Endometriosis: When to have surgery?

Endometriosis is not life-threatening but causes pain and discomfort to the patient, especially during menstruation, in addition, endometriosis also affects pregnancy. Therefore, the goals of treatment are to rule out endometriosis lesions, treat symptoms (pain and infertility), and prevent recurrence.

The endometrium is the inner lining of the uterus, at the beginning of the cycle the endometrium thickens, ready for the implantation of the embryo. But if you are not pregnant, this endometrial layer will shed, causing menstruation. Endometriosis is a disease related to the presence of endometrial glands and stroma on the outside of the uterus. This presence induces chronic inflammation, which develops and degrades with the menstrual cycle under the influence of sex hormones.
Extra-pelvic endometriosis has been reported at multiple sites, including the epigastrium, diaphragm, abdominal wall, perineum (perineal incision) and thoracic region. In addition, endometriosis can invade the entire thickness of the rectum, intestines, ureters, or bladder. Symptoms of endometriosis vary depending on the location and extent of invasion. Patients with endometriosis are initially asymptomatic. Then appeared menstrual disorders, heavy bleeding during menstruation, abdominal pain when menstruation became heavier and longer, pain during sex.
The cause of endometriosis is currently unknown. About 5-10% of women of childbearing age have endometriosis. The disease has a markedly high frequency in infertile women.

The principle of treatment for endometriosis is that it should be treated only when there are symptoms of pain or infertility or both. The goals of treatment are to reduce pain, reduce disease progression and recurrence, and increase the likelihood of pregnancy.
Most women with endometriosis want to preserve fertility. Therefore, preference should be given to the least invasive, effective, and minimally invasive treatment option. The choice of treatment is based on the treatment goal: Pain relief or pregnancy, so the following methods can be applied: Pain medication, hormones, surgery, assisted reproductive methods or a combination of these methods.

Surgical treatment of endometriosis is indicated in the following cases:
Pelvic pain: Unresponsive to medical treatment, contraindication to medical treatment Adnexal pathology: torsion or rupture cyst Deep infiltrative endometriosis: bowel, bladder, ureter, Ovarian endometriosis Infertility with additional factors Laparoscopy is preferred in endometriosis because has many advantages compared to open surgery, good surgical field, faster patient recovery.
For patients with asymptomatic endometriosis who do not require medical or surgical treatment, patients with pain associated with endometriosis only have surgery after failure of medical therapy.

In order to help customers detect and treat other gynecological diseases early, Vinmec International Hospital has a basic gynecological examination and screening package, helping customers detect early inflammatory diseases Easy, inexpensive treatment. Screening detects gynecological cancer early (cervical cancer) even when there are no symptoms.
Basic gynecological examination and screening package for female customers, has no age limit and may have the following symptoms:
Abnormal vaginal bleeding Having menstrual problems: irregular menstrual cycle, irregular menstrual cycle Irregular vaginal discharge (smell, different color) Vaginal pain and itching Female clients have several risk factors such as poor personal hygiene, Unsafe sex, abortion,... Female customers have other symptoms such as: Abnormal vaginal discharge, itching, pain in the private area, abnormal vaginal bleeding.