It is the condition of endometrial cells which normally covers inside of the uterus and discharged with menstrual bleeding, be outside of the uterus, usually on the ovaries, in the inner wall of the abdomen, on the fallopian tubes, intestines, bladder-like bodies.
The diagnosis of endometriosis seen in 10% of women of reproductive age is often made in their 30s and 40s.
Since they are sensitive to estrogen, endometriosis implants bleed during menstruation same as endometrial layer. Irritation, inflammation and swelling may occur in the surrounding tissues as a result of this bleeding . Adhesions in abdominal organs develop and normal relations of the organs with each other is lost due to repetition of these incidents.
Bleeding, inflammation and scarring lead to chronic pelvic pain in endometriosis which is the most common symptom, and especially seen severe during the premenstrual and menstrual bleeding. Depending on the localization of foci of endometriosis pain occurs sometimes during bowel movements and sometimes during urination. Pain during intercourse is often. Another condition which we often come across is infertility – difficulty in getting pregnant. Infertility cases, which are the most important complication of endometriosis, is seen in 30-50% of the cases.
Even if the symptoms, endometriosis, pelvic examination and ultrasound suggest endometriosis, definite diagnosis is made by surgery. Pathologic examination of the sample obtained with surgical procedure (mostly laparoscopy), put the diagnosis.
Treatment in endometriosis is planned depending on disease prevalence, severity of symptoms, whether there is request for having child. If the pain is at the forefront, medical treatment is tried first. Anti-inflammatory agents and hormone drugs such as birth control pills, progestins, GnRH analogues are used in medical treatment. These treatments not destroy the pathologies but slows the progression of the disease and prevent the development of new lesions.
In the treatment of endometriosis, surgery can be performed to reduce pain and increase the potential for fertility. In surgical intervention, endometriotic tissues are removed and adhesions are liberalized in order to ensure normal anatomy. Although pain problem resolves in many women after the surgery, pain recurs within the next 2 years in 40-80% of the cases.
In cases where surgery is not conservative enough for the patients willing to have child, IVF may be necessary as a method of assisted reproduction treatment.