Endometriosis

Endometriosis is a condition where endometrial tissue, that normally lines the inside of the uterus, grows outside the uterus and attaches to other organs in the abdominal cavity, such as the ovaries and fallopian tubes. Endometriosis is a progressive disease that tends to get worse over time and can reoccur after treatment. Symptoms include painful menstrual periods, abnormal menstrual bleeding, pain during or after sexual intercourse, and infertility.

The endometrial tissue outside your uterus responds to your hormones the same way as the tissue inside your uterus responds.  It becomes thickened during the first part of your cycle, then sheds after ovulation to mark the beginning of the next cycle. The blood that is shed from the endometrial tissue in your abdominal cavity has no place to go causing an inflammatory response that forms scar tissue.

This scar tissue can involve the fallopian tubes causing an obstruction or enveloping the ovary interfering with ovulation.  Endometriosis can invade the ovary and cause the formation of ovarian cysts called endometriomas that can affect egg quality, ovulation, and pelvic pain.

The cause of endometriosis is unknown, though there are a few theories that suggest possible causes. One theory suggests that during menstruation, some of the menstrual tissue flows back up through the fallopian tubes into the pelvis where it can implant and grow.

Another theory indicates there could be a genetic birth abnormality where endometrial cells develop outside the uterus during fetal development.  Other theories describe the spread of endometrial tissue through the blood stream and lymphatic system.  This could explain the appearance of endometriosis in areas outside the pelvic or abdominal cavity.

Laparoscopy is an outpatient surgical procedure that is used to confirm the diagnosis of endometriosis after a medical history review and pelvic exam. This condition is classified by the surgical findings.

Your condition is stage based on the amount of scarring and diseased tissue found during surgery.  The staging criteria was established by the American Society for Reproductive Medicine and is as follows: Stage 1 (minimal), Stage 2 (mild), Stage 3 (moderate), Stage 4 (extensive).

Based on the stage of endometriosis, your physician will determine the best treatment plan for you which may include medication or surgery, or a combination of both. Dr. Ziegler is an expert in Laparoscopic Laser surgery which minimizes adhesion due to a surgical procedure.  Laser ablation of endometrial implants and associated adhesions is associated with a success rate of >70% pain relief and improved fertility.