Glossary
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A B C D E F G H I J K L M N O P Q R S T U V W X Y Z A Ablation – Elimination of tissue from the body, usually by laser vaporization, chemical ablation or electrosurgery. Abnormal Uterine Bleeding – Vaginal or uterine bleeding that does not follow the patients "normal" cycle. This can be heavier than usual bleeding, longer than usual cycles, spotting between cycles, or more frequent cycles. Adenomyoma – A dense collection of adenomyosis. Usually, adenomyosis is present diffusely in the uterus, resulting in a gradual change from a diseased to a normal uterus. While an adenomyoma is more distinct, there is not a sharp border. Thus, unlike fibroids which can be completely removed, it is usually impossible to remove all of the adenomyosis. Adenomyosis – Endometriosis within the muscle wall of the uterus. Symptoms can be similar to endometriosis. Adhesions – Fibrous tissues that bind tissues and/or organs that would normally not be bound together. Adhesions are also called scar tissue. Allen Masters Syndrome – A defect in the peritoneum, the lining of the inside of the body. This usually forms a hole or deep pocket in the peritoneum. Appendicitis – Infection of the appendix. The wall of the appendix can weaken and rupture, resulting in spillage of bowel contents into the abdominal cavity. This condition can be life-threatening, and can also result in extensive adhesions (scar tissue) forming in the abdomen and pelvis. Aspiration – Suctioning fluids from the body. This is a technique which can be used for draining cysts in the ovaries. B Barium Enema – Radiology test that places barium sulfate, a radiopaque material, into the colon to provide an anatomic view of the inside of the large intestine or colon. Bilateral Salpingo-oophorectomy – Removal of both ovaries and fallopian tubes. Biopsy – A tissue sample which is usually removed for the purpose of examining it by a pathologist under a microscope for diagnosis. Bowel Obstruction – Blockage of the bowel (either small bowel or large bowel) resulting in the inability of fecal matter to pass through the intestines. Broad Ligaments of the Uterus – These are the peritoneum folds attached to the uterus. These connect the fallopian tubes and the ovaries to the pelvic wall. C CA 125 – An antigen produced by tissues. It was documented that some women with high CA 125 were also diagnosed with endometriosis. It was hoped that this would be a good test indicator for endometriosis, but the test has since been proved insufficiently sensitive to correctly diagnose the disease. Candidiasis – Candida (Yeast) is part of the normal flora found throughout the body in the intestinal tract, mouth, skin and vaginal area. When these species overpopulate an area of the body, the condition, Candidiasis can develop. Cauterization – The passage of electrical current through tissue resulting in coagulation. This is a type of electrical burn. Cecum – This is the first section of the large intestine joining with the small intestine. The appendix arises from the cecum. Cholecystectomy – Removal of the Gallbladder. This procedure is usually performed through the laparoscope. Cholecystitis – Inflammation of the Gallbladder. Coagulation – The process by which cellular proteins are melted and destroyed. When someone says that the endometriosis was “burned off,” this is the correct technical term to describe the procedure. This technique is good to stop a blood vessel from bleeding, but is not good for treating endometriosis. The use of coagulation, either unipolar or monopolar, has a high likelihood of destroying only a portion of the endometriosis. The result of incomplete removal is the persistence of the endometriosis, and re-growth with recurrent pain and repetitive surgeries. Coelomic Metaplasia Theory – The theory that embryonic cells transform into endometriosis. Colpotomy – Making an incision through the vaginal wall. Complete Hysterectomy – A non-medical term used by lay persons referring to a total abdominal hysterectomy and a bilateral salpingo-oophorectomy (removal of the uterus, cervix, both ovaries and both fallopian tubes). CT Scan – (CAT Scan) Stands for computed tomography or computed axial tomography. This procedure involves computer analysis of x-rays to generate pictures of the body. Cul-de-sac – Literally means dead end. The female pelvis has an anterior cul-de-sac and a posterior cul-de-sac. The anterior cul-de-sac is the area between the pubic bone and the uterus. The bladder is located at the bottom of the anterior cul-de-sac. The posterior cul-de-sac is located behind the uterus. The cervix, top of the vagina, the rectum and the uterosacral ligaments all come