Endometriosis Treatment: No Hysterectomy Required! – Antai Hospital

Endometriosis Treatment at Antai Hospital

Endometriosis is an inflammatory entity with the presence of endometrial-like tissue outside the uterine cavity. It mainly affects women of reproductive age, with a prevalence of about 10%. The wide range of symptoms, such as chronic pelvic pain, dysmenorrhea, infertility, dyspareunia, dysuria, dyschezia and fatigue which characterise this oestrogen-dependent condition, result in a delayed diagnosis.

Many gynaecological societies have published different guidelines in order to help the clinicians with the diagnosis and treatment of endometriosis. The variety of the available treatments in combination with complexity of this illness leads to significant discrepancies between the recommendations.

During a woman’s regular menstrual cycle, this tissue builds up and is shed if she does not become pregnant. Women with endometriosis develop tissue that looks and acts like endometrial tissue outside of the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity. Each month, this misplaced tissue responds to the hormonal changes of the menstrual cycle by building up and breaking down just as the endometrium does, resulting in small bleeding inside of the pelvis. This leads to inflammation, swelling and scarring of the normal tissue surrounding the endometriosis implants.

Cause

The exact causes of endometriosis are still unknown. One theory suggests that during menstruation, some of the tissue backs up through the fallopian tubes into the abdomen, a sort of “reverse menstruation,” where it attaches and grows. Another theory suggests that endometrial tissue may travel and implant via blood or lymphatic channels, similar to the way cancer cells spread. A third theory suggests that cells in any location may transform into endometrial cells.

Endometriosis can also occur as a result of direct transplantation—in the abdominal wall after a caesarean section, for example. Additionally, it appears that certain families may have predisposing genetic factors to the disease.

Where Endometriosis Can Occur

Endometriosis can be categorized into two types depending on where they are found:

1. If the tissue grows in the ovaries. (causing chocolate cysts)
2. If the tissue grows in the uterine cavity outside the ovaries. (causing lesions)

Where the endometrial tissue grows and spreads will lead to different conditions with varying severity. For example:

• If it grows in the muscle walls of the uterus, it will lead to Adenomyosis. 
• If it grows in the ovaries, it will lead to Endometrioma.

The most common sites of endometriosis include:

• The ovaries
• The fallopian tubes
• Ligaments that support the uterus (uterosacral ligaments)
• The posterior cul-de-sac, i.e., the space between the uterus and rectum
• The anterior cul-de-sac, i.e., the space between the uterus and bladder
• The outer surface of the uterus
• The lining of the pelvic cavity

Occasionally, endometrial tissue is found in other places, such as:

• The intestines
• The rectum
• The bladder
• The vagina
• The cervix

Treatment at Antai Hospital

Upon diagnosis the condition via bloodtest, ultrasound and operative laparoscopy, to effectively treat Endometriosis and prevent future miscarriages, Antai Hospital will provide a comprehensive treatment based on the following 3 points:

For the treatment of Endometriosis:

• We use specialised Antai 3D-laparoscopy to remove chocolate cysts from the ovaries.
• We use 3D-laparoscopy to remove the lesion in the uterine cavity.

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