Endometriosis surgery: in what cases, for what lesions?|Health Magazine
Not all women suffering from endometriosis are operated.The treatment of this gynecological disease is most often drug.But, in some cases, depending on the pain and the location of the lesions, it can associate surgery.When is the operation necessary?
Endometriosis is characterized by the abnormal presence outside the uterus of fragments of the endometrium.Surgery relieves pain, limiting the disease, sometimes increasing fertility.We take stock while the government is implementing a national strategy against endometriosis.
Operation of endometriosis: in which cases is it recommended?
In case of medical treatment failure
The first treatment of endometriosis is first hormonal.Its purpose is to block ovulation and remove the rules in order to reduce the growth of endometriosis.The operation is envisaged after failure of the various medical treatments, taken for at least three months."This happens in 30 to 40 % of cases," said Dr. Éric Sauvanet, head of the surgery-gynecology service at Saint-Joseph Hospital (Paris) and member of Resendo.
In case of intense pelvic pain
Intense pelvic pain due to endometriosis manifest itself during and sometimes outside the rules, in the lower belly and back, or during sexual intercourse (dyspareunia), and can become disabling.The more pain is taken into account early after three months of drug treatment, the more effective surgical management will be.
In case of infertility
Endometriosis is a major cause of female infertility."The inflammation it causes is very toxic for all stages of design: the quality of oocytes, the manufacture of eggs, the functioning of the tubes, the mobility of sperm and the impact of the embryo", lists the ProfessorHorace Roman, gynecologist surgeon, endometriosis center of the Tivoli-Ducos clinic (Bordeaux).
Providing severe endometriosis could increase the chances of spontaneous pregnancy.An operation can also be justified before in vitro fertilization, as ovarian stimulation can worsen the pain caused by significant abdominal lesions.
What are the lesions of endometriosis that are operable?
The location of lesions dictates the surgical gesture.
À lire aussiHow does the intervention take place in practice?
What if the pains persist or come back after the operation?
A second surgery is not recommended after a first operation."When pain has become intense and chronic, there is a memory effect.They must be taken care of by a doctor specializing in pain, ”says Pr Nicolas Bourdel, gynecologist surgeon, at Clermont-Ferrand CHU.
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