together at the bottom of the posterior cul-de-sac. Endometriosis, especially deep invasive endometriosis, is frequently found in this area. Cyst – A fluid filled structure. Cystoscopy – Visualization of the inside of the bladder using a cystoscope. D D and C (dilation and curettage) – A surgical procedure done by dilating the cervical canal of the uterus so that a surface of the endometrium can be removed. The base of the endometrium remains and regenerates as it normally does after each menstrual cycle. Diaphragm – The muscle that divides the abdominal and thoracic (chest) cavities. It is located just above the liver, stomach, pancreas and spleen. Abdominal breathing occurs when the muscle contracts, increasing the volume of the thoracic cavity, and pulling air into the lungs. Dorsal Column Stimulator – This procedure utilizes a small electrode that sends an electrical stimulus that in essence cancels the pain signal to the brain. A trial period before permanent implantation is usually performed as a diagnostic test to determine if this is appropriate treatment for the patient. This is effective in patients who have failed other forms of treatment, including severe cases of interstitial cystitis. This is also known as a spinal cord stimulator. Dyschezia – Painful bowel movements. Dysmenorrhea – Painful periods. Dyspareunia – Painful intercourse. Dysplasia – Tissue that has developed abnormally. Dysuria – Painful urination. E Electrocautery – The process of cauterizing the tissue with an electrically charged instrument. Electrosurgery – The use of electricity to generate heat, resulting in the vaporization or coagulation of tissue. See article. Emboli – An object present in the bloodstream; usually a blood clot, air bubble, or piece of fat, that can result in the blockage of a blood vessel (e.g., heart, lung, brain). Endometrial Tissue – Any tissue that is similar to endometrium. Endometrioma – A collection of endometriosis in the ovary. This is usually a cystic structure containing fluid resembling chocolate syrup or old motor oil. Endometriosis – Defined as the presence of endometrium outside of the uterus. The endometrial cells usually implant on the peritoneum and can invade underlying tissue including bowel and bladder. This disease can result in pelvic pain, lower back pain, pain with intercourse, pain with bowel movements and infertility. Endometrium – The layer of glands that line the inside of the uterus. Most of the uterine wall is comprised of smooth muscle. The endometrium responds to estrogen, growing thicker during the first two weeks of the menstrual cycle. After ovulation, the ovarian hormone production changes from primarily estrogen to primarily progesterone. Progesterone helps to mature the endometrium, preparing it for implantation of an embryo. If pregnancy does not occur, the menstrual cycle begins two weeks after ovulation. The theory of retrograde menstruation states that endometriosis arises from endometrium which implants inside of the body after flowing back through the fallopian tubes during a woman's menstrual cycle. Excision – To cut or remove. F Fallopian Tube – The tube that extends from the top of the uterus near the ovary. The function of the fallopian tube is to pick up the egg from the ovary, provide a location for fertilization and act as an incubator, nourishing the embryo for the first couple of days of life, prior to implantation in the uterus. Fibroid – A benign muscle tumor of the uterus. These are also known as uterine leiomyoma. They can be located near the inside of the endometrial cavity (submucus leiomyoma), deep in the wall of the uterus (intramural leiomyoma), near the outside surface of the uterus (subserosal leiomyoma) or attached to the uterus by a stalk (pedunculated leimyoma). Follicle – A follicle is comprised of the egg, the support cells and fluid produced by the support cells. Just prior to ovulation, the follicle measures about one inch in diameter. Fulguration – Surgical technique used to destroy tissue with a high frequency current. G GnRH Agonists – A group of medicines used to treat endometriosis. GnRH agonists block the release of GnRH from the brain. GnRH stimulates the release of FSH (follicle stimulating hormone) which acts on the ovaries to stimulate egg production and the production of estrogen. GnRH agonists basically creates a temporary menopause by turning off estrogen production by the ovary. H hCG – See human chorionic gonadotropin. HRT (Hormone Replacement Therapy) – After menopause, either natural or surgical, there is a dramatic decrease in hormone production including estrogen, progesterone, and even testosterone. Hormone replacement is aimed at replacing an equivalent amount