Endometriosis: Evaluation and management in a low-resource country

Abstract

background: Endometriosis is a chronic debilitating gynaecologic condition that negatively affects the health, economic, social and psychological lives of women. Though a gynaecological condition, it can affect other systems in the body. objective: To describe the presentation, evaluation and treatment of endometriosis among gynaecological patients at a tertiary centre in Ilorin, Nigeria. Methods: A retrospective descriptive study of all women managed for endometriosis over a three and half year period at a tertiary centre. A list of all individuals with the condition was compiled, the case files were retrieved and the relevant data extracted. The result was presented in tables. results: Endometriosis constituted 1.3% of gynaecological admissions and 0.6% of gynaecology clinic visit during the study period. It affected reproductive-age women with mean age 32.8 years and modal age 31-35 years (35.3%). The women were mostly nulliparas (13;76.5%) with normal menstrual cycle (13;76.6%) and duration of menstruation (16;94.1%). Eleven (64.7%) had multiple gynaecological complaints and additional extra-pelvic lesions respectively. Sixteen (94.1%) had coexisting co-morbidity, of these 9 (56.3%) was in the thoracic region. The common medical treatment offered was gonadotrophin-releasing-hormone analogues (8; 47.1%), 6(35.3%) had medical while 11(64.7%) has combined medical and surgical management; diagnosis was by histology in 11(64.7%). conclusion: Endometriosis remains a disease of reproductive-age women commonly associated with coexisting non-gynaecologic manifestations necessitating combined medical and surgical management.

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Keywords

Endometriosis, Chronic pelvic pain, Ectopic endometrium

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