Endometriosis is one of the most common causes of infertility, as well as many unpleasant symptoms in women of reproductive age. One of the most effective methods of diagnosis and treatment is laparoscopy in endometriosis. The procedure for this procedure should be known to the patient, so as not to be afraid of the operation and to understand the benefits of it.
What is endometriosis and why does
laparoscopy? Endometriosis is a pathological proliferation of endometrial cells( the inner wall of the uterus) in atypical sites. It can be the ovaries, appendages, fallopian tubes and so on( genital variant), and the intestine, bladder( extragenital variant).The etiology and pathogenesis of the disease is not fully understood, but the importance of hereditary factors and hormonal background has been proved.
This process leads to the fact that endometrial cells located atypically begin to function incorrectly, in particular, to produce pathological substances. This, in turn, causes infertility and a number of rather unpleasant symptoms:
- bleeding from the genital tract or in the abdominal cavity;
- severe pain in places of lesions;
- all manifestations of hormonal disorders in the form of dysmenorrhea, algomenorrhea and so on.
In contrast to laparotomy, where the dissection of the anterior wall of the abdominal cavity is required, the postoperative recovery period is much less.
How is the operation
performed? The laparoscopic procedure is performed by high-tech and precise technique, equipped with a computer, vision sensors and manipulators. A small hole( or two or three if necessary) is made in the abdominal wall, through which the manipulators are put on.
A certain amount of carbon dioxide is then pumped into the abdominal cavity in order to improve the visibility of the organs and to separate the peritoneal walls from surrounding tissues. Already after this, the surgeon first examines and identifies the suspected lesions, and then removes them with a manipulator.
The duration of the operation is on average from half an hour to an hour. If foci on other pelvic organs are identified, additional time and the introduction of other manipulators into the abdominal cavity may be required to remove them.
It should be separately noted that the formation of the so-called endometrioma is especially dangerous. This occurs if the pathological focus grows in the ovary and forms an endometrioid cyst. Such a cyst is a direct indication for surgery.
Endometriosis after laparoscopy significantly regresses, and the method itself shows results in a positive dynamics to reduce pain in the pelvic area, as well as in increasing the probability of pregnancy. Nevertheless, treating the operation as a panacea is not worth it, because, firstly, the outbreaks of a very small size are almost always not detected, and secondly, the disease can recur.
However, from the undeniable advantages of laparoscopy, it should be noted that the operation is of little invasive nature. This is especially true for young women who did not give birth. After all, this method of treatment allows you to remove only the foci of endometriosis, while not affecting the surrounding healthy tissue and acting as sparing as possible.
Alternative therapies
Treatment after laparoscopy of endometriosis involves basically taking hormonal medications. This is due to the fact that tissue lesions have hormone-dependent receptors, and remission is achieved when ovarian hormonal function is suppressed.
To correct the level of sex hormones( especially estrogen), the following drugs are used:
- progestin hormone series( lindineth);
- antigestagens;
- antigonadotropic drugs( oppressive synthesis of releasing factors in the pituitary gland);
- combined oral contraceptives( containing both estrogen and progestogen);
- androgen hormones;
- other steroid preparations.
Treatment of endometriosis with laparoscopy in combination with these drugs is highly effective.
We recommend reading the article about preparations for the treatment of endometriosis in women. From it you will learn about the features of the disease, the effectiveness of drug treatment, prescribed medications.
Prophylaxis of endometriosis after laparoscopy practically does not exist due to the fact that the etiology and pathogenesis of the disease are not fully understood. Nevertheless, competent contraception and the intake of hormonal drugs prescribed by a strict gynecologist scheme, can significantly reduce the likelihood of a relapse, improve the quality of life and increase the chances of becoming pregnant.