Endometriosiz
General Information
Endometriosis Treatment
Endometriosis Diagnosis
- Medication
- Surgical Method
Endometriosis Diagnosis
Endometriosis
• Endometriosis is the thin layer of tissue lining the uterus (endometrium) that sometimes grows on the organs within the abdomen. It is particularly prevalent in the peritoneum, the lining of the intestines, the lining of the urinary tract, and the ovaries (chocolate cysts). The exact cause is unknown, but several medical theories have been proposed. Endometriosis is more common in the daughters of women with family members who have endometriosis. Women with endometriosis often experience very painful periods. They visit the hospital every month during their menstrual cycle to relieve these pains with strong painkillers. Furthermore, infertility is observed in 30-40% of women with endometriosis. If a married woman is unable to conceive with ovulation therapy at least 3-4 times in two years and experiences severe menstrual pain, endometriosis should be considered. In cases of deep endometriosis, widespread adhesions in the abdomen and endometriosis foci affecting the entire bowel and bladder are observed. If deep endometriosis affects the bladder, these women may experience heavy and painful menstruation, along with blood in the urine during menstruation. If deep endometriosis affects the intestines, these women may experience severe pain and rectal bleeding with stool during menstruation. Women experiencing these symptoms should be considered to have deep endometriosis.
Endometriosis Diagnosis
• After the patient's complaints and anamnesis are thoroughly questioned: Endometriosis can be diagnosed with ultrasound examination, intra-abdominal MRI examination and CA-125 measurements.
In conclusion:
• Patients who experience painful menstruation and are not pregnant
• In patients who cannot become pregnant with medication
It should not be forgotten that endometriosis may occur.
• Endometriosis Treatment: First, drug treatment should be applied, and surgery may be preferred for patients who do not respond to medications and cannot become pregnant.
• In chocolate cyst surgery, the cyst capsule must be completely removed. If the cyst capsule is not completely removed and the cyst tissue remains in the ovary, Chocolate Cysts will develop again within 6 months to 2 years.
Medication should be continued for 3-5 months after surgery. It's possible that cyst residue not visible at the time of surgery could lead to a recurrence of a chocolate cyst. Pregnancy should be attempted 4-5 months after chocolate cyst surgery.
In infertile women with chocolate cysts:
• If the cyst is smaller than 4-5 cm in diameter:
Ovulation treatment should be done with medications (3-4 times).
• If pregnancy does not occur with ovulation treatment, IVF treatment should be applied to these patients.
In conclusion:
• Chocolate cysts should be considered in those who have severe abdominal pain during menstrual periods and those who are infertile.
• Medication should be the first treatment option. If treatment is unsuccessful, IVF treatment should be performed.
• Surgery should be considered for cysts larger than 4-5 cm. The ovaries should not be damaged during surgery.
Endometriosis Treatment
Surgical Method
Drug Therapy:
• Medical treatment is the first choice for endometriosis treatment. Treatment typically begins with Dienogest, GnRH analogs, Letrozole, and painkillers. If the patient's symptoms persist or if endometriosis progresses, surgery is necessary. Endometriosis cannot be cured definitively and persists until menopause. Once the patient enters menopause, the endometriosis disappears and no further treatment is required.
• Endometriosis foci are burned with electrocautery or laser and adhesions in the abdomen are removed by opening them using open surgery or laparoscopy.
• If the patient does not respond to any medical treatment and does not want to have children, the patient's uterus and, if necessary, ovaries are removed.
• In patients with Endometriosis (Chocolate Cyst) that develops in the ovary, the cysts are removed or the ovaries are removed with open surgery or laparoscopy, depending on the patient's condition.
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