Endometriosis

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Endometriosis is a condition where tissue similar to the lining of your uterus grows on other parts of your body. When this tissue grows in the wrong places, it can cause you to experience uncomfortable symptoms that can impact your daily life. Some people with endometriosis also have issues getting pregnant.

What are the symptoms of endometriosis?

There are many symptoms connected with endometriosis. The main symptom is pain. This pain can be intense or mild. It can typically be felt in your abdomen, pelvic region and lower back. 

People who do experience symptoms of endometriosis may have:

• Very painful menstrual cramps.
• Abdominal pain or back pain during your period or in between periods.
• Pain during sex.
• Heavy bleeding during periods or spotting (light bleeding) between periods.
• Infertility (difficulty becoming pregnant).
• Painful bowel movements.

How is endometriosis diagnosed?

Once at an appointment, your consultant start by asking you for your personal medical history, Your consultant may do a pelvic exam and pelvic ultrasound scan.

Depending on your symptoms, physical exam and ultrasound results, an MRI may also be ordered for further endometriosis mapping. 

A laparoscopy (Key hole surgery) may be offered for both definitive diagnosis and treatment. It can be a useful way to confirm endometriosis because your surgeon doing the procedure can use a small camera (laparoscope) to look inside your tummy. A biopsy (small tissue sample) might be taken during this procedure. The biopsy will be sent to a lab to confirm the diagnosis.

What is the treatment for endometriosis?

Your consultant will help create your treatment plan for endometriosis based on a few factors, including:

• The severity of your endometriosis.
• Your plans for future pregnancies.
• Your age.
• The severity of your symptoms (often pain).

In many cases, your treatment plan will focus primarily on managing your pain and improving fertility issues (if you are planning on a future pregnancy). This can be done through medications and surgery.

Medications are often used to help control the symptoms of endometriosis. These can include pain medications and hormone therapies.

In some cases, your consultant might recommend surgery as a way to confirm and treat endometriosis. There are always risks to a surgical procedure. However, surgery for endometriosis can be an effective way to relieve pain and, in some cases, improve your fertility.

Surgical options to treat endometriosis include:

• Robotic surgery & Laparoscopy: In this procedure, your surgeon will make a very small cut in your abdomen (< 1 centimetre) and insert a thin tube-like tool called a laparoscope into your body. This tool can be used to see inside your body and identify endometriosis with a high-definition camera. Additional 5-millimeter instruments can then be used to excise and remove endometriosis.
• Hysterectomy (womb removal surgery) +/- Oophorectomy (ovaries removal surgery): In severe cases, your surgeon may suggest removing your uterus based on the amount of endometriosis and scar tissue present, if you have other uterine conditions like adenomyosis and your desire for future fertility. If you have a hysterectomy, areas of endometriosis should still be excised to optimize your pain relief.

Endometriosis is considered a chronic disease. Many people experience relief from endometriosis pain after surgery, but the symptoms may return within a few years. The severity of your endometriosis could play a part in how quickly — if at all — it comes back after surgery. 

Your consultant might suggest combining a surgical procedure with medications for the best outcome.