Endometriosis’ explanation follows approximately the same concept of adenomyosis. Remember we have discussed about the inner lining of the uterus, which grows throughout the cycle and sheds off during your period. Naturally the cells are travelling through the cervix, vagina and are eliminated with a variable amount of blood.
Should these cells travel retrograde through the fallopian tubes, they reach the abdominal cavity and can’t be eliminated anymore. Most of the time they fixate on the ovaries that are located immediately next to the tubes’ ends, but they can anchor pretty much anywhere, including rectum or small bowel, bladder, omentum, or even reach as high as the diaphragm. At the newly acquired location, these cells are still endometrial cells programed to proliferate under hormonal influences and cause bleeding during the menstruation. Imagine all this process happening inside your abdomen, not inside your uterus. Obviously an internal ovarian bleeding is painful; obviously proliferation into the bladder or rectum is painful. However the amount of pain is not proportional with the severity of endometriosis. Additionally the inner scarring may cause infertility (due to tubal kinking) or abnormal adhesions between different independent organs. We find little help for you in detailing every possible consequence, as not every single one of them will apply to you even if your diagnosis is confirmed, but we place ourselves at your disposition to analyze your particular case should you chose so.
The options of treatment must also be individualized to the targeted outcome and can include anything ranging from hormonal manipulation in various ways, to focal laparoscopic ablation of endometriosis implants and, more radically, to hysterectomy with or without ovarian removal with or without partial bladder or bowel resection. In grade IV endometriosis the surgical intervention is probably one of the most challenging operation due to loss of separation between organs (“frozen pelvis”). In such instances, especially if other organs resection becomes necessary, the rate of complications is very serious. We are able to offer you supplemental information to make the right decision. Furthermore we can provide any degree of specialized care you may require, with the most integrative gynecology-general surgery approach for the widest safety margins. Contact OBGYN Care today to at 949-642-3606 to learn more about the available treatments and our level of care.
