Endometriosis is a painful disorder in which the tissue which normally lines the cavity of the uterus called endometrium is found outside the uterus. Common sites are ovaries, tubes, pelvic peritoneum, intestines
Symptoms:
- Pain: Endometriosis is a very painful condition. Pain in lower abdomen, lower back, pelvis, rectum or vagina. It may be continuous or related to periods or during intercourse.
- Menstrual abnormalities: Abnormal menstruation, heavy bleeding, painful menstruation, irregular bleeding or spotting
- Gastrointestinal disturbances: Constipation, nausea, abdominal fullness, cramping, loss of appetite
- Infertility
Most commonly patients present with severe pain during periods, pelvic pain, or infertility.
The severity of the disease is not related to the symptoms. Mild disease may have serious symptoms and severe disease may have mild symptoms.
Imaging studies like Ultrasound or MRI may detect adhesions, chocolate cysts, hydrosalpinx sometimes even intestinal obstruction or hydro nephrosis due to adhesions.
Treatment:
May be medical or surgical depending on profile of patient and severity of symptoms. It is a recurrent condition and keeps returning after treatment.
Medical Management: Regulates hormones
- Oral contraceptive pills
- Danazol
- progesterones and antiprogestins
- GnRH analogue
- Analgesics ans antispasmodic for pain relief
Surgical:
Laparoscopy is gold standard for diagnosis and management of endometriosis In laparoscopy endometriosis lesions are detected and adhesions are broken. Chocolate cystectomy is done. Other lesions are coagulated.
- Hysterectomy is done in severe cases.
- Nerve ablation procedures for severe disease