Updated: October 11, 2019
Endometriosis is the development of uterine-lining tissue outside the uterus. The tissue that normally lines the inside of your uterus, grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs.
Endometriosis can be diagnosed based on symptoms of pelvic pain and findings during physical examinations. Different types of test that are done to diagnose endometriosis include:
During a pelvic exam, your doctor manually check the areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus.
Often it is not possible to feel small areas of endometriosis, unless there is presence of a cyst. But sometimes the examination itself causes unusual pain or discomfort.
Pelvic pain in women with endometriosis depends partly on where endometrial implants of endometriosis are located. Deeper implants and implants in areas of high nerve density produces more pain. The implants may also release substances into the bloodstream which are capable of eliciting pain.
When endometriotic implants trigger scarring of surrounding tissues, pain can result. There is no relationship between severity of pain and the amount of anatomical disease which is present.
A device called a transducer is either pressed against your abdomen or inserted into your vagina to capture the images. It is called transvaginal ultrasound if inserted into your vagina.
Both types of ultrasound may be done to get the best view of your reproductive organs by using high-frequency sound waves.
Ultrasound imaging can not identify endometriosis, but it can identify cysts associated with endometriosis. Ultrasound can be helpful in ruling out other pelvic diseases and may suggest the presence of endometriosis in the vaginal and bladder areas.
A surgical procedure called laparoscopy done is to look inside your abdomen for signs of endometriosis. You will be given general anesthesia and your surgeon makes a tiny incision near your navel and inserts a laparoscope, looking for endometrial tissue outside the uterus.
A samples of tissue will be taken for biopsy. Laparoscopy can provide information about the location, extent and size of the endometrial implants to help determine the best treatment options.
Pelvic ultrasound and laparoscopy are also important in excluding malignancies such as ovarian cancer which can cause many of the symptoms similar to endometriosis symptoms.
If you have endometriosis and are trying to become pregnant, a conservative surgery may increase your chances of success where endometriosis will be removed as possible while preserving your uterus and ovaries. Severe pain from endometriosis will also get eliminated. But it may return along with endometriosis overtime.
This procedure can be done either laparoscopically or through traditional abdominal surgery in more extensive cases. In laparoscopic surgery, a laparoscope is inserted through a small incision near your navel and instruments are inserted to remove endometrial tissue through another small incision. Endometrial implants may be excised or destroyed by different sources of energy such as laser, electrical current. If the disease is extensive and anatomy is distorted, laparotomy may be required.
While surgical treatments can be very effective in the reduction of pain, the recurrence rate of endometriosis following conservative surgical treatment is possible. Therefore ongoing medical therapy following surgery is recommended in an attempt to prevent symptomatic disease recurrence.
Assisted reproductive technologies, such as invitro fertilization are sometimes preferable to conservative surgery to help you become pregnant. If conservative surgery does not work, one of these approaches are recommended.
Surgery to remove the uterus and cervix as well as both ovaries is known as hysterectomy. Hysterectomy is removal of the uterus, with or without removal of the ovaries. You can not get pregnant after a complete hysterectomy. So for women still in their reproductive years, hysterectomy is typically considered a last resort.
If your pain persists or if finding a treatment that works takes some time, you can try measures at home to relieve your discomfort.