Dr Tsaltas Explains Bowel/Colorectal Endometriosis
Endometriosis is a complex condition where the cells of the uterus lining live and grow outside the uterus.
Affecting 10-15% of the female population, endometriosis is just as common as diabetes and asthma, if not more so. However, it is still a poorly understood condition that often goes undiagnosed for many years.
The most common sites include:
• Ovaries
• Fallopian tubes
• Uterine muscle (known as adenomyosis)
• Uterosacral ligament
• Inside walls of the pelvis over the ureters
• Pelvic side walls
• Pouch of Douglas
• Surface of the rectum
• Muscle of rectum and other areas of the bowel
• Bladder surface
• Vagina
In some cases, endometriosis may also infiltrate into the bowel and deep into the bladder.
• Severe period pain
• Chronic pelvic pain
• Mid cycle (ovulation) pain
• Pain during intercourse
• Infertility
• Patient symptoms: Many patients will have symptoms for many years which is why a thorough history is very important.
• Pelvis examination: Tenderness or the presence of a nodule (lump) through the vaginal tissues may suggest endometriosis.
• Ultrasound: You may need an ultrasound with a pre-ultrasound bowel preparation to diagnose deep infiltrative endometriosis.
This surgery is specialised and complex. I will therefore ensure you have a full understanding of the procedure and associated risks beforehand.
For most patients, a laparoscopy is all that’s needed to remove the endometriosis. In severe cases such as bowel endometriosis, however, a second procedure may be necessary. If this is your situation, I will conduct the surgery in collaboration with a highly skilled multidisciplinary team at either Epworth Freemasons or St Vincent’s Private.
• Combined oral contraceptive pill
• Progesterone only pill
• Mirena IUD
• Implanon
• Zoladex
• Synarel
• Provera
• Visanne
I can advise which medications are right for you.
Endometriosis can also occur in the post-menopausal years when women are on HRT. It only very rarely occurs in post-menopausal women not on HRT.