What Is Endometriosis?
In the 17th century, endometriosis was linked to “hysteria” among women, Thankfully, we know much more about this debilitating and serious disease today, which can cause severe symptoms that affect not just your womb but also your entire pelvis area, including your ovaries, bowels and bladder, and could seriously affect your quality of life, including hampering your chances of having children. It can recur and requires ongoing treatment.
At Lotus Medics, we understand the difficulties of having this condition, and we strive to offer the most advanced treatment options. Our practices in Orange, Parkes, and Bathurst are fitted with the latest diagnostic equipment to ensure the best possible care for our patients.
Endometriosis comes from the word endometrium, the tissue that lines the uterus and womb. Endometriosis happens when tissue that usually lines the inside of the uterus grows outside of the uterus and into the fallopian tubes, ovaries, in front and behind the uterus, bladder, and even the bowel.
Types of Endometriosis
There are four types of endometriosis:
- Superficial peritoneal lesion is the most common kind of endometriosis. The peritoneum is a thin membrane that lines the abdomen, pelvis and other organs within this cavity, and endometrial tissue attaches to this peritoneum.
- Endometrioma (ovarian lesion). These dark, fluid-filled cysts are also called chocolate cysts. They can be found in different parts of the pelvis or abdomen, but most commonly on the ovaries. They are difficult to treat and can damage healthy surrounding tissue.
- Deeply infiltrating endometriosis grows under the peritoneum and can involve organs near the uterus, such as the ovaries, rectum, bowels or bladder. This rare type of endometriosis occurs in about 1% to 5% of women.
- Abdominal wall endometriosis is when endometrial tissue grows on the abdominal wall, and the cells attach to a surgical incision, such as c-section scar tissue.
How is Endometriosis Diagnosed?
Endometriosis can easily be mistaken for other pelvic pain conditions and is notoriously difficult to diagnose. Laparoscopy remains the gold standard in the diagnosis and treatment of endometriosis. Early diagnosis of endometriosis remains the key to reducing the debilitating symptoms and improving fertility.
Endometriosis cannot always be diagnosed by ultrasound/imaging unless very experienced clinicians/imaging specialists can detect physical signs like cysts in the ovaries or large nodules.
Early diagnosis of endometriosis can help to control symptoms, improve fertility and prevent female sexual dysfunction whilst improving sexual health.
What are the Causes and Symptoms of Endometriosis?
While the causes of endometriosis are still unknown, a possible explanation could be a person’s genetic makeup. Some evidence suggests that if a close relative develops endometriosis, you are more likely to develop the condition at some point in your life. Other theories postulate causes such as an immune system disorder, retrograde menstruation, and embryonic cell transformation among others.
Endometriosis symptoms include:
- Pelvic pain
- Painful menstrual cycles
- Unusually heavy menstrual periods
- Pain symptoms during or after sexual intercourse
- Painful opening of bowel or bladder pain
- Difficulty conceiving
- Significant affection for quality of life
- Continued fatigue
What are the 4 Stages of Endometriosis?
Endometriosis is usually classified into four stages and is based on the size, location, amount and depth of the endometrial tissue:
There are a few small lesions but no scar tissue.
There are more lesions but still no scar tissue.
The lesions are deeper and endometriomas and scar tissue has formed around the ovaries and fallopian tubes.
There are many large lesions and possibly large cysts in the ovaries. Additionally, there may be scar tissue around the ovaries and fallopian tubes or between the uterus and the lower part of the intestines.
Although a person could be in the “mild” stage, they could still experience severe pain, whereas someone else with severe endometriosis could be asymptomatic.
How to Treat Endometriosis?
Treatment for endometriosis usually includes pain medication or hormone treatments initially, but if this is unsuccessful, surgery may be required. Additional treatments include:
- Hormone treatments – These can be prescribed to lower the amount of oestrogen produced by your body, which in turn will reduce the bleeding of the lesions, inflammation, scarring and cyst formation.
