Patient's question:
,28 years oldI have been checked by doctors at the Provincial Maternal and Child Health Hospital multiple times, and they all said I was fine, but I have been experiencing long-term pain in my uterus. It has been going on for almost a year. It has really been hard on me. Is it endometriosis? Pain and aching in the pubic symphysis and both sides, along with a long-term burning sensation.
My menstrual flow has increased, and my period has also extended, lasting for about ten days. There is also pain in the left and right fallopian tube areas during ovulation, with slight bleeding.
An ultrasound was normal, but CA125 was 10 three months ago and then 15. I am pregnant
Doctor's answer:
Hello, can you first perform a check-up to diagnose whether there is endometriosis.Methods for diagnosing endometriosis:
1. B-mode ultrasound imaging, which helps understand ovarian endometriosis and its size, and occasionally can detect masses that cannot be palpated during pelvic examination.
2. Laparoscopic examination, which can directly visualize the affected areas, the extent and severity of the disease, and is currently the most reliable method for diagnosing endometriosis.
3. Exploratory laparotomy, performed when laparoscopy is not available or has failed, and the diagnosis remains unclear. Biopsy, if cervical, vaginal, abdominal scar, or other locations are suspected to have endometriosis, a tissue sample from the local lesion can be taken for pathological examination.
Treatment methods for endometriosis
Treatment methods are mainly divided into surgical and drug categories, comprehensively considering factors such as the patient's age, the severity of the condition, and whether there are fertility requirements. Treatment should be tailored to the individual.
1. Surgical treatment: The earliest method used for treating endometriosis, it remains one of the main approaches to this day. It is primarily suitable for patients with more severe conditions or those with severe pain that is not relieved by medication.
- (a) Conservative surgery: Only removes the endometriotic lesions while preserving the ovaries and uterus. It is suitable for younger patients who wish to preserve fertility, with approximately 50%-60% of postoperative patients achieving pregnancy. However, the recurrence rate of pain is relatively high.
- (b) Semi-radical surgery: Removes the endometriotic lesions along with the uterus, while at least retaining part of the ovaries. It is suitable for patients who have already given birth and are under 35 years old.