Does endometriosis require the removal of the uterus?

Written by Hou Jie
Obstetrics and Gynecology
Updated on September 12, 2024
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Endometrial displacement, depending on the specific location of the displacement, calls for different treatments. When the endometrial glands and stroma invade the myometrium, it is called adenomyosis. Treatment is based on the patient's symptoms, age, and fertility requirements. If there are fertility requirements, or the patient is near menopause, medicinal treatment can be tried to alleviate symptoms. For younger patients with adenomyosis who have reproductive needs, focal excision surgery can be considered. For patients with severe symptoms, who either have no reproductive needs or for whom medicinal treatment is ineffective, a total hysterectomy may be considered.

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Written by Yue Hua
Obstetrics and Gynecology
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Can endometriosis lead to pregnancy?

Endometriosis can lead to pregnancy, but about 50% of those affected may not conceive. This is because the disease can cause abnormal anatomical structures in the female pelvic, leading to extensive adhesions around the fallopian tubes, thus affecting the movement of the tubes. This, in turn, impairs their function in transporting the fertilized egg. Therefore, for patients wishing to conceive, it is advisable to monitor follicular development with an ultrasound and have intercourse during the ovulation period, which could increase the chances of pregnancy.

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Written by Yue Hua
Obstetrics and Gynecology
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How is endometriosis diagnosed?

Endometriosis is a condition where the uterine lining grows outside of the uterine cavity, commonly seen in the pelvic region, particularly above the ovaries. Therefore, ultrasound (B-ultrasound) examinations are primarily used for accuracy. The ultrasound may reveal a large mass on one side of the fallopian tubes or ovaries, with uneven content inside. During the ultrasound, it can also be observed that the capsule of the mass is intact. Additionally, during a gynecological examination, the doctor may also feel a mass in the adnexa.

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Written by Zhang Lu
Obstetrics
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How is endometriosis diagnosed?

Endometriosis refers to the occurrence of endometrial tissue outside the uterine cavity, a common gynecological condition that often leads to painful menstruation, pain during intercourse, and infertility. Diagnosing endometriosis involves several approaches. First, inquire about the patient's clinical symptoms, including any painful menstruation and pain during intercourse. Second, a pelvic ultrasound should be performed to observe the situation inside the pelvis, assessing for any ovarian endometriotic cysts or pelvic endometriotic lesions. Third, a blood test for CA-125 can be conducted, as the levels of CA-125 tend to increase with endometriosis. Fourth, laparoscopy can be used to collect local tissue for pathological examination, which is the gold standard in diagnosing endometriosis.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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What tests are done for endometriosis?

Endometriosis is generally diagnosed through color ultrasound and CA-125 blood tests. If the endometrial tissue is located within the uterine muscle, it forms adenomyosis, at which point the ultrasound will show an enlarged uterus and uneven muscle wall echogenicity. Blood tests for the tumor marker CA-125, if elevated above the normal level of 35, generally indicate adenomyosis. If the endometrial tissue is located in the ovaries, it can form ovarian chocolate cysts, which are visible on the ultrasound as ovarian sections and echoes, with typical ultrasound reports indicating ovarian chocolate cysts. Therefore, routine examinations for endometriosis typically include color ultrasound and blood tests, which can confirm the diagnosis.

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Written by Li Shun Hua
Obstetrics and Gynecology
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Endometriosis characteristics

The main characteristic of endometriosis is painful menstruation, and in severe cases, it can lead to heavy periods and prolonged menstrual cycles. If endometriosis leads to the formation of ovarian chocolate cysts, the rupture of these cysts can cause severe abdominal pain. Moreover, endometriosis can easily lead to pelvic adhesions, which are a common cause of infertility. If the condition is severe, abdominal pain may also occur after the menstrual period has ended. In the case of adenomyosis, the symptoms include an enlarged uterine body, heavy periods, and prolonged menstrual cycles. If the condition is severe, then surgical treatment may be necessary.