and type of hormone in the body. HSG – See Hysterosalpingogram. Hyperplasia – Excessive growth of normal cells in normal tissue. Hysterectomy – Removal of the uterus. See Total Abdominal Hysterectomy, Total Vaginal Hysterectomy and Complete Hysterectomy. Hysterosalpingogram – A radiographic diagnostic test which evaluates the uterine cavity and the fallopian tubes. This test evaluates the shape of the uterine cavity (can be used to identify a T shaped uterus classic of a DES Daughter), disease processes of the uterine cavity (fibroids, polyps, septum, scar tissue, etc.) and the size, shape and patency of the fallopian tube. This test is also referred to as a HSG. Hysteroscopy – A small scope (similar to a small laparoscope) that is inserted up the vagina and through the cervix into the uterine cavity. I Inguinal Hernias (direct and indirect) – A hernia is a defect in the wall that normally holds the structure surrounded by the wall. In this case the defect is in the "wall" dividing the abdominal cavity from the groin and leg. This can be a hole or a sac. Inguinal hernias are a type of groin hernia. An indirect inguinal hernia is located along the inguinal ligament. The direct inguinal hernia protrudes directly through the abdominal wall itself. Interstitial Cystitis (I.C.) – Chronic inflammation of the bladder. This can be surgically diagnosed through the Cystoscopy with Hydrodistention procedure. During this procedure, the bladder is distended fully and drained. Following distention of the bladder, individuals with IC have gromerulations (small breaks in the capillaries and bleeding) or the presence of Hunner’s ulcers. The cause of IC is unknown and there is no known cure. However, multiple forms of treatment are usually successful in controlling the symptoms. L Laparoscope – A surgical instrument that allows visualization of the abdominal cavity and contents through a small incision. Most laparoscopes vary in diameter from 1/4 to 1/2 inch and are about a foot and a half long. A video camera can be attached to the laparoscope, allowing videotaping of the surgical procedure. The laparoscope is a surgical telescope, magnifying objects at close range and minimizing objects farther away. Laparoscopic Uteroscaral Nerve Ablation – Transection (cutting) of the uterosacral ligaments (and nerves) laparoscopically. The uterosacral ligaments (one on each side) extend from the cervix to the lower back. This procedure is of questionable efficacy. Laparoscopy – A surgical procedure that usually involves placing the laparoscope through the belly button with one to three 1/4 inch incisions just above the pubic bone. This is the only method currently available to diagnose endometriosis. Laparotomy – A surgical opening of the abdominal cavity. The skin incision can be either transverse or vertical. The transverse incision is usually an inch or so above the pubic bone. This type of incision is also known as a bikini cut. This is the most common type of incision used during a C-Section. A vertical skin incision usually extends from the pubic bone to the belly button. Laser – An instrument which delivers a very concentrated uniform beam of light that contains a large amount of energy. Laser Vaporization – Surgical technique that vaporizes tissue and turns it into a gas. Liquid water is turned into vapor (like steam) and the solid components of the cell are suspended in the water vapor (as smoke). There is very little or no conduction of heat with vaporization and thus the tissue is neither "burned" nor melted. See article on Surgical Techniques Used in the Treatment of Endometriosis. Leiomyoma – See Fibroids. Lesion – Open wound in the tissue. LUNA – See Laparoscopic Uterosacral Nerve Ablation. Lysis – Removal of disease M Menorrhagia – Excessively heavy menstrual bleeding. Menses – The monthly bleeding most women experience if they are not pregnant. It is also referred to as a period. Metrorrhagia – Irregular uterine bleeding or uterine bleeding during times other than a normal menstrual cycle. MRI (Magnetic Resonance Imaging) – A diagnostic radiology test that shows images of organs and tissues using strong magnets and the absorption energy of atomic nuclei. Myofascial Release Massage – An internal physical therapy technique that can stretch and massage the pelvic muscles to decrease pelvic spasms. Myomectomy – Surgical removal of a myoma or fibroid while preserving the uterus. Myometrial – Refers to the myometrium which is the muscle wall of the uterus. N Narcotics – A group of strong pain medications that block opioid pain receptors. This group of medications depress the nervous system, and if used long enough, are habit-forming. Nocturia – Having to get up to use the