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 Xu Xiao Ming
Obstetrics and Gynecology
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Causes of endometriosis

The causes of endometriosis are not yet fully understood, but the theory of endometrial implantation is recognized by most experts and scholars. The main reason is that during menstruation, endometrial glandular epithelium and stromal cells can retrograde with menstrual blood, enter the pelvic cavity through the fallopian tubes, implant on the ovaries and adjacent pelvic peritoneum, and grow and spread there, forming pelvic endometriosis. Most clinical and experimental data also support this theory, indicating that approximately 70%-90% of women experience menstrual blood retrograde. Additionally, congenital vaginal atresia can also lead to endometriosis, as well as iatrogenic endometrial implantation, such as abdominal scar implantation after cesarean section or endometriosis at the perineal incision site after childbirth. These factors may also contribute to the development of endometriosis.

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Written by Liu Wei Jie
Obstetrics
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Can endometriosis turn into cancer?

The answer is no. First, let's explain what endometriosis is. Endometriosis is when the endometrium, or the lining of the uterus, is found outside of its normal location, including in the muscular layer of the uterus, the ovaries, the pelvic cavity, or the intestines; it can occur in any of these areas. This condition is known as endometriosis. Endometriosis within the uterus is a benign condition, but it can lead to severe painful menstruation and chocolate cysts. If the menstrual pain is very severe, there may be a possibility of needing a hysterectomy in the future. If a chocolate cyst occurs, surgery might also be necessary.

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Written by Li Shun Hua
Obstetrics and Gynecology
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How is endometriosis treated?

Treatment methods for endometriosis include conservative treatment and surgical treatment. If the patient's symptoms are relatively mild, the dysmenorrhea is not very severe, and there is no occurrence of excessive menstruation or prolonged menstrual period, conservative treatment can be applied. Common conservative treatment methods include oral contraceptive pills, and a levonorgestrel-releasing system can be placed inside the uterine cavity. If the patient has reproductive demands and the symptoms are more severe, or if there is a chocolate cyst on both ovaries, surgical treatment can be performed, but the recurrence rate after surgery is also relatively high. (The use of medication should be under the guidance of a doctor.)

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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 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.