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Endometriosis

ENDOMETRIOSIS

Endometriosis is a debilitating disease with chronic inflammation. It is estimated that 10-15% of reproductive aged women suffer from pelvic endometriosis. It is one of the most common benign gynecological proliferation in premenopausal women. Despite its prevalence, the disease remains poorly understood and current studies prove that there is no relationship between the extent of the disease and its symptomatology.

There are no blood tests available for the diagnosis of endometriosis. As of today, there is no single effective option for treatment of endometriosis. Due to the relatively poor efficacy of hormonal therapy for endometriosis, several other experimental therapies are currently undergoing trials. Medical therapies are only reserved for patients who want immediate pain relief and who are on waiting list for surgeries. Surgery is the best option for patients with endometriosis as the fulguration and ablation of endometriotic spots and implants can give greater relief and good results in terms of fertility resumption.

Endometriosis Guideline Development Group(GDG) recommends that clinicians should consider the diagnosis of endometriosis in the presence of symptoms like dysmenorrhoea, non – cyclical pelvic pain, deep dysperunia, infertility and fatigue. Some of the non – gynaecological cyclic symptoms are dyschezia, dysuria, heamaturia, rectal bleeding, shoulder pain etc. GDG also recommends that clinicians obtain tissues for histology in lap surgeries for ovarian endometriosis and deep endometriosis to exclude rare instances for malignancy.

In women with severe pain from recto-vaginal endometriosis refractory, other therapies can be considered

like aromatase inhibitors
Finally the recommendation is for both ablation and excision of peritoneal endometriosis to reduce pain. Clinicians should not perform LUNA(Laparoscopic Uterosacral Nerve Ablation) as an additional procedure to conservative surgery. Presacral neurectomy is effective to reduce midline pain but it requires high degree of skill and is a potentially hazardous procedure.

In infertile women with AFS/ASRM stage I/II endometriosis, CO2 laser vaporization instead of monopolar electrocoagulation is preferred. The GDG recommends that women should be counseled regularly regarding the risks of loss of ovarian reserve after the surgery and the possibilty of loss of ovary.

In previously operated patients, lot of care and counseling is needed before posting for repeat surgeries because of dense adhesions, anatomical disorientation and possibility of internal organs injury.
Finally, the GDG recommends the use of ART(Assisted Reproductive Technologies) for infertility associated with endometriosis, especially if tubal function is compromised or if there is male factor infertility and/or other treatments have failed.

About GarbhaGudi:

GarbhaGudi is a chain of New-Generation Infertility Treatment Hospitals equipped with state-of- art-infrastructure & cutting-edge IVF Technology to address infertility issues & their emotional & mental effects on couples. We have a team of qualified & experienced doctors; their in-depth knowledge & expertise leaves no stone unturned to solve all your infertility issues. The Supportive & caring staff is always by your side to motivate & guide you throughout the journey. GarbhaGudi IVF, the best fertility treatment hospital in Bangalore, provides emotional support to couples facing infertility issues and sexual problems

For further details, you can also write to GarbhaGudi at dreams@garbhagudi.com or directly talk to our team at 8880000909

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