Patient's question:
Every month when I have my period, the pain is extremely severe. Now, injections and medication aren't helping much. After getting the injection and taking the medicine, I often feel nauseous.Doctor's answer:
Now, the primary treatment for endometriosis should first involve laparoscopic diagnosis and treatment to remove as many ectopic lesions as possible, followed by medication for consolidation therapy. Based on the scope of laparoscopic surgery, it can be categorized into the following three types:Fertility-sparing surgery is suitable for young patients with a desire for fertility. The surgical scope aims to completely excise or ablate the endometrial lesions while preserving the uterus and one or both ovaries, or at least a portion of them. Common procedures include:
- Cystectomy for chocolate cysts (a type of endometriosis)
- Pelvic adhesiolysis
- Spot ablation of pelvic endometrial lesions
Additionally, fallopian tube hydrotubation (this procedure can be beneficial in resolving infertility caused by fallopian tube blockage) may be performed.
Ovary-sparing surgery involves the removal of pelvic lesions and the uterus to prevent the reimplantation and spread of endometrial tissue via the fallopian tubes into the abdominal cavity, while preserving at least one ovary or a portion of it to maintain postoperative ovarian function. This surgery is suitable for severe patients under 45 who do not wish to have children and should be followed by additional medication.
Radical surgery involves the complete removal of the uterus, bilateral adnexa (fallopian tubes, ovaries, etc.), and all pelvic endometrial lesions. It is suitable for severe patients over 45 who are nearing menopause and may not require postoperative medication.