Symptoms

• chronic pelvic pain

• period-related pain (dysmenorrhoea) affecting daily activities and quality of life

• deep pain during or after sexual intercourse

• period-related or cyclical gastrointestinal symptoms, in particular, painful bowel movements

• period-related or cyclical urinary symptoms, in particular, blood in the urine or pain passing urine

• infertility in association with 1 or more of the above.

Causes

The specific reason isn't known. It can influence any lady of childbearing age

You're bound to foster endometriosis on the off chance that you:

1.  have a mother or sister who has it

2.  have trouble in conceiving

3.   have successive, hefty, or difficult periods

4.  start your period early

5.  go through the menopause late

Diagnosis

Ultrasound

1. to investigate suspected endometriosis even if the pelvic and/or abdominal examination is normal
2. to identify endometriomas (chocolate cyst) and deep endometriosis involving the bowel, bladder, or ureter.

Serum CA125 

1. A blood test looking for a chemical known as CA125
2. a raised serum CA125 (that is, 35 IU/ml or more) may be consistent with having endometriosis
3. endometriosis may be present despite a normal serum CA125 (less than 35 IU/ml).

MRI

MRI scan will be considered to assess the extent of deep endometriosis involving the bowel, bladder, or ureter.

Diagnostic laparoscopy

Laparoscopy will be considered to diagnose endometriosis in women with suspected women with symptoms. The biopsy will be taken to confirm endometriosis. Mild to moderate disease will be cleared at the same time (first laparoscopy). For more severe diseases involving bowel, bladder, or ureter a second stage laparoscopy will be performed with a surgeon.

Treatment

There is presently no remedy for endometriosis, yet medicines are accessible for dealing with the side effects. These expect to:

1. relieve pain.

2. shrink or hinder the development of the endometrial tissue on different organs

3. improves your quality of life.

It involves analgesics, pain killers specific for neuropathic pain, contraceptive hormonal medications, and GnRH injections.

Surgery

You may require a surgery if:

1. you have serious endometriosis that isn't reacting to clinical treatment

2. you need to have kids yet are experiencing issues considering

3. you have huge ovarian growth because of endometriosis

4. endometriosis is meddling with the ordinary functions of organs like your gut and bladder

Laparoscopic excision of endometriosis involving skin lining of the tummy. It is a day case procedure, and it is a treatment option for superficial endometriosis.

Laparoscopic ovarian cystectomy for endometriomas to remove the cyst of the ovary completely along with the removal of scar tissues which releases ovaries and bowel from its attachment. This is more specific for patients who are subfertile due to endometriosis.

Laparoscopic bilateral removal of tubes that are affected by blood due to endometriosis prior to IVF treatment.

Hysterectomy with bilateral salpingo-oophorectomy may be offered (pelvic clearance) if you have completed your family. A low-dose hormone replacement therapy will be offered to you after the procedure.

For the more advanced and atypical location of endometriosis like scar site endometriosis, lung endometriosis Mr. Kunal Rathod will suggest you options in the clinic which needs specilaised tertiary level care.

Complications

There are some complications of the major surgical procedure like injury to surrounding organs, post-operative pain and sexual dysfunction, and recurrence of endometriosis

For more information about endometriosis; click here

https://www.rcog.org.uk/en/patients/patient-leaflets/endometriosis/

www.nice.org.uk/guidance/ng73

www.eshre.eu/Guidelines-and-Legal/Guidelines/Endometriosis-guideline.aspx