The endometrium is the inner lining of the uterus, the part that thickens before a menstrual period and then breaks down and flows out if pregnancy does not occur.
Endometriosis is a gynecological condition in which the endometrial tissue grows outside the uterus. It can grow on organs in the abdomen or pelvis.
Even though it is outside the uterus, this tissue still responds to a woman's hormones. It thickens during the menstrual cycle, then breaks down and bleeds, but it has nowhere to go.
Endometriosis is very common, often causing no symptoms and requiring no treatment.
But surrounding tissue can become inflamed and cause pain, scarring and heavy bleeding. Endometriosis can also damage fallopian tubes and ovaries.
Symptoms of endometriosis range from mild to severe. They are not predictable: severe endometriosis may cause little pain, while minimal endometriosis can be associated with intense pain. In about 30 to 40 percent of cases of infertility, endometriosis can be found.
Symptoms may include:
- Generalized cramping and pelvic pain
- Pain during sex
- Painful periods
- Low back pain
- Pain during bowel movements or urination
Even when there are no symptoms, endometriosis can be suspected during a routine pelvic exam. Imaging tests, such as ultrasound — or in some cases, an MRI or CT scan — can help doctors locate tissue that looks suspicious for endometriosis.
But the diagnosis can only be confirmed via surgery. Typically, a laparoscopic procedure is done that allows the doctor to confirm the diagnosis and potentially treat the affected areas.
Endometriosis does not lead to any type of gynecological cancer. The goals of treatment are to eliminate symptoms and protect fertility.
Treatment options include:
- Pain medications to ease symptoms
- Nonsteroidal anti-inflammatory drugs (such as ibuprofen) to help reduce inflammation
- Hormone therapy to decrease pain and shrink the size and number of endometrial areas
- Surgery to remove endometriosis
- Hysterectomy in severe cases not resolved by more conservative methods
Robotic surgery can be a good option for women who require a surgical approach to treating endometriosis. Surgery may include removing ovarian cysts, an entire ovary, or more with a hysterectomy.
About 60 percent of women who have hysterectomies at Swedish have a robotic hysterectomy. That's because of the better results these robotic surgeries provide patients, including:
- Less pain
- Shorter hospital stays
- Much quicker recovery
Swedish has been at the forefront of robotic gynecological procedures since the daVinci Surgical System was approved for these procedures by the FDA in 2005.