Endometriosis is a common problem which affects young women in the reproductive age group. In this, the tissue which lines the womb (endometrium) is found growing in abnormal locations such as the ovaries or around the uterus.
Every time the patient has her menses, there is also bleeding inside this. As a result thick dark blood accumulates in the ovaries (endometrium cyst) and there are blood spots all over the pelvis which cause the intestines tubes and ovaries to stick to each other.
Endometriosis can cause severe pain before or during periods, also heavy or abnormal bleeding. As it damages tubes and ovaries, it often causes infertility (inability to conceive). The condition always worsens with time and in severe cases can result in total damage to all pelvic organs causing a frozen pelvis.
The diagnosis is made by history, examination and sonography. Sometimes a laparoscopy (Key hole surgery) may be required to diagnose and treat endometriosis at the same time.
The treatment is essentially surgical. Nowadays, 2-3 visual cuts on the stomach wall are used to introduce a camera and operating instruments inside the pelvis and the endometriotic areas are removed and burnt using current or laser.
Despite surgical removal, there is a possibility of recurrence of endometriosis, and the same patient needs multiple surgeries within a few years.
Medical treatment is used to create artificial menopause as when there are no periods, the endometriosis subsides. This can be done using continuous hormone tablets or once a month injections. However this form of treatment is temporary.
Young patients with endometriosis who want to have a baby may require specialized treatment like IUI or IVF (Test tube baby). If the patient is older and has had repeated surgery, a total hysterectomy with oophoorectomy (removing uterus and ovary) is the final solution.
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