Endometriosis
I'm Tatnai Burnett, consultant in minimally invasive gynecologic surgery and endometriosis specialist at Mayo Clinic. Endometriosis is a condition where the cells that line the uterus are instead found outside of the uterus where they are not supposed to be. These abnormally located cells can be found on the surface of the pelvic cavity, inside the ovary, on the fallopian tubes or uterus, and even on the bowel or bladder. In rare instances, it can be found outside of the pelvis. In most cases, endometriosis grows on the surface of these structures, but it can also grow into and invade tissues and organs.
Endometriosis may be associated with pain or infertility, but in some women it may cause no symptoms at all. In women who experienced pain, this may start as very painful menstrual periods, and then over time pain may extend outside of bleeding. Other symptoms can include painful sexual intercourse, bloating, and pain with bowel movements. Interestingly, the amount of pain a woman has does not correspond to the amount of endometriosis found at the time of surgery.
Surgery is required to be certain that a woman has endometriosis, with the tissue sample removed and sent to the lab for examination under a microscope. There are both medical and surgical treatment options for endometriosis and choosing between them depends on multiple factors, including the patient's symptoms, prior treatments, disease location, and organ involvement. When surgery is chosen, a woman's symptoms and examination findings allow us to recommend the appropriate preoperative workup, which can include an MRI scan in some women.
In severe cases of endometriosis, we work with a multidisciplinary team to plan the surgical approach. Even with severe cases, surgery can be performed with a minimally invasive approach for the vast majority of patients, using a small camera and small instruments through small holes in the abdomen for a quicker and easier recovery. We prefer excising endometriosis rather than burning it, both for accurate diagnosis, and to ensure appropriate treatment of deeply invading endometriosis without leaving any cells behind. Please visit our website at MayoClinic.org more information and to book an appointment for a comprehensive evaluation.