Endometriosis

What?

Endometriosis is a disease of menstruation. It occurs when tissue similar to the lining of the uterus, or endometrium, migrates outside of the womb, where the tissue should not be. It is found in the pelvic cavity, and it can affect female reproductive organs such as the uterus, fallopian tubes, ovaries, uterosacral ligaments, the peritoneum, or any of the spaces between the bladder, uterus, vagina, and rectum. Endometriosis can also involve the bowel, intestines, appendix or rectum.

Why?

While multiple theories regarding the cause of endometriosis exist, there has been no proven cause that can adequately explain every aspect of endometriosis. It is the result of an inflammation process, as the endometrial tissue outside the uterus responds to the monthly fluctuations of a woman's menstrual cycle. This bleeding can lead to severe pain, inflammation and scarring of the pelvic structures and cyst formation in the ovaries.

Who?

Endometriosis affects women mostly in their reproductive years (25-35 years old). It affects an estimated 200 million women worldwide, and many women often experience a decade-long delay in diagnosis suffering from severe pelvic pain, heavy periods, painful sex and infertility

How?

Endometriosis has many symptoms and affects women differently. The disease is often not recognized or understood. It is fundamental to know about your pain symptoms, your medications and your previous surgery. We perform an abdominal and pelvic examination to assess genital organs and any abnormality. In case of suspicious endometriosis, we look for abdominal masses and specific pelvic signs, such as reduced organ mobility and enlargement, tender nodularity in the posterior vaginal fornix, and visible vaginal endometriotic lesions. Advanced ultrasound scan can detect endometriosis and other rarer presentations of endometriosis and adenomyosis. However, MRI may also be used to diagnose deep infiltrating endometriosis if it is suspected. In the other hand, superficial endometriosis is not reliably confirmed or refuted on any form of scan currently and the only way to diagnose it is to undergo a diagnostic laparoscopy (keyhole surgery) under general anaesthetic and to see it directly and treat it by excision at the same time.