Patient's question:
How is endometriosis caused by childbirth treated, and can pregnancy be achieved again?Doctor's answer:
Hello: Treatment methods are mainly divided into two categories: surgery and medication. The choice of treatment should be comprehensive, considering factors such as the patient's age, the severity of the condition, and whether they have fertility requirements. Treatment should be tailored to the individual.I. Surgical Treatment: The earliest method used for treating endometriosis, it remains one of the primary approaches to this day. Surgery is mainly suitable for patients with severe conditions or those experiencing severe pain that is not effectively managed by medication.
（1）Conservative Surgery: Only the endometriotic lesions are removed, while the ovaries and uterus are preserved. This is suitable for younger patients who wish to preserve their fertility, with approximately 50%-60% achieving pregnancy after surgery. However, the recurrence rate of pain is relatively high.
（2）Semi-radical Surgery: Endometriotic lesions are removed along with the uterus, while at least part of the ovaries must be preserved. This is suitable for patients who have already borne children, are over 35 years old, suffer from persistent pain, or have concurrent uterine conditions. Semi-radical surgery can cure dysmenorrhea, and the recurrence of endometriosis after surgery is very rare.
（3）Radical Surgery: Both bilateral adnexa and the uterus are removed, which can completely cure endometriosis. This is suitable for women in menopause. In recent years, laparoscopic surgery has been widely used to treat endometriosis. All surgeries that can be performed through open surgery can also be done laparoscopically. Additionally, laparoscopic surgery offers advantages such as minimal trauma, faster recovery, and reduced postoperative pelvic adhesion.
The symptom relief rate and pregnancy rate after surgery can achieve the same effects as open surgery. It is gaining increasing attention.
II. Medication Treatment: Suitable for patients with mild conditions and small chocolate cysts. The treatment course is generally 6-9 months. If used as adjuvant therapy before or after surgery, the course can be shortened to 3