What is endometriosis?
Endometriosis is a condition where the inner lining of the uterus (the endometrium) is found in other parts of the body (apart from the uterus).
What causes endometriosis?
Endometriosis can be due to lifestyle changes like smoking , weight gain , late marriages , late pregnancies , environmental changes , etc. Hormonal imbalances play a vital role in the progression of endometriosis.
There are several theories on how endometriosis spreads one says that menstrual endometrium passes backwards from the uterus into the abdomen through the fallopian tubes.
What happens due to endometriosis?
Because the endometrium is able to grow every menstrual cycle, it can bleed and cause problems. It could cause severe adhesions (sticky connections between organs) causing severe pain while passing stools or while urinating. Adhesions are also responsible for infertility because the anatomy gets distorted significantly. An endometriosis within the ovary can cause an endometrioma (chocolate cyst).
Some of the key symptoms area)Painful periods
b)Pain during sex
c)Pain while passing motion/stools
d)Pain while urinating
e)Lower back pain
How do you diagnose endometriosis?
Endometriosis is a disease of exclusion, meaning there are no easy ways to diagnose it. Sometimes chocolate cysts can be diagnosed using an ultrasound.An elevated CA-125 blood level is suggestive of endometriosis.
On laparoscopy endometriosis looks like dark brown spots within the pelvis sometimes with small blebs.
There are four grades of endometriosis depending on the severity.
How do you treat endometriosis?
Endometriosis is treated with a combination of medical and surgical treatments depending on the severity of the symptoms.
The focus on treatment is for reducing the symptoms of endometriosis and trying to arrest the spread of the disease.
Patients are given a combination of NSAIDS and Oral contraceptive pills to reduce pain associated with endometriosis as well as reduce its progression.Other medical treatment include anti-progestin, Intra uterine device, Leupride , Danazol , etc.
How do you completely eliminate endometriosis?
Surgical management is the gold standard treatment to remove all visible lesions of endometriosis and restore anatomy to its original form. Being fertility specialists we give special emphasis on conserving fertility and reducing the amount of damage to ovarian tissue. Unfortunately, endometriosis is a recurring disease and about 50% of women will have pain 2-3 years after an endometriotic resection.
What is adenomyosis?
Adenomysis is the ingrowth of endometrial tissue into the uterus, thus making the uterus large and bulky.
Does adenomyosis require intervention?
Mostly ultrasound diagnosed “bulky” uterus or mild adenomysis do not require any treatment, but when it is associated with heavy bleeding or pelvic pain, then medical intervention is required. If medical management does not relieve pain, then surgical intervention is required.
How is adenomyosis treated surgically?
Adenomyosis is treated depending on the age and parity of the patient. A younger woman who has not yet completed her family life would usually undergo a wedge resection (wherein a small wedge shaped portion of the adenomysis is resected out ) . An older woman who has completed her family life would undergo a hysterectomy
What’s laparoscopic pre sacral neurectomy?
This is an alternative treatment for patients for pain relief associated with adenomyosis and endometriosis. This laparoscopic procedure helps patients with excessive pain due to endometriosis who do not respond to medical intervention. This is a very skilled laparoscopic procedure involving the removal of nerve tissue retroperitoneally from near the sacral promontory.
Indigo Womens Center is proudly one of the few hospitals in Chennai where this procedure can be performed.
Why choose Indigo Womens Center for your procedure?
We at Indigo Womens Center empathise with women suffering from endometriosis and we put their needs first.
Choosing the right specialist for your treatment for endometriosis is crucial because when the disease is only partially removed, the endometrial implants can continue to cause issues like pain and infertility. Most surgeons are only comfortable with burning of the lesions (which might bring suboptimal results), whereas we are specialized in resecting off the endometriosis completely.
Our doctors being fertility specialists also specialise in restoring the anatomy of the uterus to its original form.
Our expertise lies in suturing, while most ob gyns do not make attempts to conserve the ovary, we make sure that we remove the complete endometriotic cyst (along with its capsule) and re-suture the ovary back to its normal anatomic state.Failure to do so might risk the chance of fluid collection within the ovary.
We are obsessed at giving the best treatment possible for endometriosis, we use specialized adhesion barriers after completing endometriotic resection, this way we can avoid any further adhesions from being formed in the future.
The most dreaded complication of an endometriotic surgery is the damage to the ureters. Rest assured we have urologists assisting our grade 4 endometriosis surgeries so all mishaps are actively avoided.Our patient volume gives us enough experience to perform these surgical techniques without complications.