Endometriosis – Gynecure By Dr. Hitendrasing Patil

Endometriosis - OB/GYN Physicians

GYNE CURE – WEST END PLAZA, AUNDH PUNE

Securing an appointment with an expert in endometriosis is essential for accessing effective management and treatment of the condition. It is vital to choose a gynecological surgeon who not only has board certification but also extensive training in minimally invasive surgical techniques. Dr. Hitendrasing Patil emerges as a renowned, board-certified authority, celebrated for his expertise in laparoscopic endometriosis surgery. Offering his services in Pune, Aundh, Maharashtra, India, he represents a pinnacle of specialised care in the realm of minimally invasive gynecological surgery for patients in these areas.

What Is Endometriosis?

Endometriosis is a health condition impacting women predominantly in their reproductive years, typically from ages 25 to 40, and is a leading factor contributing to infertility issues. This condition emerges post-puberty and resolves at menopause, attributed to the cessation of ovarian hormone production. The prevalence of endometriosis is notably higher in women facing challenges with infertility, with rates ranging from 25% to 40%, in contrast to a 3% to 10% occurrence rate in the wider female population.

Endometriosis involves the abnormal expansion of tissue resembling the inner lining of the uterus, occurring not just within the muscular layer of the uterus, known as the myometrium, but also in locations external to the uterus.

Internal Endometriosis

Internal Endometriosis, known as Adenomyosis, occurs when tissue resembling the lining of the uterus grows within the myometrium, the muscular layer of the uterus.

External Endometriosis

External Endometriosis refers to the condition where tissue similar to the uterine lining is found growing outside the uterus. This type of endometrial tissue can be located in various parts of the body, with the ovaries, peritoneum, rectum, intestines, vagina, vulva, bladder, and liver being among the most commonly affected areas.

To date, the exact cause of pelvic endometriosis remains unclear, though various theories have been proposed to shed light on its origins. Among the most widely accepted explanations are:

Metaplasic theory
Implantation theory
Metastatic theory
Surgical scar implantation
Immune system disorder

Risk Factors For Endometriosis

Numerous factors connected to the female reproductive system are often linked with an increased risk of developing endometriosis. Fluctuations in hormones play a significant role in the onset of this pelvic condition. Factors such as early onset of menstruation, a higher body mass index, and shorter lengths of menstrual cycles are also recognized as potential risk contributors. Additionally, other variables associated with a heightened risk of endometriosis encompass:

Never giving birth
Uterine abnormalities
A history of pelvic infections
A family history of endometriosis (mother, sister, aunt, etc.)

Signs and Symptoms of Endometriosis

Initiating the path to recovery begins with identifying the diverse symptoms of endometriosis, acknowledging that these symptoms can vary widely among individuals. Recognizing every potential sign and understanding the risk factors is crucial. Our OB-GYN specialists, with expertise in endometriosis, are adept at identifying the symptoms indicative of this condition, including:

Key symptoms highlighted by our specialists in endometriosis include:

Pelvic Pain: Intense discomfort during menstrual cycles, localized in the lower abdominal area.
Dyspareunia: Experiencing pain during sexual activities.
Menorrhagia: Having unusually heavy menstrual bleeding.
Menometrorrhagia: Experiencing bleeding outside of regular menstrual periods.
Abdominal Pain: General pain within the abdominal region.
Rectal Pain: Discomfort or pain in the rectal area.
Anal Bleeding: The presence of blood from the anus, unrelated to bowel movements.

The symptoms of endometriosis can vary significantly depending on the location of the endometrial-like tissue. For example, when this tissue appears in the nasal area, it may cause nosebleeds that align with the menstrual cycle. Conversely, if the tissue is found in the bladder, the individual might experience symptoms such as pain above the pubic bone, blood in the urine, and an increased urgency to urinate.

When endometrial-like tissue is located in the intestines, it can lead to gastrointestinal symptoms such as diarrhea, constipation, the presence of blood in the stool, and discomfort during bowel movements.

Four Stages of Endometriosis

Stage I : Endometriosis is characterized as minimal, where the lesions are superficial and there may be the presence of a few filmy adhesions.

Stage II: Endometriosis is considered mild, with deep lesions located in the cavum Douglasi, which is the extension of the peritoneal cavity situated between the posterior wall of the uterus and the rectum.

Stage III: Endometriosis is categorized as moderate, marked by the presence of endometriomas on the ovary along with an increased number of adhesions.

Stage IV: Endometriosis is classified as severe and is characterized by large endometriomas and widespread adhesions.

Infertility represents a significant challenge associated with endometriosis, standing as a primary reason for infertility among women in their reproductive years. Endometriosis can impair fertility through various mechanisms, including altering the structure of the ovaries and pelvis, compromising egg quality, disrupting the implantation process, modifying hormonal balances, and leading to the formation of numerous adhesions.

How is Endometriosis Diagnosed?

