Endometriosis: Diagnosis & Treatment

Overview

Endometriosis is a condition in which endometrial tissue (the inner lining of the uterus) grows outside the uterus, affecting the ovaries, fallopian tubes, peritoneum, and other pelvic organs. It occurs in 10-15% of women of reproductive age and is a common cause of pelvic pain and infertility.

Symptoms:

• Painful menstruation (dysmenorrhea)

• Chronic pelvic or abdominal pain

• Infertility

• Pain during intercourse (dyspareunia)

• Heavy or irregular menstrual bleeding

Diagnosis

A combination of clinical evaluation and imaging studies is used to confirm endometriosis:

• Transvaginal ultrasound – First-line imaging for detecting endometrial cysts (endometriomas).

• Magnetic Resonance Imaging (MRI) – Provides a detailed assessment of deep infiltrative endometriosis.

• CA-125 Blood Test – A tumor marker that may be elevated in moderate to severe cases.

• Biopsy – Confirms diagnosis when obtained through laparoscopy.

• Diagnostic Laparoscopy – The gold standard for diagnosing and staging endometriosis; allows direct visualization and biopsy of lesions.

Treatment

The choice of treatment depends on symptom severity, lesion extent, and reproductive goals:

1. Medication TherapyHormonal therapy (combined oral contraceptives, progestins, GnRH agonists) to suppress endometrial growth and relieve symptoms.
   Pain management (NSAIDs) to control inflammation and discomfort.
   

2. Surgical TreatmentLaparoscopic Surgery – Minimally invasive removal of endometriotic lesions and adhesions to preserve fertility.
   Abdominal Surgery – Reserved for severe cases where deep infiltrative lesions involve multiple organs.
   Hysterectomy with Ovariectomy – Performed in advanced or refractory cases when other treatments fail, particularly in women not planning future pregnancies.
   

Cost of Diagnosis & Treatment:

• 10,000,000 – 12,000,000 KRW