Q1. What is endometriosis?

Endometriosis is a condition in which the normal lining of the womb (endometrium) is found elsewhere. It is a very common condition, during the child-bearing years affecting 2-10 women out of 100. It is not cancer and it is not infectious.

Endometriosis may be found in:

• ovaries (chocolate cysts)
• area between the vagina and the rectum
• lining of the pelvis and abdomen
• the muscle of the uterus (adenomyosis)
• bowel and/or bladder

Q2. What are the symptoms?

Common symptoms include:

• lower abdomen pain
• painful, irregular or heavy periods
• pain related to your bowels, bladder, lower back
• infertility
• painful intercourse

Q3. What investigations might be needed for diagnosis?

After a thorough clinical examination, you might be offered:

• a pelvic ultrasound scan, to check the uterus and ovaries (chocolate cysts)
• laparoscopy, which is the gold standard for diagnosis

Treatment of endometriosis can be done at the time of your first laparoscopy, either by removing cysts on the ovaries or treating any areas on the lining of the pelvis.

Q4. What are the options for treatment?

The options for treatment will depend on the severity of symptoms and include those listed below.

• Pain-relieving medication
• Hormone treatments- combined oral contraceptive pills, an intrauterine system (IUS/Mirena®) and GnRHa injections (gonadotrophin-releasing hormone agonists).
• Laparoscopic (key hole) surgery is the definitive treatment for removal of endometriosis.

We will discuss the above options with you in detail and individualize the treatment.

Q4. What is the role of 3D laparoscopy in treating endometriosis?

Laparoscopic surgery for endometriosis requires specialised skill and expertise.

It is a very challenging surgery as it may involve various important structures such as bladder and/or bowel.3D laparoscopy provides excellent depth perception and hence the relationships of structures are more easily defined.

The enhanced vision and magnification in 3D laparoscopy ensures a more complete removal of endometriotic areas, hence leading to better relief of symptoms post-operatively. It is often said that the first surgery for endometriosis, if done well, gives the best long term results. 3D laparoscopy is a patient friendly surgery as it increases patient safety and is cost effective.