To identify signs of endometriosis, healthcare professionals may employ a variety of diagnostic techniques, including:

Pelvic Examination: In this procedure, a physician palpates the pelvic region to detect any irregularities or abnormalities.
Pelvic Ultrasound: Utilizing high-frequency sound waves, this imaging test generates detailed pictures of the body’s internal structures.
Laparoscopy: This surgical diagnostic procedure, often recommended by an endometriosis specialist, involves making a small incision in the abdomen to insert a laparoscope, allowing the surgeon to directly observe the abdomen’s interior. It helps in assessing the precise location, size, and extent of endometrial growths.
Magnetic Resonance Imaging (MRI): An MRI scan employs a magnetic field and radio waves to produce comprehensive images of the organs and tissues, providing valuable insights into the condition.
Tumor Markers CA – 125: Although not exclusively indicative of endometriosis, elevated levels of the CA – 125 protein in the blood can suggest the presence of the condition among other potential issues.

Endometriosis, while not curable, can be managed effectively through medical or surgical interventions to alleviate symptoms and potentially improve fertility. Specialists in endometriosis, including those in Brooklyn, typically advise starting with conservative medical treatments. Should these initial approaches not yield satisfactory outcomes, surgical options may then be considered essential for further relief and management of the condition.

Pelvic Exam for Endometriosis

The pelvic exam plays an integral role in diagnosing endometriosis, serving as a preliminary assessment where a healthcare professional examines the vagina and rectum for indicators of the condition, including areas of tenderness, lumps, or scarring. While this exam on its own cannot definitively diagnose endometriosis, it is invaluable in guiding the decision for additional tests. Prompt identification and diagnosis of endometriosis are crucial for initiating timely treatment.

Medical Treatment of Endometriosis:

NSAID – for the pain
Hormonal therapy– Hormonal contraceptives, Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists, and Danazol are used as part of hormonal therapy strategies to treat endometriosis by modulating hormone levels, aiming to minimize the progression and symptoms of the condition.

Surgical Treatment of Endometriosis:

Conservative surgery – Conservative surgery aims to remove or destroy endometrial growths while preserving the uterus and ovaries, focusing on alleviating pain and preserving fertility
Radical surgery: including hysterectomy and the removal of both ovaries, is considered for severe cases, targeting the complete elimination of endometriosis symptoms but resulting in infertility

Assisted reproductive technologies (ART) are employed to aid individuals facing challenges in conceiving, particularly in scenarios where endometriosis affects fertility. These technologies include a range of treatments designed to assist with the conception process, offering hope to those looking to start or expand their families despite the complications associated with endometriosis.

Frequently Asked Question (FAQ)

How Common Is Endometriosis?

Studies indicate that approximately 10 percent of women, translating to over 6.5 million individuals in the United States, are affected by endometriosis. Experts in the field note that the condition is particularly prevalent among women in their 30s and 40s, contributing to increased challenges in achieving pregnancy.

How Serious Is Endometriosis?

Endometriosis often leads to inflammation and scarring within the pelvic cavity’s tissues, yet it might be overlooked by medical professionals as merely severe menstrual cramps. As the condition advances, scarring can extend to various body areas. The disease is known for causing intense, sometimes constant, pain, alongside symptoms like abdominal bloating. Hence, seeking a skilled endometriosis surgeon for prompt diagnosis and appropriate treatment is crucial.

What Are the Causes of Endometriosis?

The precise cause of endometriosis remains a mystery, with multiple theories proposed but none definitively proven through scientific evidence. Among these, the oldest and a widely discussed theory is that of retrograde menstruation. This phenomenon involves menstrual blood, containing endometrial cells, flowing backwards through the fallopian tubes into the pelvic cavity, rather than exiting the body via the vagina, potentially leading to endometriosis.

How Much Does Endometriosis Treatment Cost?

The expense associated with treating endometriosis varies based on the healthcare provider and the type of treatment—whether medical or surgical. Insurance coverage can significantly influence out-of-pocket costs, particularly for medications like anti-inflammatory drugs, which are often covered to some extent by health insurance plans. Based on the specifics of your case, our specialists in endometriosis might recommend an extended course of hormone therapy, which could span anywhere from 3 to 9 months. This hormone therapy is designed to manage endometriosis by regulating hormone levels, potentially reducing the presence and impact of endometrial-like tissue.

If you have any questions or wish to book an appointment with a top-rated Endometriosis surgeon in Pune, please don’t hesitate to get in touch with our Gynecure office. Our team is here to provide you with the information and support you need to address your concerns.

Dr. Hitendrasing Patil
MS – Obstetrics & Gynaecology,
Gynecologist
Add: Office No.45, 1st Floor,
Westend Plaza, Nagras Road, Above Yes Bank,
Near Demart, Ward No. 8, Aundh, Pune- 411007
Phone: +91 9689956634

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