Your Evidence-Based Clinical Intervention should be submitted in a Microsoft Word document following APA style and should include the following:

A Evidence-Based Clinical Intervention for Endometriosis

Medical problem: Endometriosis (Dunselman and colleagues, 2014) is an estrogen-dependent, chronic, inflammation disease that causes chronic pain, irregular menstrual cycles, infertility, and other symptoms.

A few of the most common symptoms and signs are: Infertility, pain during menstruation, pelvic discomfort, dyspareunia and painful periods. Endometriosis pain can either be non-cyclic or cyclic. It can also occur during any part of the menstrual cycle. Additional symptoms that may be associated with endometriosis include nausea, vomiting, diarrhea and digestive problems. There can also be genitourinary issues such as dysuria and hematuria. The most common age group that is affected are reproductive-aged females, which has an estimated prevalence between 6-10% (Dunselman, et al. 2014).

Pathophysiology. Endometriosis is caused by the abnormal growth of tissue that looks like endometrial-like tissues outside the uterus. It is unclear what the exact mechanism of endometriosis may be. However, several theories suggest that retrograde menstruation, lymphatic and hematogenous spread, and coelomic metaplasia are the possible mechanisms underlying endometriosis development (Burney & Giudice, 2012).

Differential Diagnoses

  1. Pelvic Inflammatory Disease, also known as PID, is characterized by lower abdominal pains, fever and vaginal discharge. Endometriosis is distinguished by fever.
  2. Ovarian cyst: Symptoms include lower abdominal pain, bloating and changes in the bowel or bladder habits. An ovarian cyst is distinguished from endometriosis by the presence of an identifiable mass in the pelvic.
  3. Adenomyosis is characterized by painful periods and heavy bleeding. It also causes an enlarged and tender uterus. Brosens and colleagues (2013) describe adenomyosis as a uterus that has a diffusely large, tender uterus.

Endometriosis is a Evidence-Based Procedure: This was the conclusion of a Nisenblat study. (2018), laparoscopic excision is the best option for treating endometriosis. This surgery can significantly reduce pain and increase fertility. Study results showed that laparoscopic surgery had a significant impact on pain relief and quality of living. Surgery was also found to be better than hormonal therapy for pain relief and fertility improvements.

Expected Outcomes in Endometriosis Patients: Laparoscopic excision surgery can result in a decrease of pain symptoms as well as an improvement of quality of life. Surgery may result in improved fertility (Nisenblat and colleagues, 2019,).

Algorithms: The American Society for Reproductive Medicine (ASRM) has developed an algorithm to guide the management of endometriosis, which includes medical and surgical options depending on the patient’s symptoms, age, and fertility desires (Johnson et al., 2012).

SOAP Note: A 30-year old female presented with persistent pelvic pain and dyspareunia. She also has heavy periods over the last 3 years. O: A pelvic examination revealed tenderness at the left adnexal region. There were no uterine masses, enlargements or palpable masses. A transvaginal ultrasound shows a 4 cm long endometrium in the left side of an ovary. A: It is endometriosis. Other differential diagnoses include ovarian cyst or pelvic inflammation disease. P: Laparoscopic excision surgery to remove endometriotic implants and the endometrioma is recommended based on the patient’s symptoms and ultrasound findings.

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