SYMPTOMS

Endometriosis is a common disorder that affects women during their reproductive years. It occurs when endometrial tissue, which lines the uterus, grows outside the uterine cavity. This misplaced tissue may implant and grow anywhere within the pelvic cavity, in small, superficial patches called implants; in thicker, penetrating nodules; or it may form cysts in the ovary called endometriomas.

Endometriosis is highly unpredictable. Some women may have a few isolated implants that never spread or grow, while in others the disease may spread throughout the pelvis. Endometriosis irritates surrounding tissue and may produce web-like growths of scar tissue called adhesions. This scar tissue can bind any of the pelvic organs to one another and may sometimes cover them entirely.

Many women who have endometriosis experience few or no symptoms. In fact, it is often diagnosed when a patient is undergoing pelvic surgery for other reasons. However, in some women, endometriosis may cause severe menstrual cramps, pain during intercourse, infertility or other symptoms. Endometriosis is more likely to be found in women who have never been pregnant. For this reasons, the condition is sometimes labelled a "career woman's disease", because working women often delay pregnancy.

DIAGNOSIS

The diagnosis of endometriosis cannot be made from symptoms alone.

Your symptoms of fertility problems, severe menstrual cramps or pain during intercourse maybe very suspicious of the condition. Certain findings of a pelvic examination can lead your physician to suspect endometriosis.

The diagnosis of endometriosis is finally made at the time of a surgical procedure called a laparoscopy. During this procedure the physician can see inside the pelvis and can verify the presence of endometriosis. If there is any uncertainty a small piece of tissue can be removed for microscopic examination at this time. This is called a biopsy.

TREATMENT

Treatment can either be surgical or medical (by means of medication).

The usual approach is to treat endometriosis surgically at the time of the diagnostic laparoscopy. Deposits of endometriosis can be removed or destroyed laparoscopically and scar tissue can be excised.

Some patients need a combination of medical and surgical treatment. If an infertile woman with endometriosis fails to conceive even after medical and surgical treatment, in-vitro fertilisation may be an option. Even women with extensive disease, whose ovaries are surrounded by adhesions, are candidates for in vitro-fertilisation.


Endometriosis 1 - The role of laparoscopic treatment of endometriosis in patients who have failed in vitro fertilization E.D. Littman, A.A. Milki, C.R. Nezhat - Fertility and Sterility