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What is Endometriosis?

How do you know if you have endometriosis? Dr. Grace Janik of Reproductive Specialty Center in Milwaukee, Wisconsin explains what is endometriosis to help women better understand the signs and symptoms.

Video Transcript

What is endometriosis?, Grace Janik, M.D., Reproductive Specialty Center: Endometrioses is a very common disease. In the infertility patient population, it is anywhere from 10-12 percent. Some of the typical symptoms that patients have, in addition to infertility, is some subtle clues that when you ask a history you can tease these out. One is progressive dysmenorrhea, meaning their cramps have gotten worse over time. Beginning in your 20s, your 30s, your cramps have gotten worse, that's a clue for endometriosis. Other clues are pain with intercourse, pain with bowel movements, pain when your bladder's full or when you empty your bladder. Another way, sometimes, endometriosis is diagnosed is on ultrasound. You see a collection of endometriosis within the ovary, called an endometrioma. These endometriomas are frequently removed at the time of laparoscopy, but the problem is, if you're not an experienced surgeon, the problem of peeling the endometriomas of off the ovary and saving as much ovary as possible can be problematic. There's been a new profession called minimally invasive surgery which is a fellowship that is one to two years. It's focused just on surgery. Some of these people have training in endometriosis, but not all, and not all have the fertility emphasis, so it's a little difficult to just go by the title in order to figure out who's an endometriosis surgeon. As a patient, you need to ask some core questions of how the physician operates. What percentage of their practice is endometriosis surgery? Do they keep their own statistics on outcome? There's been some new techniques in the last few years of how to treat endometriosis to get a better long-term results, and this concept is called peritoneal resection. What's done is instead of the classic way of taking cautery and just cauterizing individual implants, you do a surgery where you actually remove the peritoneum, which is like the skin that covers the pelvis that has the endometriosis in it, and by removing that peritoneum, new peritoneum regenerates in about two to three days free of disease. The long-term pain relief for patients, followed out five years or greater, is over 85 percent will pain-free or pain-controlled, so it gives them a much more permanent cure. In addition, we've looked at these patients as far as fertility, and what we see is that patients get pregnant very quickly after resection with peritoneal resection. They'll get pregnant in the first six months, typically, after resection, and then it starts to taper off in those patients that will get pregnant are usually by a year.