Patients with endometriosis can have symptoms varying from constant excruciating pelvic pain to no symptoms whatsoever. Paradoxically, the extent of endometriosis has no correlation to the amount of pain a women will experience. Some women with severe endometriosis do not have any symptoms and may not know they have endometriosis until a pelvic mass is detected on a routine pelvic examination or a problem with infertility is discovered.
C.Y. Liu, MD
The real cause of endometriosis remains unknown. The following theories represent current thinking of the etiology of endometriosis, but none of them can explains all cases of endometriosis. We do know, however, that endometriosis is not caused by anything that the patient has done.
Endometriosis is a condition in which the lining of the uterine cavity (endometrium) grows outside of the uterus. Endometriosis can be found anywhere in the pelvic cavity, including all the reproductive organs as well as on the bladder, small bowel, colon, rectum, appendix, and vagina. However, endometriosis cannot be considered simply as misplaced endometrium, because it differs in hormonal responses and visual appearance.
Laparoscopy succeed in overcoming technical difficulties and poor outcome of traditional open ureteroureteral distal anastomosis. A technique for laparoscopic repair of injury involving the distal ureter has been successfully developed.
Currently there are two ways to treat endometriosis – hormonal therapy and surgery. Depending on the patient’s expectations and the extent of the disease, we may prescribe hormonal therapy, surgery, a combination of surgery and hormonal therapy, or occasionally a just “wait and see” approach.
A significant number of women experience infertility due to surgically correctable causes. Most cases are a result of endometriosis and/or adhesions (scar tissue) from previous surgery or pelvic infection. Endometriosis and adhesions cause distortion and blockage of the fallopian tubes, thus causing infertility. Infertility surgery tries to unblock, release and restore normal anatomy of the fallopian tube.
The goal of laparoscopic repair of female organ prolapse is to restore normal functioning by correcting female organ supporting defects in the pelvis. The supporting system in the female pelvis is quite complex; however, it is dynamic rather than static. There are basically two systems in the pelvis that provides the active and passive support of pelvic organs to their proper places.
Urinary incontinence is the involuntary loss of urine to the degree that is socially and hygienically unacceptable to the patient. The amount of leakage, which varies from a few drops to a large gush, usually increases with age.