DIAGNOSIS AND TREATMENT OF ENDOMETRIOSIS
Endometriosis is a disease of the peritoneum. The diagnosis can only be made by inspecting the abdominal cavity and, if necessary, taking tissue samples; this is done by laparoscopy under anesthesia. Important: the laparoscopy should be performed in an appropriately equipped hospital so that, if necessary, a targeted and gentle laser treatment can be performed under the same anesthesia. In this process, the foci are partly excised and sent for tissue examination, and partly vaporized (vaporized).
Top: Advanced endometriosis (stage III) with typical chocolate cyst on the left ovary. This is thickened menstrual blood. The cyst is opened, flushed ...
... and, depending on the situation, removed completely or treated all around with the laser beam. The healthy ovarian tissue recovers quickly; the patient shown above became pregnant naturally within six weeks!
POST-TREATMENT AFTER LASER SURGERY
According to the current state of knowledge, it is only rarely useful to obliterate remnants of endometriosis with medication after laser surgery. This is best done with so-called GnRH analogues, which are administered as injections every four weeks and inhibit the function of the pituitary gland. This induces a state similar to menopause for two to three months. However, in order to prevent the patient from experiencing troublesome menopausal symptoms (sweating, flushing, vaginal dryness), she is also given a low, constant dose of estrogen in tablet or patch form (so-called add-back treatment). From this "downregulation", IVF treatment can be started directly.
Microscopic tissue examination (histology) of an endometriosis lesion with glandular tubes and so-called stroma.
In young women who do not wish to have children, it is advantageous to use a special form of contraception (e.g. continuous pill or hormonal IUD). The course of endometriosis is not predictable. Some women are cured (often after pregnancy), some have numerous, painful relapses over years.
Patients with supplementary hospital insurance can be treated by Dr. med. Niklaus Lang with the laser method in the Hirslanden and Im Park clinics.