What is Endometriosis? Know symptoms, treatments and surgical options for chronic pelvic pain

Endometriosis is the modern epidemic of gynaecology. A woman normally sheds the inner lining of the uterus (endometrium) at the end of each menstrual cycle.

This manifests in the form of menstrual bleeding. Some of this blood containing living endometrial cells can also reach the abdominal cavity through her Fallopian tubes, blood vessels or lymphatics.

According to Dr. Nagendra Sardeshpande
Gynecological Endoscopic Surgeon, Sir HN Reliance Hospital, in a small percentage of women, these cells can implant (stick) on the various organs of the pelvis (ovaries, intestines, Fallopian tubes and surface of the uterus) and grow & bleed inside the abdomen.

This irritates the abdominal cavity and causes the various organs (intestines, ovaries, Fallopian tubes and uterus) to stick to one another (adhesions). The important structures passing through the pelvis such as the pelvic nerves, blood vessels and ureters (tubes carrying urine from the kidneys to the bladder) can become encased and constricted in these adhesions.

Endometriosis can lead to the following symptoms:

Severe chronic pelvic pain worsening during menstruation. Pain during the passing of stools (tenesmus) & blood in faeces (hematochezia) and occasionally intestinal obstruction.
Infertility by blocking the ovaries and Fallopian tubes due to adhesions and inflammation which can damage the sperm and eggs.
Occasionally, endometriosis involving the urinary bladder can cause painful passage of urine (dysuria) and passage of blood in urine (hematuria)
Compression of ureters can lead to dilatation of the ureters (hydronephrosis) causing pain and, rarely, renal failure.