Endometriosis

Endometriosis is an abnormal condition where endometrial tissue (the same tissue that lines the inside of the uterus) located outside the uterus. The most common places to find endometriosis are the ovary, behind the uterus and on the ligaments that support the uterus. Endometriosis may be found anywhere in the pelvis, between the vagina and rectum, on the rectum or bowel, and on the bladder. It has even been identified in locations away from the pelvis such as on the diaphragm and in the lungs!

The endometriosis responds to hormones much the same way as the lining of the uterus. Cyclical swelling results in inflammation and scarring of the normal tissue. The scarring may lead to symptoms.

The most common symptoms of endometriosis are:

• Pelvic pain
• Painful periods
• Pain during intercourse
• Infertility

Less common symptoms include:

• Painful bowel movements
• Constipation
• Bloating
• Painful pelvic exams

The amount of pain does not correlate with the amount of endometriosis present. Some women may have minimal endometriosis but significant pain. Other women may have severe endometriosis, but few symptoms.

Hormones such as oral contraceptive pills or progestins may improve the symptoms of endometriosis. If medical therapy does not relieve the symptoms of endometriosis, then surgical treatment is offered. The surgical treatment of endometriosis is removal of the endometriosis, itself. We prefer to perform this procedure laparoscopically. Laparoscopic surgery offers a magnified view of the tissues in the pelvis and abdomen, more so than open surgery. In addition, with laparoscopic surgery, patients are often discharged the day of surgery, have a shorter recovery period, and require less postoperative pain medication when compared to open surgery.