Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- presencia de factores de riesgo
- dismenorrea
- dolor pélvico crónico o cíclico
- dispareunia
- subfertilidad
- nodularidad del ligamento uterosacro
- masa pélvica
- útero fijo y retrovertido
- depresión
- ansiedad
- no puede asistir al trabajo o a la escuela debido a la dismenorrea
Otros factores de diagnóstico
- disuria, dolor en la fosa lumbar, hematuria
- disquecia, hematoquecia
Factores de riesgo
- grupo en edad reproductiva
- raza blanca
- antecedentes familiares positivos
- nuliparidad
- índice de masa corporal (IMC) bajo
- anomalías mullerianas
- enfermedad autoinmune
- primer encuentro sexual tardío
- tabaquismo
- cesárea previa
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- ultrasonido transvaginal
Pruebas diagnósticas que deben considerarse
- ultrasonido endoscópico rectal
- ultrasonografía 3D
- histerosalpingografía
- resonancia magnética (IRM) de pelvis
- laparoscopia diagnóstica
Algoritmo de tratamiento
fertilidad inmediata no deseada: dolor en ausencia de endometrioma o de sospecha de enfermedad grave/profunda
fertilidad inmediata no deseada: dolor en presencia de endometrioma o sospecha de enfermedad grave/profunda
deseo de fertilidad inmediata
Colaboradores
Autores
M. Jonathon Solnik, MD, FACOG FACS

Professor of Obstetrics, Gynaecology and Medical Imaging by Cross-Appointment
Temerty School of Medicine at the University of Toronto
Head of Gynaecology & Minimally Invasive Surgery
Sinai Health System & Women's College Hospital
Toronto
Canada
Divulgaciones
MJS is an author of a number of references cited in this topic. He acts as a consultant for AbbVie (manufacturer of depot leuprolide and elagolix), Medtronic, Felix Health and Olympus.
Ari Sanders, MD, FRSCS
Clinical Assistant Professor of Obstetrics and Gynecology
Division of Minimally Invasive Gynecologic Surgery
Department of Obstetrics and Gynecology
Peter Lougheed Centre
University of Calgary
Calgary
Canada
Divulgaciones
AS acts as a speaker for Abbvie, Hologic, and Bayer. He is an author of one of the articles cited in this topic.
Agradecimientos
Dr M. Jonathon Solnik and Dr Ari Sanders would like to gratefully acknowledge Dr Sharon M. Jakus, a previous contributor to this topic.
Divulgaciones
SMJ declares that she has no competing interests.
Revisores por pares
Joseph S. Sanfilippo, MD, MBA
Professor
Department of Obstetrics, Gynecology, and Reproductive Sciences
Vice Chairman
Reproductive Sciences
Director
Division of Reproductive Endocrinology and Infertility
University of Pittsburgh
Pittsburgh
PA
Disclosures
JSS declares that he has no competing interests.
Justin C. Konje, MBBS, FMCOG, MRCOG, FWACS, MD, MBA
Professor of Obstetrics and Gynaecology
Leicester Royal Infirmary
Leicester
UK
Disclosures
JCK declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020 Mar 26;382(13):1244-56. Abstract
Falcone T, Flyckt R. Clinical management of endometriosis. Obstet Gynecol. 2018 Mar;131(3):557-71. Abstract
Hughes E, Brown J, Collins JJ, et al. Ovulation suppression for endometriosis for women with subfertility. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD000155.Full text Abstract
Sutton CJ, Pooley AS, Ewen SP, et al. Follow-up report on a randomized controlled trial of laser laparoscopy in the treatment of pelvic pain associated with minimal to moderate endometriosis. 1997 Dec;68(6):1070-4. Abstract
Abbott JA, Hawe J, Clayton RD, et al. The effects and effectiveness of laparoscopic excision of endometriosis: a prospective study with 2-5 year follow-up. Hum Reprod. 2003 Sep;18(9):1922-7.Full text Abstract
Marcoux S, Maheux R, Bérubé S. Laparoscopic surgery in infertile women with minimal or mild endometriosis. Canadian Collaborative Group on Endometriosis. N Engl J Med. 1997 Jul 24;337(4):217-22.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Adenomiosis
- Cistitis intersticial
- Enfermedad inflamatoria pélvica (EIP)
More DifferentialsGuidelines
- Endometriosis: diagnosis and management
- ACR appropriateness criteria: endometriosis
More GuidelinesPatient information
Menstruación dolorosa
Endometriosis: ¿Qué tratamientos funcionan?
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