A fairly common disease that often accompanies infertility is external endometriosis. The main method for diagnosing and treating this pathology is laparoscopy. After this intervention, pregnancy occurs more often.
With external endometriosis, the cells of the uterine mucosa appear on the peritoneum, fallopian tubes, ovaries, intestines. They have receptors for progesterone and estrogens, therefore , they are prone to changes throughout the cycle, and are rejected during menstruation.
However, since the affected organs are not adapted to this, inflammation, hemorrhage and edema of nearby tissues occur. With each menstruation, the process progresses, organs increase in size, their functioning is disrupted, adhesions arise between them.
External endometriosis usually manifests itself as pelvic pain, which intensifies during menstruation, and infertility. In addition, the patient may experience pain during sex and examination on a gynecological chair. With the germination of endometriosis in the intestines and bladder, soreness and blood discharge occur during defecation and urination.
Scientists do not yet know exactly why external genital endometriosis occurs . There are several theories about this. One of them suggests its appearance when menstrual flow enters the tubes and abdominal cavity. Endometrial cells invade the mucous membranes of the organs, and endometriosis occurs.
However, experiments showed that not always throwing menstrual flow into the abdominal cavity leads to endometriosis. Therefore, it is believed that the disease appears with predisposing factors. The main ones are hormonal and immune disorders, as well as stress.
External endometriosis, the gynecologist may suspect during examination and questioning of the patient. Ultrasound shows a disease in a common process when there are ovarian cysts. The main diagnostic method for external endometriosis is laparoscopy.
This endoscopic procedure involves only a few small incisions. Through them, instruments are introduced, including an optical device. The doctor examines the organs, and if endometriotic lesions and adhesions are detected, removes them. This surgery is the main way to treat the disease. Hormone therapy is prescribed rather for preventive and preparatory purposes.
After laparoscopy, the pregnancy rate is very high. If conception does not occur within two years after the intervention, then the second operation is not effective.
Quite often, patients are offered to resort to reproductive technology after surgery. This significantly increases the likelihood of pregnancy.
In the treatment of endometriosis , hormonal therapy is also used. Apply COCs, gestagens and drugs that cause artificial menopause. They should be selected by a gynecologist-endocrinologist taking into account the severity of the disease, the patient's plans, and concomitant pathologies.
Most often, with the help of ultrasound, ovarian endometriosis is detected, the treatment of which is carried out mainly surgically using laparoscopy. Since only hormone therapy for large cysts is not effective.
Diagnostic laparoscopy is performed for infertility and pelvic pain. The method of treatment is chosen by the doctor. Quite often, surgery is combined with hormone therapy. Moreover, it is carried out both before and after the operation.
Sometimes with minor endometriosis, the doctor tries to get by with hormones. However, studies show that this has little effect on fertility, although it alleviates other symptoms.
Thus, external endometriosis often leads to infertility and pelvic pain. The main method for its diagnosis and treatment is laparoscopy. Also, hormonal therapy is used to combat it, which must be selected individually by the gynecologist-endocrinologist.