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Chapter 13. ENDOMETRIOSIS

ICD-10 Codes

N80 Endometriosis.

N80.0 Endometriosis of uterus, adenomyosis.

N80.1 Endometriosis of ovaries.

N80.2 Endometriosis of fallopian tube.

N80.3 Endometriosis of pelvic peritoneum.

N80.4 Endometriosis of rectovaginal septum and vagina.

N80.5 Endometriosis of intestine.

N80.6 Endometriosis in cutaneous scar.

N80.8 Other endometriosis.

Endometriosis is defined as an abnormality when benign proliferation of tissue takes place outside the uterus; regarding its morphology and function the cells of this tissue are similar to those in the endometrium.

Epidemiology

According to the WHO, about 176 million women worldwide, mostly women of childbearing age, that is every tenth one, have endometriosis. Among patients in whom endometriosis was confirmed with laparoscopy, 50% of women start the signs at an age under 24; 21% of patients are under 15, and 17% are aged 15 to 19. Endometriosis is described as an overlooked condition as 7 to 8 years usually elapse (5 to 6 years in Russia) from the onset of the first signs of disease until correct diagnosis and administration of appropriate treatment.

Classification

A classification adopted in 2015 is currently in use.

• Endometriosis interna (adenomyosis, endometriosis of the body of uterus):

- stage I: the lesion is limited to submucous layer of the body of uterus;

- stage II: the lesion involves the muscular layer;

- stage III: the lesion involves the whole depth of the muscular layer reaching its serous coating;

- stage IV: involvement, apart from the uterus, of parietal peritoneum of the pelvis and adjacent organs.

Adenomyosis may be diffuse or focal, nodular or cystic. Adenomyosis differs from uterine fibroids by characteristic absence of a wall or clear-cut boundaries, and tenderness to palpation (in case of nodular adenomyosis).

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