Endometrioma (or chocolate cyst of the ovary) is estimated to affect 17-44% of women suffering from endometriosis (1). Its presence is often associated with infertility and/ or chronic pelvic pain and its surgical management may be indicated. What are the available methods of surgical management of endometrioma and what outcomes are they linked with? In this article, we…
Endometrioma is a type of ovarian cyst that develops secondary to the presence of endometriosis. It is, also, called ‘’chocolate cyst’’ due to the characteristic colour of the fluid it contains. 17% to 44% of women with endometriosis have an endometrioma (1), of which, in 19% to 28% of cases, the endometrioma is bilateral (2). The exact cause, as…
Studies have demonstrated that the endometrium of women with endometriosis is different to that of women without endometriosis (1,2). Those differences may interfere with normal implantation as well as placental growth (3). However, the existing literature has demonstrated conflicting results regarding a possible link between endometriosis and miscarriage. Let us have a look at the evidence. It is…
We know that endometriosis is associated with infertility and, in patients with deep infiltrating endometriosis (DIE), spontaneous pregnancy rate (without the use of assisted reproduction technologies) is estimated to be around 2 and 10% (1). Although these patients often end up using assisted reproduction in order to get pregnant, can surgical management of endometriosis increase the chances of conception? …
Endometriosis is associated with a number of symptoms, such as infertility, painful sexual intercourse and chronic pelvic pain. Their impact on the mental health and social life of women with endometriosis is often significant (1,2). This is understandable if one considers the negative effect of chronic pain in the social and professional life of patients in general. Pope…
Many things have been written as to whether patients with endometriosis have higher risk of developing other diseases. One of these diseases is adenomyosis. Adenomyosis is the condition in which cells from the lining of the womb (endometrium) are found with the muscular wall of the uterus (myometrium). We recognise 2 types, focal and diffuse. Some believe that adenomyosis and…
Endometriosis of the gastrointestinal system accounts for 5 to 12% of deep endometriosis cases1. 90% infiltrates the rectum and the sigmoid (large bowel)2. In most cases, the patients present with severe symptoms, such as the following: dyschezia (pain on opening the bowels), haematochezia (blood in the stools), bloating and change between constipation and diarrhoea. Those symptoms are, often, more intense…
The urinary tract is infiltrated in 14-20% of patients with deep infiltrating endometriosis1. They often coexist with other endometriosis lesions. The most common symptoms are frequent urination, pain and burning on urination, strong desire to pass urine, blood in the urine and inability to fully empty the bladder. Some patients may have no symptoms at all. Diagnosis can be achieved…
As we saw in another article, one of the surgical management options for bowel endometriosis is the laparoscopic segmental bowel resection (removal of the affected segment of the bowel). But how is the actual specimen removed? Classically, a small incision below the belly button is required to remove the specimen. Although this incision is smaller than that of a caesarean…
Endometriosis is a ‘’hormone-sensitive’’ disease. The disease is ‘’dependent’’ on oestrogens, as we observe raised levels of oestrogens as well as changes in the oestrogen receptors of women with endometriosis1. We also observe ‘’progesterone resistance’’ as a result of dysfunction of its receptors2. Apart from the dependence on oestrogens and the progesterone resistance, patients with endometriosis present higher levels of…
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