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Endometriosis : Conservative Surgery For Endometriosis

Endometriosis is a condition that affects women of reproductive age, and is associated with both pelvic pain and infertility. If you have been diagnosed with endometriosis, it means that the tissue that normally lines the inside of your uterus - the endometrium - is growing outside your uterus; it could also involve your ovaries, bowels and the tissue that lines the pelvis. However, the displaced endometrial tissue continues to act as it normally would: that is it thickens, breaks down and bleeds with each menstrual cycle. And because it has no way to exit the body, it becomes trapped. When endometriosis involves the ovaries, cysts may form. In some women, endometriosis grows deep beneath the peritoneal lining, such as in the area between the vagina and the rectum. These cases are often associated with more severe pain, but not necessarily more severe infertility.

How is a diagnosis of Endometriosis made?

To diagnose endometriosis and other conditions that can cause pelvic pain, your specialist asks you to describe your symptoms, including the location of your pain and when it occurs.

  • Pelvic exam. During a pelvic exam, your specialist manually feels (palpates) areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus. Often it's not possible to feel small areas of endometriosis, unless they've caused a cyst to form.
  •  Ultrasound. This test uses high-frequency sound waves to create images of the inside of your body. To capture the images, a device called a transducer is either pressed against your abdomen or inserted into your vagina (transvaginal ultrasound). Both types of ultrasound may be done to get the best view of your reproductive organs. Ultrasound imaging won't definitively tell your doctor whether you have endometriosis, but it can identify cysts associated with endometriosis (endometriomas).
  • Laparoscopy. Medical management is usually tried first. But to be certain you have endometriosis, your specialist using a surgical procedure called laparoscopy, look inside your abdomen for signs of endometriosis.

While you're under general anesthesia, your surgeon makes a tiny incision near your navel and inserts a slender viewing instrument (laparoscope), looking for endometrial tissue outside the uterus. He or she may take samples of tissue (biopsy). Laparoscopy can provide information about the location, extent and size of the endometrial implants to help determine the best treatment options.