Endometriosis / Adenomyosis

Endometriosis is a disease that affects your reproductive organs and monthly menstrual cycle. It can cause cramps and pain during your periods or pelvic pain throughout the month. If you have this disease and it is not treated, your health can be affected. But, with early diagnosis and treatment, endometriosis can be managed.

Understanding Endometriosis

If you have endometriosis, endometrial tissue grows outside the uterus in the pelvic cavity. During your menstrual cycle, this extra tissue swells with blood along with the normal tissue in your uterus. The tissue may also release tiny drops of blood. The swelling and blood irritate nearby tissues, causing pain and cramps. Constant irritation may cause scar tissue to form. This scar tissue can bind organs together and cause trouble getting pregnant (infertility).

 

Normal Female Anatomy

Severe Endometriosis

Common Symptoms

If you have endometriosis, you may have one or more of these symptoms:

• Cramps and menstrual pain
• Pelvic pain
• Pain during sexual intercourse
• Trouble getting pregnant (infertility)

Stages of Endometriosis

The stages of endometriosis are ranked as follows: Minimal (I), Mild (II), Moderate (III), or Severe (IV). Staging depends on certain factors. These include the number, size, and site of the implants. The stage also depends on the extent of the adhesions and whether other pelvic organs are involved. The severity of your disease may not match the pain you feel. Even mild endometriosis can cause a lot of pain.

Stage 1		Stage 2
Stage 3		Stage 4

Treatment Options for Endometriosis

Endometriosis can be treated with hormone therapy, surgery, or a combination of both. Talk to your health care provider to see which treatment is best for your condition.

Hormone Therapy

Hormone therapy regulates or blocks the hormones that control your menstrual cycle. This means it can limit the swelling of your endometrium and extra endometrial tissue (implants). This treatment may be used before, instead of, or after surgery. Following are different types of hormone therapies:

• GnRH Agonists and FSH and LH Inhibitors stop or lower the production of estrogen and progesterone hormones.
• Birth control pills contain estrogen and progesterone. Birth control pills help to regulate the levels of estrogen and progesterone in your body.
• Progestins are a form of progesterone. Progestins help keep estrogen levels low.
• Danazol is a hormone that stops or lowers the production of estrogen and progesterone.

Surgery

Surgery can be used to remove implants of endometrial tissue or for removal of the reproductive organs.

• With laparoscopy, a laparoscope (a thin, lighted tube) is inserted through a small incision in your abdomen. Your doctor uses the laparoscope and another small instrument to remove the implants.
• Laparotomy is open surgery to remove large implants that can't be reached with the laparoscope or when pelvic organs such as your bowel are involved.
• Hysterectomy is the surgical removal of your uterus. Any implants or adhesions in your pelvic cavity will also be removed.
• During a Total Hysterectomy with Bilateral Salpingo-oophorectomy procedure, your uterus, ovaries, and fallopian tubes are removed. Any implants or adhesions in nearby tissue are also removed.

da Vinci Hysterectomy

A new, minimally invasive approach to hysterectomy, da Vinci Hysterectomy, combines the advantages of conventional open and minimally invasive hysterectomies - but with potentially fewer drawbacks.

For patients, the benefits of da Vinci Hysterectomy may include:

• Significantly less pain
• Less blood loss
• Less scarring
• Shorter recovery time
• A faster return to normal daily activities
• And in many cases, better clinical outcomes

It is performed using the da Vinci System, which enables surgeons to perform surgical procedures with unmatched precision, dexterity and control. Read about what may be the most effective, least invasive approach to hysterectomy - da Vinci Hysterectomy.

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© 2000-2007 The StayWell Company, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

While clinical studies support the effectiveness of the da Vinci^® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

Content provided by Intuitive Surgical. For more information on this topic, please visit www.davincisurgery.com

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