Endometriosis and Ovarian Cysts

What is Endometriosis?

Endometriosis is a condition where the lining of the womb responsible for menstruation is found outside the womb. Up to ten percent of women are affected with endometriosis.

The lining of the womb responds to menstrual hormones and causes ‘menstruation’ outside the womb. Over time, this will cause inflammation, tissue damage and scar formation (adhesions).

Endometriosis commonly affects the ovaries giving rise to ovarian cysts or endometrioma. It can also be found behind or within the womb, causing pelvic pain.

Symptoms of Endometriosis

If you have endometriosis, you may have some of the following symptoms or be symptom-free.

1. Pain during menstruation
2. Pain during sexual activity
3. Chronic pelvic pain
4. Heavy or irregular menstruations
5. Pelvic mass from large ovarian cysts/endometrioma
6. Enlarged womb (adenomyosis) from infiltrative endometriosis
7. Subfertility
8. Bowel-related symptoms during menstruation (diarrhea, constipation, painful bowel movements)
9. Urinary-related symptoms during menstruation (painful urination, bloody urination)

Diagnosis of Endometriosis

Endometriosis can be suspected based on symptoms. Sometimes, endometriotic spots can be seen and felt during pelvic examination.

Pelvic ultrasound scan and blood tests may support the diagnosis.

To diagnose endometriosis conclusively, surgery is needed and a diagnostic laparoscopy (keyhole surgery) is the gold standard.

Laparoscopy is a surgery done under general anaesthesia. It allows a detailed and magnified view inside the pelvis to indicate the locations, extent and size of endometriosis.

Surgical treatment of endometriosis can then be undertaken at the same setting during diagnostic laparoscopy.

Medications for treatment of Endometriosis

Treatment of endometriosis is aimed at alleviating symptoms and improving quality of life.

1. Painkillers – help to stop mild menstruation pain
2. Hormonal treatments – reduce pain and correct heavy or irregular menstrual flow.
   • Oral contraceptive pills
   • Progesterone drugs
   • Danazol (testosterone derivative)
   • GnRH analogues (menopause inducing injection)

Surgery for treatment of Endometriosis

Laparoscopy (keyhole surgery) can:

1. Remove ovarian endometriomas
2. Remove endometriotic spots
3. Remove scarring (adhesions) caused by endometriosis
4. Repair the damage endometriosis has caused to the tubes and hence restore normal anatomy to improve fertility
5. Remove the womb and both ovaries (definitive cure, generally reserved for patients who have completed their family and are near menopause)

Sometimes open (conventional) surgery may be required.

KKH Endometriosis Centre

The KKH Endometriosis Centre is a one-stop centre, focused on providing holistic and multidisciplinary care to patients with endometriosis.

Our centre is supported by a team consisting of:

1. Gynaecologists with interest and surgical expertise in management of endometriosis
2. Specialists in pain management
3. Colorectal specialist
4. Nurse counsellor
5. Endometriosis support group
   

Call us if you need further information or for an appointment.

• +65 9233 1457 (Centre Co-ordinator Hotline)
• + 65 6294 4050 (Appointment)

SGH Obstetrics & Gynaecology Centre

SGH Department of Obstetrics & Gynaecology at SGH is a comprehensive clinical department that provides investigative, treatment and emergency services for a whole range of obstetric and gynaecological conditions.

Call us if you need further information or for an appointment.

• Make an appointment online
• Appointment hotline: + 65 6321 4377