Endometriosis is one of the most common diseases in the field of Gynaecology. In this condition, cells from the uterine lining start growing on organs outside the uterus, including the ovaries, fallopian tubes, the bowels, bladder and other organs within the pelvic cavity.
While most women don’t experience any signs or symptoms of the disease, the presence of endometriosis is first suspected if a woman is having difficulty conceiving.
In those women who are symptomatic, the most frequent complaint is very heavy and painful periods. Other symptoms are…
- Irregular vaginal bleeding in between periods
- Pain during or after having sex
- Pain when defecating
- Chronic pelvic and lower back pain
- Chronic fatigue
Treatments for Endometriosis
Women with endometriosis symptoms but do not have any desire to become pregnant yet are first given medications. These would include hormone therapy using oral contraceptives. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are given to relieve menstrual cramps and pelvic pain.
Some doctors may prescribe Gonadotropin-Releasing Hormone Analogs (GnRH-a) to shrink the endometriosis growths and relieve pain. However, these medications may induce early menopause together with its side effects, particularly hot flushes, insomnia, fatigue, bone loss, headaches, vaginal dryness and depression.
If the symptoms are severe and there is extensive endometriosis growth within the pelvic cavity, and at the same time, the woman wants to have a child, the patient is referred to Obstetrics & Gynaecology surgeons like Dr. Steven Teo of the IVF Center for laparoscopic surgery.
Laparoscopic Surgery for Endometriosis
Laparoscopic surgery has become the procedure of choice in the treatment of mild to moderate endometriosis. This surgery involves making a small incision on the abdomen and a scope with a light is inserted into the abdomen.
Laparoscopic surgery serves two goals…
- It allows for actual viewing of the internal organs, enabling the surgeon to identify and locate growths of endometriosis. Please note that even if the surgeon doesn’t find any signs of the disease, it does not mean that it’s not there. There are cases wherein the growths are too small to be seen or may be hidden.
- The procedure allows for the removal of the endometriosis growths.
How is laparoscopy done? Prior to the procedure, you will be asked to abstain from eating or drinking for at least eight hours. Once in the hospital, you will be placed under general anaesthesia. You may choose to stay awake during the procedure. In this case, you will be given local or spinal anaesthesia.
The surgeon proceeds to inflate the abdomen with gas – usually nitrous oxide or carbon dioxide – which is pumped through a needle. Better visualization is achieved because the gas pushes away the abdominal wall from the internal organs.
One small incision is made on the abdomen, allowing for the insertion of a lighted scope. Other incisions may also be done to accommodate surgical instruments that will move organs and structures gently aside for better viewing.
Whenever the surgeon locates endometriosis growths or scar tissue, the surgeon either cuts and removes the tissue or burns them away with a laser or electrocautery. Once all these abnormal growths are removed, the surgeon closes all incisions made.
In the hands of an expert surgeon, you can expect zero to minimal scarring with the procedure lasting only between 30 and 45 minutes.
Women who suspect that they may have endometriosis should go for a medical consultation so that it can be readily determined if there is a need for laparoscopic surgery to be done.