Endometriosis Specialist

What is endometriosis?

Sometimes normal uterine lining (endometrial) cells seep through the fallopian tubes and implant into and proliferate through the inner coating of the pelvis (peritoneum). This results in different degrees of irritation of the pelvic peritoneum, causing pelvic pain. Such a phenomenon is called endometriosis.

Since at least 10% of women have endometriosis, it’s one of the most common diseases worldwide -- even more common than HIV/AIDS and cancer. In addition to affecting the lining of the pelvis, endometriosis may also affect one or more of the pelvic organs, including the uterus, fallopian tubes, ovaries, bowel, and bladder.

Endometriosis may cause the formation of large ovarian “chocolate” cysts (endometriomas), pelvic adhesions and scarring, infertility, and bowel and bladder dysfunction. Sometimes, it may even invade the bladder, bowel, and other pelvic structures, causing severe complications.

What are the symptoms of endometriosis?

Pain is the main symptom of endometriosis, and women often experience chronic pelvic pain, painful periods, and/or painful intercourse. Pain is perceived by the brain when endometriosis invades the nerves that supply the pelvis.

Prostaglandin activity in the uterus also aggravates deposits of endometriosis in the abdomen and pelvis causing significant pain. Ultimately, estrogen promotes the growth and expansion of endometriosis. Therefore, the mainstay of treatment is aimed at counteracting or eliminating the effects of estrogen and prostaglandins.

How is endometriosis treated?

Conservative treatment of endometriosis should be attempted first, and surgery is the last resort after exhausting conservative options. One minimally invasive surgical option is laparoscopic excision of endometriosis and the pelvic adhesions it may form.

If pelvic adhesions are severe and involve the bowel or bladder, additional procedures may be necessary. Sometimes your surgeon might request assistance from a urologist or colorectal surgeon.

A urologist can place illuminating ureteral stents to aid in identification of the ureters and decrease the risk of injury. A colorectal surgeon can perform a proctosigmoidoscopy and possible bowel surgery. Laparoscopic excision or laser ablation of endometriosis is the recommended approach if the patient wishes to preserve her ability to get pregnant.

If conservative surgery is unsuccessful or future pregnancy is not desired, then the definitive solution is a hysterectomy. Removal of solely the uterus significantly reduces prostaglandin activity, which in turn considerably diminishes aggravation of endometriosis. Thus, the ovaries can usually be preserved preventing undesirable, sometimes debilitating, menopausal symptoms.

Abdominal hysterectomy and vaginal hysterectomy are the standard of care and involve an overnight stay in the hospital. The definitive minimally-invasive solution is provided by outpatient laparoscopic hysterectomy or robotic hysterectomy.

Most cases at AMIGS are performed laparoscopically. The advantages of a laparoscopic procedure are many. Patients usually go home the same day, the recovery time is faster and less painful, and the cosmetic outcome is better.

Find out more by calling Atlanta Minimally Invasive Gynecologic Surgery Center today, or book an appointment online.