Endometriosis

Endometriosis is a common gynaecological problem affecting women of reproductive age. It occurs when the tissues of the uterus start growing on surfaces of other organs in the pelvis. Endometrium may grow on ovaries, fallopian tubes, an outer surface of the uterus, pelvic cavity lining, vagina, cervix, vulva, bladder or rectum. Patients may experience painful cramps in the lower abdomen, back or in the pelvis during menstruation, heavy menstrual bleeding, painful bowel movements or urination and infertility.

Causes of Endometriosis

The exact cause for the endometriosis is not known, but it is thought to be inherited through genes that run in families. A defect in the immune system, hormonal imbalance, or as a complication of other surgeries, women may develop endometriosis.

Diagnosis of Endometriosis

Diagnosis of Endometriosis can be clinical or surgical. It can be based on history and pelvic examination. Investigations like specialty Pelvic ltrasounds can help detect Deep Infiltrating Endometriosis and Endometrioma (ovarian cyst caused by endometriosis).

Laparoscopy (key hole surgery) remains gold standard in confirmation and surgical treatment of Endometriosis.

Treatment

There are several treatment options available to minimize the pain as well as control heavy bleeding.

Pain Medication

Over the counter pain, relievers may be helpful for mild pain. Nonsteroidal anti-inflammatory medications will be prescribed by your doctor in cases of severe pain.

Hormone Treatment

Hormone treatment is recommended if there are small growth and mild pain. Hormonal preparations can be taken in the form of pills. Birth control pills help to decrease the amount of menstrual bleeding.

Surgery

Surgery is an option for women having multiple growths, severe pain, or fertility problems.

Laparoscopy: During this surgery, growths and scar tissue are removed or burnt. This is a minimally invasive technique and does not harm the healthy tissues around the growth.

Laparotomy or major abdominal surgery: This involves a larger cut in the abdomen which allows the doctor to reach and remove the endometrial growth.

Hysterectomy: It is a surgery that involves removal of the uterus. This procedure is done when there is severe damage to the uterus and only if the patient is not wishing to become pregnant.