Endometriosis can be found in the muscle layer of the womb (adenomyosis), ovary (endometriotic cyst), bladder and bowel. In adenomyosis, the endometriotic cells will accumulate in the muscle layers of the uterus overtime causing the uterus to enlarge which ultimately leads to pelvic pain especially during menses.
There are three types of endometriosis, which can be classified according to their location:
Some of the common symptoms of endometriosis are:
Over-the-counter medicines can be used to treat patients who are experiencing mild endometriosis pain. Alternatively, hormonal therapy in the form of oral medication or injections is used to suppress endometriosis activity during the menstrual cycle in order to reduce any discomfort and regulate menstrual periods.Some medications that can alleviate symptoms of endometriosis include:
Surgery is recommended by your gynaecologist when medication is proven to be ineffective. Endometriotic lesions and cysts can be successfully removed via open or laparoscopic surgery (minimally invasive surgery). During laparoscopic surgery, the gynaecologist creates a small incision in the belly button so that a tiny tube-like camera (laparoscope) can be inserted. Once the laparoscopic instruments have been inserted, the gynaecologist can proceed to remove the pelvic endometriosis lesion and endometriotic cyst.
On the other hand, open laparotomy is a more invasive procedure. This is done by creating a horizontal incision across the lower abdomen. The gynaecologist usually performs this when the endometriosis is severe and the risk for laparoscopy is too high.
As endometriosis tends to recur, women who have plans to conceive are advised to do so as soon as possible after the endometriosis surgery.
Classic symptoms of endometriosis include pain in the pelvis that worsens during periods, pain during or after sex, pain during bowel movements and urination while on one’s period, excessive heavy menstrual bleeding, and infertility.
Some complications of endometriosis include infertility and damage to surrounding tissues such as the bladder and bowel.
Before undergoing endometriosis surgery, ask a friend or family member to accompany you; avoid eating or drinking for a sufficient period of time prior to the surgery (specific instructions will be given, depending on the timing of your surgery); notify your doctor about any medications you are taking; and stop smoking.
If the patient had a laparoscopy (minimally invasive surgery), she can go home on the same day as long as she is cleared by the doctor. Returning to normal activities will take two weeks or more. For laparotomy surgery (open surgery), this will take up to one month to recover. Be sure to attend your follow-up appointments with your gynaecologist to ensure that you have properly healed.