Typically, there are small black dots, the so called ‘powder burns’ seen on the uterosacral ligaments and pouch of Douglas. Fibrosis and scarring in the peritoneum surrounding the implants is also a typical finding.
Other subtle appearances are: red flame shaped areas, red polypoid areas, yellow brown patches, white peritoneal areas, circular peritoneal defects or subovarian adhesions. These lesions are thought to be more active than the “powder burn” areas.
The ovaries are frequently involved usually bilaterally. The endometriomas (chocolate cysts) are of varying sizes and are visible as bluish colorations. The ovaries get adherent to the pelvic structures including rectum and sigmoid colon.
Microscopic Appearance: There is presence of endometrial tissue—both glands and stroma. Due to pressure effect, the lining epithelium of the cyst may be absent or flattened (cuboidal) or replaced by granulation tissue. Adjacent to the lining epithelium, there may be presence of large polyhedral phagocytic cells, laden with blood pigment—hemosiderin (pseudoxanthoma cells). The cyst wall is composed of fibrous tissue and compressed ovarian cortex.
Some medicines which can be used after consultation with doctor are:-
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