bathroom to urinate in the middle of the night. Nodule – Small lump of tissues. O Oophorectomy – Surgical procedure to remove one or both ovaries. Osteopenia – Low bone mass. Defined as -1.00 to -2.49 standard deviations below the average peak adult bone mass as determined by a bone mineral density examination. A post menopausal woman with osteopenia is at an increased risk of experiencing a bone fracture. Osteoporosis – Defined as a bone mass that is >2.50 standard deviations below the average peak adult bone mass as determined by a bone mineral density examination. A post menopausal woman with osteoporosis is at a marked increased risk of experiencing a bone fracture. Ovarian Fossa – The area along the pelvic sidewall, lined with peritoneum, underneath the ovary. Ovarian Remnant Syndrome – Presence of a piece of the ovary unintentionally left after surgical removal of the ovary. This can result in pain and cyclic symptoms, similar to those experienced with a menstrual cycle, following theoretical removal of the ovaries (usually with a hysterectomy). Ovulation – The process by which the egg is released from the ovary. This usually occurs mid-cycle (around cycle day 14) of a woman's menstrual cycle. P Pain Receptors – Nerve endings that are found throughout the body. They are the first to respond to pain and injury. Paracecal – Next to the cecum. Pararectal – Next to the rectum. A common area that endometriosis invades and may not be completely excised in some surgeries due to the concern of damaging surrounding blood vessels. Parietex Mesh – A 3-dimensional polyester weave mesh used in hernia repair. Pathology Report – When a surgeon removes tissue at surgery, it is sent to the pathologist. A pathologist is a physician who specializes in a type of tissue or disease based upon looking at tissue under a microscope. When the pathologist receives a tissue specimen from surgery, he/she provides a report describing the tissue’s overall appearance, what it looks like under the microscope, and a diagnosis based on the microscopic findings. This is known as a pathology report. Patient Assisted Laparoscopy – Uses a small 2mm laparoscope while the patient is awake but under supervision of an anesthesiologist in an operating room. The abdominal wall is numbed and the laparoscope and a 2mm probe is carefully placed. The probe to used to palpate the internal organs and structures in order to re-create the pain. The patient helps to locate the pain during the procedure. Pelvic Congestion – Dilation of the pelvic veins, usually including the uterine veins. This can result in pressure and pain in the pelvis. Pelvic Inflammatory Disease (PID) – Infection of the pelvic area, usually the fallopian tubes. This can result in long term pain and/or infertility. Perineum – The area which includes the vaginal opening, the anus and the surrounding tissue. Peritoneal Fluid – Fluid surrounding the organs of the abdomen. Peritoneum – The tissue lining the inside of the abdominal cavity. The body does not have skin inside, but peritoneum, which one can think of as resembling saran wrap. Peritonitis – Inflammation of the peritoneum. Polycystic Ovarian Disease – A disease process characterized by a hormone imbalance, multiple small cysts in the ovary, excess androgen and insulin resistance. Polyps – Benign growth in the body characterized by finger-like projections. Presacral Neurectomy – Cutting or removing a portion of the presacral nerve plexus. This plexus or group of nerves conducts the pain signal to and from the uterus and the brain. This procedure is effective in controlling pain or cramping in the middle of pelvis. This can be an effective procedure for treating severe primary dysmenorrhea. Prognosis – Medical opinion regarding the course of a disease, usually referring to the chance of improvement or cure of the disease. Pudendal Neuropathy – Pain of the pudendal nerves. R Rectocele – Protrusion of the vaginal wall into the wall of the rectum and abdomen. The protrusion can be repaired surgically. Rectovaginal Septum – The area in between the rectum and the vagina. It is the area under the bottom of the posterior cul-de-sac and is one of the areas into which deep endometriosis invades. Resection – Surgical removal of tissue. Tissue can be resected with the carbon 13 CO2 laser, scissors, and cutting current electrosurgery. S Sampson’s Theory (Implantation) – This is one theory as to the cause of endometriosis. Dr. Sampson, a gynecologist from Albany, New York, theorized in the 1920’s that during menstruation each month, instead of all the menstrual blood flowing into the vagina, some of it goes in reverse and flows out the ends of the fallopian tubes. This menstrual blood