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Laparoscopic management of endometriosis
Endometriosis is a common health problem affecting a woman’s uterus. Endometriosis occurs when the tissue that lines the uterus or womb (endometrium) grows in other areas outside the uterine cavity resulting in pain, irregular bleeding, and infertility. Endometriosis involves the ovaries, bowel, rectum, bladder, and the lining of the pelvic area. Rarely, it can occur in other areas of the body.
Causes:
The exact cause of endometriosis is not known, however, there are few theories on the cause of endometriosis. One theory states that the cells lining the endometrium shed during menstruation flows back through the fallopian tubes and into the pelvis, where they implant and grow. This is known as retrograde menstruation or reversed menstrual flow.
The other causes of endometriosis include:
- Cells in the abdomen and pelvis may change into endometrial cells.
- Drainage of endometrial cells to other parts of the body by blood or lymph fluids.
- Low and weak immune system of the body.
- Attachment of endometrial cells to the incision following surgery such as caesarean delivery.
Signs and Symptoms:
- One of the major symptoms of endometriosis is severe abdominal pain. Other symptoms include: Painful menstruation
- Pain in lower part of abdomen before and during menstruation
- Spasmodic contractions of the uterus for a week or two before and during periods; cramps may range from dull to severe and may be stable
- Pain while or following sexual intercourse
- Pain with bowel movements
- Low back or pelvic pain that may occur at any time during the menstrual cycle
Diagnosis:
To diagnose endometriosis your doctor will perform a physical examination. Various tests that help support the diagnosis of endometriosis are: Tests that are performed to help diagnose endometriosis include:
- Pelvic examination is an evaluation of the pelvis and its structures by inspection (look) and palpation (feel).
- Transvaginal ultrasound: It is an advanced imaging test that uses high-frequency sound waves to create pictures of the female reproductive organs.
- Pelvic laparoscopy is a surgical examination of the pelvic organs using a laparoscope, a tiny instrument with a light and a mini camera.
Treatment:
Treatment of endometriosis will depend on your age, severity of symptoms and plans for getting pregnant.
Treatment options include:
- Non-surgical treatment: Your doctor may prescribe certain medications such as NSAID’s and oral contraceptives to relieve pain and make you feel comfortable.
- Surgical treatment:
Laparoscopy is a surgical procedure through which the endometrial growths and scar tissue are removed to improve pain and chance for pregnancy.
During the procedure, your surgeon makes a small incision in or around the belly button (navel). Laparoscope, a thin instrument with a light and camera is inserted through the incision which allows the surgeon to view the internal pelvic organs on a monitor. Additional small incisions may be made for a variety of surgical instruments to be used to remove the damaged endometrial tissue. After completion of the procedure, the surgeon closes the incisions with sutures.
In severe cases of endometriosis, uterus and ovaries (hysterectomy and oophorectomy) are removed. This surgery can result in premature menopause. This surgery is usually performed for women who have no plans of pregnancy and have had little relief from other treatment modalities.
Endometriosis is a common condition that occurs when the endometrial cells grows on ovaries/bowels/bladder or behind the uterus. It can cause pain, infertility and heavy bleeding during menstruation. It can be treated with medications and surgery.
