<prompt> Not true bout Endometriosis:Sampson gave implantation theoryCause infertilityLaproscopy is gold standard for diagnosisCommon in low socio-economic group  <response>: Ans: D Common in... Laproscopy is the gold standard in diagnosis of endometriosis.It is both diagnostic therapeutic- Shows Gynaecology 16th415Sampson gave implantation theory of endometriosis in 1922 - Shows Gynaecology 16th 409Endometriosis possibly interferes with tubal motility and function. It may inhibit ovulation and because of dyspareunia there is reduced frequency of sexual intercourse. Other causes of infertility are luteinized unruptured follicular LUF syndrome, increased prolactin and corpus luteal phase defect, nonovulation and tubal blockage. Prostaglandin affects the tubal motility causes corpus luteolysis too. The macrophages in the peritoneal fluid engulf the sperms or immobilize them Shaw 16th414Dysmenorrhoe is the most common symptom- Shaw 16th413ENDOMETRIOSISOccurrence of functioning endometrial tissue both glands stroma outside the cavity of uterus.Age group:30 -40years Most common0 jeffcoate 7th368Seen in high socio-economic status because of late marriage13 late child bearing13,Most common in nulliparous females3. -Jeffcoate 7th369- 370; Shaw 14rh420Familial predisposition risk is seven times higher if a first degree relative has diseases. Risk is further increased in homozygous twins.It is a hormlome dependant condition Estrogen dependant.Site: It can occur anywhere in the body. Most common site is ovary 30-40, 2nd most common site is pouch of douglasPathology:Peritoneum: Earliest lesion is red petechial, later becoming cystic, dark brown, blue black in appearance called as Powder burn appearance Gun shot appearance.Ovary: Ch aracteristic bilateral0 cyst? or endometrioma which is a true cyst0 with columnar lining epitheliumdeg. Beneath the epithelium are large cells with brown cytoplasm due to ingested pigments like hemosiderin called as Pseudoxanthoma ceils. Cyst contains tarry brown fluid. Shaw 14e, p 421Peritoneal cavity : Contains yellow brownb fluid which has prostaglandin responsible for the pain of endometriosis.Symptoms: Patients present with a characteristic triad of:infertilityProgressively increasing dysmenorrheaDyspareuniaDyspareunia : Occurs when POD and rectovaginal septum are involved.Menstrual irregularities : Like menorrhagia, polymenorrhea are seen.Premenstrual spotting may occur and is more likely to be associated with endometriosis than with luteal phase inadequacyOther symptom : Chronic pelvic painr pain during defecation. Intermittent pyrexia and urinary symptoms. 