- Surgical procedures – such as laparoscopic surgery, can be recommended to remove endometrial tissue which can reduce the symptoms. More extensive surgery may be necessary when endometriosis affects other organs, such as the bowel and bladder.
- Alternative or complementary therapies – although using alternative therapies cannot remove endometrial tissue, many women find it relieves some symptoms. Therapies such as massages, acupuncture and herbal medicines can assist in alleviating some pain associated with endometriosis.
What is adenomyosis?
Endometriotic cells when present inside the muscular lining of the uterus-that condition is called adenomyosis. Adenomyosis is very difficult to diagnose and until the recent advances in imaging was a retrospective diagnosis after a hysterectomy.
Advances in imaging (ultrasound and MRI) have made it possible to suspect adenomyosis in women prior to surgery. This certainly helps plan further management.
The Cost of Endometriosis
Surgery at Lotus Medics Clinic
The cost of treating Endometriosis at our Orange, Parkes and Bathurst practices largely depends on the severity of your condition and the specific treatment required to best treat it.
At your initial consultation, a thorough examination will be conducted to determine the best form of treatment option for your stage of the condition. Dr Kotasthane will then walk you through your options when it comes to:
- Consultation costs
- Endometriosis surgery costs
- Laparoscopy costs if necessary
How Lotus Medics can help with Endometriosis
At Lotus Medics, we diagnose and treat endometriosis while also giving you comprehensive support to improve your pain management, fertility and sexual health.
We only work with the best local health resources, such as colorectal surgeons, urologists, physiotherapists, and pain specialists. We focus on easing your pain and discomfort, adding to your quality of life, and helping you achieve pregnancy easily and safely.
Please feel free to watch the ‘Explain My Pelvic and Period Pain – Endometriosis’ video on the Lotus Medics website.
Meet Dr Sachin Kotasthane
Dr Sachin Kotasthane is an Obstetrician and Gynaecologist who has been part of the medical community in Orange since 2013.
He trained in the UK in various specialised skills such as Advanced Laparoscopy, Urogynaecology, Pelvic Ultrasound, and Menopause Management. He also worked as a Consultant Obstetrician and Gynaecologist in Glasgow. Later he emigrated to Orange with his young family to settle in the Australian countryside.
He is passionate about introducing all the latest technology in gynaecological care and treatments typically only available to women in large cities, to those in more rural areas. This led him to pioneer these treatments in the Orange, Parkes and Bathurst regions.
Bathurst Specialist Centre
There is currently no cure for endometriosis, however, surgery can be used to treat symptoms and relieve endometriosis pain. Laparoscopic surgery can help with fertility and pregnancy.
In most cases having surgery to remove endometrial tissue will significantly relieve symptoms and reduce endometriosis-related pain. However, surgery is only one aspect of the treatment of endometriosis and pelvic pain and at Lotus Medics, we believe in holistic management of pelvic pain and endometriosis. Our role does not just end at surgery but continues on until we help you achieve the resolution of your symptoms, enhance your fertility and improve your quality of life.
Historically, surgeons would perform traditional abdominal surgery to remove endometrial tissue which would be considered major surgery. But these days surgeons usually opt for laparoscopic surgery, which is minimally invasive and only requires a few small incisions. The extent of the surgery depends on the extent of the disease-surgery for grade 3 or 4 diseases is usually considered at par with a major surgery whereas for the milder diseases is more intermediate.
There is no “one size fits all” and we adopt a customised approach to treatment based on your individual situation.
Laparoscopy surgery is performed under general anaesthetic, with only a few small incisions required to remove endometrial tissue. This procedure is, therefore, usually less painful as compared to an open surgery like a caesarean section. However, pain may be experienced during recovery, and pain medication will be prescribed to make the patient more comfortable. Most women experience shoulder-tip pain due to some gas trapped inside the abdomen (even after we deflate the abdomen after the procedure). This pain is usually temporary and responds well to heat packs and ambulation.