Endometriosis is the abnormal growth of uterine tissue (endometrium) outside of the uterus.
Endometriosis can occur on fallopian tubes, ovaries (mostly as a cyst), bladder, and bowel or even beyond the pelvis and genitals.
Areas of endometrial tissue could be found on abdominal wall (in the cutaneous and subcutaneous fat tissue or intramuscularly).
It is a condition which develops after a uterine surgery especially after a Cesarean section.
Most patients who exhibit symptoms are women of childbearing age, so the diagnosis is usually made between the ages of 25 - 45.
What the symptoms of endometriosis are?
- Heavy or painful periods. The pain usually occurs 3 days before period
- Pelvic pain, lower abdominal pain or lower back pain
- Painful sexual intercourse
- Chronic pelvic pain
- Infertility problems
However, some women have few or no symptoms.
What does cause the endometriosis?
It is not known what exactly cause the endometriosis, but nevertheless there are various theories.
The main theory states that the menses escape though the fallopian tubes into the pelvic cavity where deposited (retrograde menstruation).
However, as time goes by, the theory that endometriosis is genetic becomes stronger.
For example, it is suggested that during utero life some endometrial cells develop outside of the womb and later in puberty become active.
Another theory involves immunological disorder which may allow endometrial growth outside the uterus.
How is the diagnosis made?
- Gynecological history
- Pelvic exam
- Ultrasound exam
Unfortunately, the above practices might be insufficient and the diagnosis should be confirmed by a laparoscopic surgery in order to take sample for biopsy.
It would be a mistake if a laparotomy was performed in this case due to the fact that lesion of endometriosis are usually not naked-eye visible.
On the other hand, laparoscopy provides us a clear view of the area using high magnification.