Endometriosis is a common disease, which affects around 10-15 % of the female population. It is benign and chronic , It characterized by the presence of endometrial tissue ( tissue shed every month with menstruation) outside the endometrium. It affects young women, childbearing age and has dependence of female hormones.

It usually occurs in the ovary, forming endometriomas ( or also called chocolate cysts) or as implants in the peritoneal cavity, although it may aparcer in munltiples body localizaiones.

The most common symptom of endometriosis is the dismenaorrea or pain with menstruation. It can also cause pain unrelated to the rule, especially in young adolescents. Other symptoms include: pelvic pain or abdominal pain, painful bowel movements during menstruation, pain with sex. Abundant Menstrauciones , bleeding between periods. Painful urination during periods. Other gastrointestinal problems.

The symptoms are varied, and can also occur without any symptoms.

It is a disease difficult to diagnose by specific symptoms and women should visit several specialists before they reach the diagnosis. The delay in diagnosis is the ealrededor 9 years from the onset of symptoms. Why women are advised to consult specialists in the field, with the possibility of multidisciplinary approach to the disease.

For the diagnosis should perform a complete medical history and a thorough physical examination. The most useful image purebas are gynecological transvaginal ultrasound and Nuclear Magnetic Resonance. The clinical analysis: the tumor markers may be performed as CA 125, but it is not specific and can be positive in various diseases. Sometimes , and depending on symptoms, I could be performing cystoscopy and / or colonoscopy / colonoscopy.


Nowadays , You can not cure endometriosis, but if you can alleviate symptoms eimpedir disease progression

The main treatment modality is hormonal manipulation, for amenorrhea, lower hormone levels to prevent disease progression and reduce off-existing implants. They are treatments of endometriosis:

  • Progestágenos
  • Oral contraceptives
  • GnRH analogues

Surgical treatment of endometriosis.

Surgery is done if the quality of life of the woman is very affected or when vital organs are affected may compromise the health of the patient
It is recommended that this type of surgery is performed by specialized professionals with a multidisciplinary management, often necessary.

Surgery for endometriosis has two general indications: diagnostic and therapeutic.

They are indications of "diagnostic" surgery:Diagnosis of pelvic mass (endometrioma) to rule out malignancy, and diagnosis of pelvic pain.

They are indications of surgery in the treatment:

  • Acute symptoms: endometrioma rupture or torsion
  • Disabling pain or dysmenorrhea
  • Advanced disease suspected
  • Contraindication of medical treatment

Its objective is the disappearance of the symptoms of the disease eradication

Surgery should be the last option in the treatment of pain caused by endometriosis, and should always be performed after medical treatment. It will be made only if the pain is disabling, persistent and suspected deep endometriosis

Surgical approaches in endometriosis:

  • Surgical Laparoscopy
  • Conventional laparotomy
  • Robot-assisted


Laparoscopy is the technique of choice for surgical treatment of endometriosis. Most procedures can be performed using this technique.

In surgery for endometrioma or superficial endometriosis, laparoscopy is as effective as laparotomy. It has advantages as a minor complications, postoperative pain, complications and hospital stay

Laparotomy approach in endometriosis.

In some situations the laparotomy approach of endometriosis could be necessary:deep endometriosis,Severe adhesions,intestinal or ureteral involvement

No laparotomy is indicated in mild endometriosis

Robot-assisted laparoscopy

Robotic assistance has some advantages such as more accurate three-dimensional image or instruments and skillful

Finally, from the point of view of the multidisciplinary approach of endometriosis, there are a number of complementary treatments that can improve the quality of life of patients:

  • Acupuncture
  • Rehabilitation and physiotherapy
  • Sexological treatment
  • Nutritional and dietary treatment
  • Psychology
  • Psychiatry
  • Pain clinic
  • Support groups