Endometriosis & Adenomyosis

 

This is a condition where the cells lining the inside of the womb (Endometrium) are found within the pelvis (Endometriosis) or within the muscle of the womb (Adenomyosis). They are responsive to hormonal cycles and grow in the same patterns as to the cells within the womb. Their presence within the pelvis can typically cause pain which is related to your menstrual cycles.

The condition can cause the growth of cysts on the ovary called Endometriomas. They can cause pain when enlarged or reduction in fertility. Endometriosis can also cause pelvic scarring and if affect the fallopian tubes can cause infertility. Tubal surgery might be required to open or repair affected tubes.

Endometriosis and adenomyosis are often found at the same time as laparoscopy. There is as yet no definite curative treatment, though various treatment options are being researched. At present the diagnosis is a clinical one and is aided with the combination of pelvic ultrasound scan and blood tests including CA125. MRI (Magnetic resonance imaging) can be performed where more extensive endometriosis is suspected or to evaluate the nature of an ovarian cyst. These investigations will pick up endometriosis causing cysts or severe scarring within the pelvis but might not identify pelvic endometriosis which is spread within the pelvic peritoneum (pelvic skin). The Gold standard treatment for diagnosis and removal of endometriosis is an operative laparoscopy where endometriosis is cauterised with laser treatment and diathermy, or stripped and removed together with any scar tissue (called Laparoscopic Adhesiolysis). Every case will be discussed in detail to advise optimal management.

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