de expresión clínica se encuentra el hecho de que asimismo podemos encontrarnos una amplia variedad de opciones terapéuticas, de tal manera que la individualización es un concepto básico a la hora del abordaje terapéutico de nuestras pacientes...
Endometriosis is defined as the presence of endometrial glands and stromae extra-uterus. Ectopic endometrial implants are normally located in the pelvis although they can be found almost anywhere in the body. It is an estrogen-dependent benign chronic disease. Its etiology is still uncertain and there are many theories that explain in many ways how these endometrial tissue implants appear on other places than the endometrial cavity (their original location) and that associated with many predisposing factors, make certain patients more likely to develop this disease. As we say on the title of our dissertation, endometriosis may manifest in many ways and even though the most frequent symptoms are dysmenorrhea, pelvic pain and reproductive impairement, it is not odd to find patients on a range from asymptomatic to very symptomatic; having a great deterioration of their quality of life, as well as patients with symptoms dependent on the affected organ. Due to this variety in clinical presentation, the disease may not be detected for a long time and diagnosis can be delayed up to 8 to 10 years, so when we know what is actually happening to the patient, it is already at an advanced stage, sometimes with irreversible sequelae. Given that there is wide range of clinical manifestations, there are also many therapeutic options, so individualization of treatment is a key concept on our center in patient care. On this dissertation, we present four studies that deepen on several aspects related to this disease and show the different clinical presentations and multiple therapeutic options on which investigation is opening new doors in hope of reaching in the future a non surgical treatment, knowing that as of today, deterioration of quality of life makes us resort to complex surgical treatments with high risk of complications even when performed by experts working in Multidisciplinary Care Divisions...
Endometriosis is defined as the presence of endometrial glands and stromae extra-uterus. Ectopic endometrial implants are normally located in the pelvis although they can be found almost anywhere in the body. It is an estrogen-dependent benign chronic disease. Its etiology is still uncertain and there are many theories that explain in many ways how these endometrial tissue implants appear on other places than the endometrial cavity (their original location) and that associated with many predisposing factors, make certain patients more likely to develop this disease. As we say on the title of our dissertation, endometriosis may manifest in many ways and even though the most frequent symptoms are dysmenorrhea, pelvic pain and reproductive impairement, it is not odd to find patients on a range from asymptomatic to very symptomatic; having a great deterioration of their quality of life, as well as patients with symptoms dependent on the affected organ. Due to this variety in clinical presentation, the disease may not be detected for a long time and diagnosis can be delayed up to 8 to 10 years, so when we know what is actually happening to the patient, it is already at an advanced stage, sometimes with irreversible sequelae. Given that there is wide range of clinical manifestations, there are also many therapeutic options, so individualization of treatment is a key concept on our center in patient care. On this dissertation, we present four studies that deepen on several aspects related to this disease and show the different clinical presentations and multiple therapeutic options on which investigation is opening new doors in hope of reaching in the future a non surgical treatment, knowing that as of today, deterioration of quality of life makes us resort to complex surgical treatments with high risk of complications even when performed by experts working in Multidisciplinary Care Divisions...
Description
Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Obstetricia y Ginecología, leída el 28-01-2016