Endometriosis is an often painful disorder in which tissue similar to the tissue that normally lines the inside of a woman’s uterus — the endometrium — grows outside of the uterus.
Endometriosis most commonly involves a woman’s ovaries, fallopian tubes and the tissue lining their pelvis. Rarely, endometrial tissue may spread beyond pelvic organs.
Displaced tissue continues to act as it normally would – thickens, breaks down, and bleeds with each menstrual cycle. As this tissue has to way to exit the body, it becomes trapped and the surrounding tissue can become irritated developing scar tissues and adhesions.
Cause
During a regular menstrual cycle, the woman’s body shed the lining of their uterus. This allows menstrual blood to flow from their uterus through the small opening in the cervix and out through their vagina.
Possible explanations include;
- Problems with Menstrual Flow – menstrual blood enters the fallopian tube and the pelvis instead of leaving the body in the usual way
- Embryonic Cell Growth – at times, embryonic cells lining the abdomen and pelvis develop into endometrial tissue within those cavities.
- Fetal Development – data shows that endometriosis can be present in a developing fetus, but pubertal estrogen levels are thought to trigger the symptoms.
- Surgical Scar – endometrial cells can move during a procedure such as a hysterectomy or c-section.
- Endometrial Cell Transport – the lymphatic system transports endometrial cells to various parts of the body
- Genetics – there may be an inherited component. A woman with a close family member who has endometriosis is more likely to develop endometriosis herself.
- Hormones – endometriosis is stimulated by the hormone estrogen.
- Immune System – problems with the immune system can prevent the destruction of extrauterine endometrial tissue.
Treatments
Treatment of endometriosis depends on the severity of the symptoms and whether the patient intends to become pregnant.
- Medications – nonsteroidal anti-inflammatory drugs (NSAIDs) to help ease painful menstrual cramps.
- Hormone Therapy – oral contraceptive pills, contraceptive injections, and vaginal rings to help control the hormones responsible for the buildup of endometrial tissue.
- Surgery – laparoscopic surgery is less invasive. The surgical wound will be only small cuts (less than 6 cm). The surgical treatment also includes minilaparotomy myomectomy and abdominal myomectomy.
Patients with previous abdominal surgery or abdominal adhesions are suitable candidates for laparoscopic surgery, as this treatment option can reduce complications and risks.
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