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Endometrios

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Sakkunnig:

Definition:
Förekomst av endometrievävnad utanför uteruskaviteten.
Förekomst:
Prevalensen är 6–10 % bland kvinnor i fertil ålder och 25–70 % bland kvinnor med mens- och bäckensmärtor.
Symtom:
Cykliska smärtor i nedre delen av buken ofta med premenstruellt smärtmaximum, ovulationssmärta, uttalad dysmenorré, djup samlagssmärta och känsla av tyngd och tryck i underlivet.
Kliniska fynd:
Den kliniska undersökningen är ofta normal. Fynd kan vara palpationsömhet över uterus eller adnexa, små och ömma knutor bakom uterus eller i fossa Douglasi och/eller resistenser vid/på adnexa. Ibland ses blåaktiga tumörer på portio och i vagina vid inspektion.
Diagnostik:
Bilddiagnostikk (UL/MR) eller laparoskopi.
Behandling:
Symtomatisk behandling med NSAID och paracetamol i kombination, p-piller, gestagener, GnRH-analoger eller kirurgi. Eventuellt assisterad befruktning.
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  • Margita Gustavsson, specialist i gynekologi och obstetrik, gynekologiska mottagningen Närhälsan Mölndal
  • Anna Nager, med dr och specialist i allmänmedicin, Karolinska institutet