子宫内膜异位症

最后审阅: 6 一月 2023
最后更新: 30 八月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 痛经
  • 慢性或周期性盆腔痛
  • 性交疼痛
  • 低生育力
  • 宫骶韧带结节形成
  • 盆腔肿块
  • 子宫后倾、固定
  • 抑郁症
  • 焦虑
  • 因痛经而无法上班或上学
更多 关键诊断因素

其他诊断因素

  • 排尿困难、腰痛和血尿
  • 大便困难、便血
其他诊断因素

危险因素

  • 育龄期人群
  • 白种人
  • 阳性家族史
  • 未育
  • 体重指数 (BMI) 较低
  • 苗勒管畸形
  • 自身免疫性疾病
  • 初次性生活年龄较晚
  • 吸烟
  • 既往剖宫产
更多 危险因素

诊断性检查

首要检查

  • 经阴道超声
更多 首要检查

需考虑的检查

  • 直肠超声内镜
  • 3D 超声
  • 子宫输卵管造影
  • 骨盆核磁共振 (MRI)
  • 诊断性腹腔镜检查
更多 需考虑的检查

治疗流程

持续性治疗

无立即生育意愿:无巧克力囊肿或可疑重度/深部子宫内膜异位症的疼痛患者

无立即生育意愿:有巧克力囊肿或可疑重度/深部子宫内膜异位症的疼痛患者

有立即生育意愿

撰稿人

作者

M. Jonathon Solnik, MD, FACOG FACS
M. Jonathon Solnik

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

利益声明

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

利益声明

AS acts as a speaker for Abbvie, Hologic, and Bayer. He is an author of one of the articles cited in this topic.

鸣谢

Dr M. Jonathon Solnik and Dr Ari Sanders would like to gratefully acknowledge Dr Sharon M. Jakus, a previous contributor to this topic.

利益声明

SMJ declares that she has no competing interests.

同行评议者

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

利益声明

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

利益声明

JCK declares that he has no competing interests.

  • 子宫内膜异位症 images
  • 鉴别诊断

    • 子宫腺肌病
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    更多 鉴别诊断
  • 指南

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    更多 指南
  • 患者教育信息

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    更多 患者教育信息
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