What is endometriosis?
Endometriosis is a condition characterised by the presence of endometrial lining tissue outside the uterus in the abdomen or pelvis. Endometrial tissue lines the uterus and is shed regularly by women who menstruate. When found elsewhere, this tissue may cause prolonged pain, inflammation, scarring, and infertility. It may also affect the appendix, bladder, and small and large intestines if it spreads.
What are the signs and symptoms?
Endometriosis may manifest and manifest itself in a number of different ways. The “trifecta” of symptoms includes menstrual cramps, sexual pain, and infertility. When women exhibit all three issues concurrently, the index of suspicion is fairly high.
However, we do not always perceive all three concurrently. Sometimes, symptoms are mild. Occasionally, people have blood in their pee or stools, painful bowel movements, or urinating discomfort. Or, individuals may have pelvic pain due to an endometrioma, a cyst that develops when endometrial tissue grows on the ovaries.
Now, these symptoms are not necessarily exclusive to endometriosis, since painful periods and a few of these other symptoms may be brought on by other disorders. As a result, it is often misdiagnosed. However, after seeing the patient, analysing their symptom history, and reviewing the imaging, we begin to think that this patient may be suffering from this ailment.
How is endometriosis diagnosed?
The gold standard is minimally invasive surgery using laparoscopy, an outpatient procedure in which a camera is introduced via a small abdominal incision to see the pelvic organs. We may do a clinical history and physical examination, which may enhance the index of suspicion based on our findings and the patient’s remarks, but unless surgery is performed, we cannot confirm it conclusively. We check the abdomen and pelvis for implants associated with endometriosis. Additionally, we inspect the ovary for the existence of cysts. Next, we will decide the appropriate treatment technique based on our results.
How is endometriosis treated?
For mild cases, the treatment goals include symptom control and prevention of disease development. Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) are efficient painkillers. Additionally, hormonal therapy may benefit in the prevention of progression.
If a patient does not respond to prescribed medication, laparoscopic surgery may be required. This is one of the most successful surgical endometriosis treatments. It is often done robotically and entails just a few tiny abdominal incisions. If a cyst is present, it is excised; implants are removed. In most cases, excision is the best therapy for endometriosis. Occasionally, we use ablative therapy, in which the implants are successfully cauterised. The combination of incision, ablation, and cystectomy is very effective.
The average surgical treatment involves three to five “Band-Aid incisions” in the belly, and patients may return home the same day. Normal recovery time is two weeks, however many women return to work and regular activities earlier.
What about more serious cases?
If endometriosis has spread to organs such as the colon or bladder, it may be essential to remove the lesion by operating on those organs (s). People may sometimes need bowel resections, which is surgery to remove a part of the small or large intestine, or appendectomy, which is the removal of the appendix. If all other treatment options have failed, a hysterectomy or removal of the ovaries is the last option that you hope a patient does not have to take. In several challenging cases, however, surgery is profoundly transformative and dramatically enhances a woman’s quality of life.
What are some concerns from patients undergoing surgery to treat their endometriosis?
Loss of fertility and ovarian function is one of women’s most important issues. In other words, will therapy for ovarian endometriosis affect the number of eggs they produce? The ultimate goal of endometriosis surgery for patients who intend to conceive in the future is to protect and optimise fertility. The great majority of patients can conceive and give birth to children.
How does endometriosis affect fertility and pregnancy?
The primary obstacle for women with endometriosis is pregnancy. When trying to conceive in an inflamed pelvic environment owing to endometriosis, it is fairly difficult. Endometriosis may impair the ovaries and fallopian tubes, which are essential to connect the sperm and egg. It may induce anatomical deformities that make conception more difficult. To facilitate pregnancy, women may need surgery to correct the abnormal anatomy caused by the disorder.
Once a woman gets pregnant, endometriosis becomes irrelevant. Pregnancy is an excellent treatment for endometriosis, since something about the pregnant state causes the ailment to clear up and go into remission. Endometriosis has no effect on the development or delivery of the baby.
Menopause is often advantageous from an endometriosis perspective, since the patient’s ovarian function can no longer cause endometriosis implants.
Is there a cure for endometriosis?
Endometriosis is a chronic condition that requires multidisciplinary, meticulous treatment. Among the most effective therapeutic options is surgery. It is crucial for women to understand that treatment must be tailored to their future reproductive aims and ambitions. Endometriosis must be specifically and uniquely treated for each patient.
Our team at the Endometriosis Treatment Program at Columbia and NewYork-Presbyterian is a great believer in endometriosis patients receiving comprehensive care. It is not just about eliminating the disease. It entails taking a patient’s future concerns and wants into consideration. Women who are suffering must know that there are competent specialists in this field who can aid them.
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What should I know about endometriosis?
Endometriosis (en-doe-me-tree-O-sis) is an often painful disease characterised by the development of endometrium-like tissue outside the uterus. Endometriosis often affects the ovaries, fallopian tubes, and pelvic lining.
Is endometriosis a serious problem?
Endometriosis is a painful condition that may negatively impair your quality of life, but it is not fatal. However, in very rare instances, endometriosis problems may have potentially lethal implications.
What is the main cause of endometriosis?
Although the precise aetiology of endometriosis is unknown, several ideas explain how and why it develops. During a woman’s period, blood and tissue from her uterus flow via her fallopian tubes and into her abdominal cavity, according to a popular theory concerning the beginning of menstruation.
