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Endometriosis: Is Surgery Necessary?

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Endometriosis is a condition that affects many women. It occurs when the cells from the endometrium, the lining of the uterus, grow outside of the uterus and get stimulated by your monthly cycle. Several symptoms can be caused by endometriosis, such as pelvic pain, painful cycles, painful intercourse, and infertility. While there are medications available to help treat endometriosis, some women may need surgery as well. In this blog post, we will explore whether surgery is necessary for treating endometriosis and discuss the different types of surgery available.

There is no one-size-fits-all answer when it comes to treating Endometriosis. No two women are alike, and many factors must be considered when evaluating treatment options. Such considerations are as follows:

·       Severity of Symptoms

·       Extent of Disease

·       Pregnancy Intentions

·       Overall Health and Medical History  

In most situations your doctor will likely suggest conservative, non-invasive treatment options before recommending surgery for diagnosis and treatment. First line therapies are generally non surgical options, such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) and hormonal therapy.  Depending on symptoms and goals of treatment, surgery can be considered. Endometriosis is a disease that can have a direct impact on other organs, leaving surgery as the only treatment option. 

There are different types of surgery available to treat Endometriosis. The type of surgery performed will depend on the severity of the disease and where it is located. The two surgical approaches used to treat Endometriosis are:

·       Laparoscopic (with or without robotic assistance) : An endoscope (small tube with camera on the end) is inserted through a tiny incision. The surgeon can then see inside the pelvis, visualize the Endometriosis and remove it, either by the use of an electric current or laser.

·       Laparotomy: A larger incision is made in the lower abdomen and the surgeon removes the Endometriosis. Previously, this was the only type of surgery available for Endometriosis Excision. It is now only done in rare cases.

Each type of surgery has its own risks and benefits. Your doctor will be able to discuss these with you in more detail and help you decide which surgery is best for you. If surgery is necessary, be sure to discuss all of your options with your doctor so that you can make an informed decision about the best course of treatment for you.

Does Surgery Cure Endometriosis?

Sadly, surgery is not always 100% and does have associated risks. Depending on goals of treatment and post surgical management, some women will experience recurrence of their symptoms. The reasoning behind reoccurrence can vary depending on clinical context. However, one thing you do have control over is choosing an experienced gynecologic surgeon.  You want an experienced surgeon who has an expertise in the surgical management of Endometriosis, improving the success rate of treatment.

If you are experiencing any of the symptoms associated with Endometriosis, please see your doctor. There is no need to suffer in silence. Treatment options are available and getting an accurate diagnosis is the first step on the road to recovery. In need of an experienced gynecologic surgeon? Call to schedule a consultation with me today! We’ll explore your options for treatment and set you on a path for healing!

All There is to Know About Bladder Prolapse

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by Admin

As a woman, you may have heard of bladder prolapse or know someone it has happened to. Bladder prolapse is the falling or sagging of the pelvic organs into or through the vagina due to a weakened pelvic floor. In other words, as gravity pulls down on our internal organs they slip and fall out of place causing pain and discomfort for those who suffer from this problem. You may not know for sure if you’re at risk for bladder prolapse but there are some warning signs you should look out for such as changes in urinary patterns, pressure in the vagina, pain with intercourse or difficulty urinating – so read on if you want more information on this issue!

Bladder Prolapse, otherwise known as Cystocele, is one of multiple Pelvic Organ Prolapse disorders. Each prolapse type is categorized by the organ it impacts. Bladder Prolapse impacts the bladder, thus why it is called Bladder Prolapse. Other types of prolapse and the impact they have are listed below. 

  • Enterocele – Small intestine descends into the pelvis, pushing down at the top of the vagina
  • Rectocele – Weakening of the tissue between the vagina and rectum
  • Uterine – Uterus drops down into the vagina

What Causes Bladder Prolapse? 

A prolapsed bladder occurs when the muscles and supportive tissues between a woman’s bladder and vagina weaken, letting it sag from its normal position. This can be the result of multiple causes, such as damage to the muscles and tissues that typically support the pelvic organs, keeping them inside the pelvis. Other causes can result from damage to the muscles and pelvic support system following childbirth, as well as the following: 

  • Obesity 
  • Heavy Lifting
  • Constipation 
  • Chronic Coughing 
  • Having a hysterectomy

What are the Signs and Symptoms of Bladder Prolapse?

Surprisingly, there are some women who have a Pelvic Organ Prolapse, and do not experience any symptoms. On the contrary, there are women who can have just a mild prolapse, but express significant discomfort as a result of the disorder. Symptoms they can experience are as follows:

  • Pelvic Pain or discomfort 
  • Urinary Incontinence 
  • A feeling or sensation that something is falling out of the vagina 
  • A feeling of pelvic heaviness or fullness
  • Painful intercourse 
  • Difficult urination  

How is Bladder Prolapse diagnosed?

If you have any of the above symptoms, it is important to make an appointment with your gynecologist, who will want to complete a pelvic exam, and possibly order additional diagnostic exams as well. During the pelvic exam, your physician will look for tissue bulging into the vagina. Upon confirmation of having a Bladder Prolapse, your physician will grade the severity of the prolapse based on how far the bladder has dropped into the vagina. 

How is Bladder Prolapse Treated?

The treatment for Bladder Prolapse ranges from conservative management (such as pelvic floor physical therapy) to surgical management. If the patient has limited to no symptoms, and the prolapse is not severe, treatment may not be necessary. Rather, the patient will need to be cautious about the activities that exacerbate the prolapse, such as heavy lifting. 

However, if the prolapse is creating disabling symptoms, and/or is severe, there are a number of non-surgical treatment options. One non-surgical and rather simple form of treatment is exercise and/or pelvic floor physical therapy. Another non-surgical option is the use of a pessary device. A pessary is a small medical device inserted into the vagina to assist in holding the bladder in place and relieve symptoms 

If the above options do not work, although hope may seem lost, it is not. Dr. Praba Jeyalingam is a skilled gynecologic surgeon in the repair of Pelvic Floor Disorders, including Bladder Prolapse. Using a minimally invasive approach, there are multiple procedures Dr. Jeyalingam uses to correct Pelvic Organ Prolapse, such as Colporraphy and Sacropoplexy. Interested to learn more? Call today to schedule a consultation with Dr. Jey! 

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