DIAGNOSIS & TREATMENT

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OUR APPROACH

  • We will provide you with a clear diagnosis of the cause of your pelvic pain and discuss with you therapeutic options.
  • We aim to treat your endometriosis by meticulously removing all diseased tissue. In 98-99% of cases this can be performed laparascopically, leading to speedy recovery, minimal scarring and the long-term relief from symptoms. The technique we use is called laparascopic excision of endometriosis which involves cutting away areas of affected tissue.
  • If your endometriosis affects your bowel or bladder we have the appropriate skills within our multidisciplinary team to deal with even the most severe cases of endometriosis in these areas.
  • We will follow you up as an outpatient for a minimum of twelve months after your surgery to ensure your recovery is complete.

We also work closely with IVF specialists where necessary, helping to improve fertility and achieve successful pregnancies, either with or without the need for assisted conception.

WHAT ARE THE SYMPTOMS OF ENDOMETRIOSIS?

Endometriosis is a disease that is misunderstood by many people and often, particularly when severe, requires a team of highly experienced specialists to treat.

There are numerous symptoms associated with endometriosis and these often vary widely between patients; one of the most frequent symptoms experienced by patients is pain in the pelvis and / or abdomen. This pain can be continuous, cyclical or intermittent, and it can occur during sexual intercourse, when emptying your bladder or bowels, it can be worse leading up to or during the menstrual period. Indeed, it is often, but not always, related to the patient’s menstrual cycle.

You may experience some or all of the following symptoms:

  • Painful periods that get worse over time.
  • Chronic pain in the lower back and pelvis which radiates down the legs.
  • Pain during or after sex.
  • Intestinal pain.
  • Painful bowel movements or painful urination, especially at the time of your periods.
  • Gastro-intestinal problems such as diarrhoea, constipation or bloating, especially during your periods.
  • Heavy and/or long menstrual periods.
  • Spotting or bleeding between periods.
  • Infertility.
  • Fatigue.

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Some women have no symptoms, while others may suffer debilitating pain, even with mild disease.

Women who have gone through menopause (when a women stops having her period) can still have symptoms, as may women who are pregenant or who have previously had children. Pregnancy is not a cure for endometriosis.

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ENDOMETRIOSIS DIAGNOSIS

At The Endometriosis Clinic, we have the experience to help with our aim of confirming the diagnosis as efficiently and swiftly as possible. We achieve this using some or all of the following, as appropriate to each individual case:

  • History taking and examination. We take time to understand your history and the symptoms that you have experienced in the past.
  • Ultrasound scan. This type of scan may be used as it is particularly helpful in diagnosing ovarian cysts due to endometriosis.
  • MRI Scans. This will show often be helpful in characterising ovarian cysts as well as assessing disease severity in rectovaginal disease.
  • Laparoscopy. This involves passing a fibre-optic scope through a small cut in the navel. This is a very effective technique in diagnosing endometriosis and is often referred to as the “Gold Standard” for diagnosis.

ENDOMETRIOSIS TREATMENT

At The Endometriosis Clinic we provide an integrated approach to the treatment of women with endometriosis with a multi-disciplinary team made up of highly experienced specialists.

Endometriosis is divided into four stages: stage (severe) to stage 4 (most severe). The aim of treating is to alleviate the symptoms caused by endometriosis and to improve fertility which is often affected by the disease. In the majority of cases we achieve this by surgery which involves removal of endometriosis and reduces the need for medical therapy such as Zoladex, Prostap or Synarel.

For cases where a woman is suffering significant pain or has fertility problems, the most effective treatment is the meticulous removal of the disease through laparoscopic excision carried out by highly experienced, specialist surgeons.

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TREATMENT OPTIONS FOR ENDOMETRIOSIS

Painkillers

Pain is the most common symptom for many women with endometriosis. If the pain is relatively mild, regular painkillers during your period may be enough. Pain killers vary simple analgesic (such as aspirin and paracetamol), through compound analgesics (which combination of drugs often including aspirin or paracetamol and a mild narcotic such as codeine) through to non-steroidal anti-inflammatory drugs (such as Nurofen, Ponstan and Voltarol) and narcotic analgestics (similar to morphine or Tramadol).

Hormone Therapy

Hormone therapy can help to reduce the endometriosis from growing by preventing the body from making the female sex hormones (particularly oestrogen) that stimulate the growth. However, hormones do not remove the condition, they only suppress it, leading to a return of symptoms as soon as the hormone therapy is stopped. In addition, patients can sometimes experience unpleasant side effects such as a 'medical menopause' brought on artificially by hormone therapy.

Surgical Therapy

Having treated endometriosis for more than a combined total of 30 years, we have found that the most effective treatment for the disease is surgical excision. This applied to moderate, mild and severe endometriosis and is the most thorough way of ensuring long-term relief from symptoms and improvement in fertility. It also increases the likelihood of the patient not having to take drugs which often cause significant side effects whilst not treating the cause of the disease (ie, without removing or eradicating the endometriosis). The technique of surgical excision involves removal of the lesions of endometriosis and, in the majority of cases (98 - 99%), this is performed laparoscopically, even if it involves removal of endometriosis on the bladder or bowel. We remove the endometriosis using very fine scissors that are placed into the abdomen through very small incisions (around 1cm in size) and we aim to remove all of the disease in order to eradicate symptoms of pain, increase fertility and reduce the likelihood of disease ever returning.

Diaphragmatic and Thoracic Endometiosis

At The Endometriosis Clinic we also have the skills of two very experienced surgeons who are able to help those patients with diaphragmatic and thoracic endometriosis – Mr Rob Sutcliffe and Mr Maninder Kalkat, who both have a specialist interest in the management of patients with endometriosis affecting the diaphragm and thorax ( lungs and ribcage). They are able to work with our pelvic surgeons with the aim of excising the disease from these areas of the body.

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ENDOMETRIOSIS FAQs

Although endometriosis is a common cause of pelvi pain there are other causes of pelvic pain such as fibroids; ovarian cysts; adhesions; adenomysis and pelvic inflammatory disease.

The most accurate way to know for sure whether or not you have endometriosis is to have a surgery called laparoscopy.

In this procedure, a tiny cut is made in your abdomen (through the navel). A thin tube with a light is placed inside which allows the surgeon to check for the presence of endometriosis and to diagnose any other problems which may be present.

No one knows for sure what causes this disease, but there are a number of theories.

Endometriosis runs in families. If your mother or sister has endometriosis, you are six times more likely to get the disease than other women, so one theory suggests that endometriosis is caused by genes. However, we know that this is only part of the story as most women who have endometriosis do not have a mother or sister suffering from the condition.

Another theory is that during a woman's monthly periods, some endometrial tissue backs up into the abdomen through the fallopian tubes. This transplanted tissue then grows outside of the uterus.

Many researchers think a faulty immune system plays a part in endometriosis. In women with the condition it is thought that the immune system fails to find and destroy endometrial tissue growing outside of the uterus.

It is also thought that endometriosis may develop as a result of one type of tissue transforming into another (metaplasia).

Although the cause of the disease is not yet fully understood, this does not stop us at The Endometriosis Cinic from providing treatment to help eradicate and alleviate the symptoms and problems associated with the condition.

You will want to seek the best possible treatment for your endometriosis. However, at the same time, you may feel many emotions - sadness, fear, anger. frustration and loneliness. It is important to find support to cope with these feelings. Consider joining a support group to talk to other women who have shared your experiences. There are support groups on the Internet and in many areas of the country.

It is also important to learn as much as you can about the disease.