/assets/images/provider/photos/2534467.jpg)
Endometriosis is a common chronic condition, which affect more women than diabetes or asthma, However public awareness , Surgical training and management is lagging behind.
Endometriosis is when a tissue that resembels the linning of the uterus is present outside the uterus .a common condition that requirs some level of awareness by women.
1) Most women dont know what Endometriosis is:
A survey in the UK showed that 54 % of women didnt know what endometriosis is and 45% cannot name any of its symptomes.
The numbers are even higher in the young age group 16-24 years.
2) Endometriosis is more common than diabetes:
Endometriosis is estimated to affect > 10% of women,this is slightly more than the prevalence of Diabetes or even Asthma!.However Public awarness of endometriosis is poor.
3) THe exact cause of Endometriosis is still not fully understood:
Many theories exist ,but the exact process is still poorly understood
4) Misconceptions about endometriosis surgery are common among OBGYNs:
Because of the extent of the disease in many cases ,some OBGYNs still perform a limited procedure at the time of surgery,as some believe that a more extensive excision may be dangerous or of limited benifit.
5) Endometriosis surgery is a complicated surgery because oftn it is not confined to one organ:
Endometriosis commonly involve the linning of the pelvic cavity,ovaries,tubes and the ligaments supporting the uterus.other locations include the bladder,bowel,vagina and rectum.Less common sites include the diaphragm and the lungs cavity!
6) Endometriosis surgery may require the expertise of surgeons from differrent specialities:
Since endometriosis can involve differrent organs,developing a team of colorectal surgeons,urologist surgeons and even sometime thoracic surgeons is necessary for the proper surgical treatment.
7) The key to success in endometriosis surgery is a good preoperative evaluation and planning:
Complete evaluation of the deep endometriosis disease is a key to proper counselling and crucial in the surgical planning.In surgery its always better to be prepared than suprised!
8) Endometriosis surgery can be long,complex and may have a higher complication rate compared to other gynecologic surgeries.
Its improtant to work with a surgeon that is experienced and willing to properly treat endometriosis,suboptimal surgery means prolonged symptomes and repeat future surgeries!
9) At endometriosis surgery,often most of the implants are not removed:
The truth is that because endometriosis implants can be numerous and close to vital structures like blood vessels ,bowel and ureters,many surgeries end up being a simple ablation of few implants while leaving the bulk of the disease untouched.
10) The benifits of excsion as opposed to thermal ablation have been demonstarted and confirmed in multiple studies:
ablation heat may not reach the deeper layers of the endometriosis implants
Excision is associated with a longer symptomatic relief,less recurrence or need for repeat surgery.
11) Surgery for endometriosis is poorly compensated by health insurances:
the experience and time spent in surgery is not properly compensated by health insurances,another reason why fewer surgeons are interested in the field of endometriosis surgery.
12) Removal of the endometriosis cyst can damage the ovarian reserve:
The risk of the potential damage of the ovarian reserve due to surgery should be weighed against the risk of damage to the ovarian reserve that is caused by the endometrioma . indivisualized approach that takes in consideration the fertility planning is important.
13) Drainage of an endometriosis cyst is a totally ineffective surgery:
The endometriosi tissue is present in the wall of the cyst and not the fluid of the cyst,so drainage of the fluid does literally nothing to the endometrioma!
14) In endometriosis,the average time from presentation to diagnosis is 7-10 years!
While nonsurgical (medications) managment of endometriosis has a definit role in many patients,in many cases of failed medical treatment,surgery is unnecessarily delayed.
So in Summary,a complex condition like endometriosis should be managed by a surgeon with the knowledge and surgical skills needed to manage this condition,which sometimes require working with surgeons from other specialities to properly handle its complexities.
For a surgical consult with The Southern California Center For advanced Gynecology ,call or book your appointment online .