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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Consequences of Endometriosis

The consequences of endometriosis primarily include abnormal menstruation and infertility, with about 50% of those affected experiencing infertility. The reasons for this stem from the abnormal pelvic structures caused by endometriosis, as well as extensive adhesions of the fallopian tubes and ovaries, and abnormal motility of the fallopian tubes, all of which lead to reduced functions in transporting sperm and eggs. Furthermore, changes in the microenvironment within the pelvis also lead to infertility. Abnormal menstruation is mainly characterized by an increased amount of menstrual flow and prolonged menstrual periods, which can easily lead to anemia in patients.

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Written by Xu Xiao Ming
Obstetrics and Gynecology
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Endometriosis

Endometriosis means that the endometrial tissue, which normally lines the uterus, grows in other locations. It can grow on the ovaries, inside the muscular layer of the uterus, or in the pelvic cavity. The ectopic endometrial tissue responds to changes in the body's estrogen levels during each menstrual cycle, creating symptoms similar to menstrual bleeding. If it grows on the ovaries, it may form a "chocolate cyst" on the ovaries that gradually enlarges with each menstrual cycle. If it grows within the muscular layer of the uterus, it can lead to adenomyosis, causing significant pain during menstruation. If it grows in the pelvic cavity, it can lead to the formation of pelvic lesions. Therefore, it is recommended that patients with such conditions seek prompt medical treatment.

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Written by Shen Li Wen
Obstetrics and Gynecology
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How to treat endometriosis in the pelvic cavity?

When women suffer from pelvic endometriosis and the symptoms are not too severe—for instance, if the pain is relatively mild—they can be clinically observed during menstruation. If dysmenorrhea occurs, oral administration of non-steroidal anti-inflammatory drugs such as indomethacin can help alleviate the symptoms. However, some women may experience more severe symptoms and may require pseudopregnancy treatment with drugs, such as oral contraceptives or progestin-based medications. Another approach involves using GnRH analogues, a method known as 'medical oophorectomy.' If symptoms are severe and treatments are ineffective, surgical intervention might be considered. Surgical options include electrocoagulation of endometriotic lesions in the pelvis, sharp or blunt dissection of adhesions, which can also improve the pelvic environment and potentially enhance fertility in women. (Note: Medication should be taken under the guidance of a doctor.)

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Written by Yue Hua
Obstetrics and Gynecology
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Does endometriosis need treatment?

Whether or not endometriosis requires treatment entirely depends on the patient's symptoms. If it is a mild case of endometriosis without severe symptoms, the patient can undergo regular follow-up visits. However, if the patient experiences severe abdominal pain during menstruation, it depends on whether the patient has reproductive demands. If there are reproductive demands, medication can be administered; clinically, high-dose progestogens are commonly used to prevent the ectopic endometrial tissue from continuing to grow. If the patient has no desire for childbirth and suffers from severe pain, a hysterectomy and bilateral adnexectomy may be performed.

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Written by Wang Jing Hua
Obstetrics and Gynecology
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Can endometriosis be cured?

The treatment of endometriosis should be determined based on the individual's specific circumstances. Complete cure typically requires the removal of both ovaries. As long as the ovaries are present, there generally is no talk of a complete cure; treatment can only control the condition. It is possible to surgically remove lesions and use medication to reduce the likelihood of recurrence. The specific treatment for endometriosis should be determined based on factors such as age, whether there is a desire for children, and specific symptoms like painful periods and bleeding conditions.