Surgical treatment of endometriosis

We use the Fast Track Surgery Protocol which facilitates rapid postoperative recovery. This method supposes minimal surgery preparation, reducing of pain and restrictions after surgery, and returning to a normal lifestyle in 1-2 days.

More than 176 thousand women suffer from endometriosis all around the world. It is the main cause of abdominal pain and one of the most frequent indications for laparoscopy in gynecology.

Endometriosis is a complex disease that can spread to different organs. It is easier to cure it at the early stages. The main symptom of endometriosis is severe pain during menstruation, but many women consider it normal and do not consult a doctor. You can suspect the disease in time if you know the exact symptoms.

Endometriosis is almost always treated surgically. Surgery is the only way to remove the foci of the disease and get rid of the pain in full. Modern surgery makes it possible to do this carefully and to return the patient to her normal life quickly. 

Depending on the location of the disease, endometriosis is divided into the following types:

• genital – endometrium grows through other organs of the reproductive system (vagina, fallopian tubes, ovaries);
• extragenital - the endometrium grows outside the reproductive system and affects other internal organs.

Endometrial tissue can grow through almost any organ, although most often it develops in the genitourinary system.

If extragenital endometriosis takes place, the traits of the disease may appear in:

• abdominal wall;
• bladder;
• kidneys;
• intestine;
• liver;
• diaphragm;
• lungs and other organs.

Endometriosis can progress without timely treatment. The number of foci of the disease, as well as the depth of endometrial penetration in healthy tissues can increase.

Thus 4 stages of the disease are distinguished:

• At stage 1 one or more superficial endometrial foci appear;
• At stage 2 the number of sites of the disease and the depth of endometrial penetration increases;
• At stage 3 many deep sites located in different places, as well as individual cysts and adhesions are diagnosed;
• At stage 4 the prevalence of the disease increases even more, as well as the number and size of cysts and adhesions.

At the «Oxford Medical» Сlinic the treatment is carried out in a surgical hospital which has two high-tech operating units, an intensive care unit and comfortable individual wards. They are supplied with new equipment of the world's best brands, which allows performing operations of any difficulty.

One of the advantages of our clinic is a  successful implementation of the advanced Protocol of rapid rehabilitation - Fast Track Surgery.

It helps to simplify the preparation for surgery, gives better control for the depth of anesthesia, prevents postoperative pain and abandons restrictions in nutrition and motion immediately after the operation, makes it possible for the patient to return to a usual lifestyle in 1-2 days.

In Ukraine this technology is used by only a few clinics, as it requires special training of surgeons and anesthesiologists.

 At the «Oxford Medical» Clinic all operations are performed by qualified surgeons with many years of experience, We use only new endoscopic equipment from the world's best brands. Specialists are guided by national and international treatment protocols, using innovative technologies with proven effectiveness and safety. This allows performing of low-traumatic organ-preserving operations in all possible cases, which is especially important for young women.

At the «Oxford Medical» Clinic the treatment of endometriosis is performed by the following types of operations:

• hysteroscopy – supposes getting the access through the vagina;
• laparoscopy – the access to the operated organs is provided through 3 small punctures of the abdominal cavity;
• laparotomy is a classic open-access operation, which is now used quite rarely and only in complicated cases.

Most often the locations of endometriosis are removed by laparoscopy. The operation is performed with the help of modern endoscopic equipment. The doctor makes 3-4 punctures on the anterior wall of the peritoneum, up to 1 cm in diameter, through which surgical instruments and optical devices are inserted. The magnified image from the miniature camera is transmitted to the monitor. This provides the surgeon with good visualization and allows him to perform all actions with maximum accuracy.

After laparoscopy the punctures are sewn up and sterile bandages are applied to them. This operation is much less traumatic than classical laparotomy since damage to healthy tissues is reduced to the minimum.

Due to the usage of the Fast Track Surgery Protocol, the patient can leave the clinic the next day after the operation and return to her usual lifestyle.

In some cases, when we deal with widespread endometriosis, an open operation is required – a longitudinal incision is made to ensure access. This method allows removing of endometriosis of complex localization.

Surgeons at Oxford Medical work according to the Fast Track Surgery protocol, which provides for easier preparation for surgery and ensures an easy and short rehabilitation period.

This technology has been used in leading clinics around the world for many years. Studies have confirmed its effectiveness and safety.

Endometriosis is a rather complex disease that can spread to various organs. It is easier to cure it in the early stages. The main symptom of endometriosis is severe pain during menstruation, but many women consider them the norm and do not consult a doctor. You can suspect the disease in time by knowing its symptoms.

Sites of extragenital endometriosis can appear in different parts of the body, so the symptoms of the disease differ. This complicates the diagnosis and requires a thorough complex examination. First of all the doctor prescribes laboratory tests and ultrasound of the pelvic and peritoneal organs.

If a new growth is detected, the doctor can immediately make a diagnosis (if the results of other studies and symptoms match) or schedule additional examinations. Computer (CT) or magnetic resonance imaging (MRI) is often performed. These examinations provide more accurate and detailed visualization and help to determine the size of the endometriosis site and the depth of tissue invasion.

According to indications, endoscopic examinations can also be prescribed: cystoscopy (examination of the bladder), rectoromanoscopy (examination of the intestine) and others.

The most accurate method of diagnosis is laparoscopy with tissue biopsy and subsequent histological analysis. But since it requires surgical intervention for diagnostic purposes, laparoscopy is rarely performed.

Treatment of extragenital endometriosis is carried out mainly by surgical method. Only the operation can completely eliminate the site of the disease. But in some cases conservative therapy is also used: hormonal medications are prescribed to stop the development and bleeding of endometrioid sites, and other medications to relieve pain and other symptoms of the disease.

Hormone therapy can also be prescribed before surgery (sometimes it reduces the size of endometriosis site) or after to normalize the endocrine profile and prevent relapses.

The doctor chooses the way of treatment  individually, taking into account the stage of the disease, the presence of concomitant pathologies, the age of the woman and other individual characteristics.

Indications for surgical treatment of endometriosis are:

• multiple sites of endometriosis;
• the size of the site is more than 2 cm;
• presence of adhesions and cysts;
• dysfunction of organs affected by endometriosis;
• endometriosis of the umbilicus or surgical scar;
• combination of endometriosis with abnormalities in the development of reproductive organs;
• infertility caused by endometriosis;
• ineffectiveness of conservative therapy, etc.

You can make an appointment for a gynecologist’s consultation or diagnosing at the «Oxford Medical» clinic by calling our contact center or writing in the chat.