carries with it some living cells from the lining of the uterus. These cells come to lie on the surfaces of the pelvis where they attach, implant, grow, and develop into endometriosis. This theory also postulated that endometriosis could occur by implantation resulting from rupture and spread of endometrioma cysts of the ovary. Sonogram – An instrument that uses sound waves to look inside of the body. Also referred to as an Ultrasound. Spinal Cord Stimulator – see Dorsal Column Stimulator. Stages of Endometriosis – Endometriosis is defined from Stage I to Stage IV, depending upon the amount of endometriosis and scar tissue present. The stage of endometriosis does not correlate with the chance of pregnancy or the amount of pain. See "Classification of Endometriosis" in the Ask Dr. Cook archives. Subtotal Hysterectomy – Another name for supracervical hysterectomy. Supracervical Hysterectomy – During a supracervical hysterectomy, the body of the uterus is removed and the cervix is left in place. The entire procedure is usually performed through the laparoscope (Laparoscopic Supracervical Hysterectomy; LSH). The uterus is removed from the abdomen with a morcellator. Systemic – Affecting the whole body. T T cells – An immune system cell (a type of lymphocyte) that differentiates in the thymus and protects against intracellular organisms. Thoracic Endometriosis – Endometriosis in the thorax or chest cavity. The two most common areas are either deep in the lung tissue or on the pleura, the tissue surrounding the lungs. See "Endometriosis of the Lung" in the Ask Dr. Cook archives. Thoracoscopy – A surgical procedure using a laparoscope to evaluate the inside of the chest cavity. Total Abdominal Hysterectomy (TAH) – Removal of the uterus and cervix through the abdominal cavity. This definition does not refer to the removal of the ovaries and should not be confused with the term occasionally used by lay persons; a complete hysterectomy. Total Vaginal Hysterectomy (TVH) – Removal of the uterus and cervix through the vagina. U Ultrasound – Another name for Sonogram. Ureter – The tube which carries urine from the kidneys to the bladder. The ureter courses through the pelvis under the ovaries along the pelvic sidewall and passes just lateral to the uterine blood vessels. Involvement of the ureter with endometriosis can result in mid back pain. Urethra – Tube that passes the urine from the bladder to the outside of the body. Uterine Prolapse – Relaxation of the uterus from its normal position in the pelvis down into the vagina. The descent can be of varying degrees. In extreme cases, the uterus can actually prolapse outside of the vagina. Uterine Suspension – To suspend or raise the uterus in the pelvis. This is most often done by plicating the round ligaments. The round ligament is a support structure that runs from the top of the uterus to the area of the groin. A suture is run through the round ligament and then tied, shortening up the round ligament. Uterus – An organ in the female reproductive tract which has the appearance of an upside down pear. Most of the uterus is made up of smooth muscle. The inside of the uterus is lined with a thin layer of glandular tissue known as the endometrium. The uterus holds the baby during pregnancy and contracts during labor to deliver the baby. V Vaginal Cuff – The top of the vagina after a total hysterectomy, where the uterus and cervix are removed. If the surgeon does not remove all of the endometriosis prior to performing a hysterectomy, this is one of the areas were endometriosis can persist and re-grow. Vaporization – To turn a solid or liquid into vapor (gas form). The laser is commonly used to vaporize tissue. This is a process in which the highly concentrated energy of the laser beam instantaneously turns the water inside of the cell into water vapor. This results in approximately a 1500 fold increase in volume. The cell literally goes up in smoke. Unlike electrocautery this does not "burn" the tissue, nor is there significant heat conduction, thus the surrounding tissue is not damaged. See article on EVE Procedure for the Treatment of Endometriosis. Vascular Theory – This theory states that endometriosis can arise by transport of endometriosis via the vascular system. This accounts for endometriosis that is discovered in virtually every organ of the body instead of just the pelvic area. Viscera – Pertaining to the internal organs of the body. Visceral Hypersensitivity – This condition is seen with irritable bowel syndrome. Pressure and sensation that is normally non-painful or not perceived is felt as intense pain. Von Willebrand Disease – This is a congenital bleeding disorder due to a lack of coagulation factor VIII. |
