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गर्भाशय में एंडोमेट्रियोसिस
में चर्चा 'All Categories' started by लक्ष्मण सिंह पंवार - Apr 4th, 2012 4:03 pm.
लक्ष्मण सिंह पंवार
लक्ष्मण सिंह पंवार
मेरी याद का 16 सप्ताह का गर्भपात (उम्र 29 वर्ष)3 साल पहले, अब गर्भधारण में समस्या। उसने 10 मिमी आकार का एंडोमेट्रोसिस किया, 1 वर्ष का डफस्टोन कोर्स किया, और डिकैफ़र, डिकैपेप्टाइल 0.1, म्यूको 500, आईयूआई ने भी 4 बार किया लेकिन कोई गूग समाचार कृपया सलाह नहीं दी।
re: गर्भाशय में एंडोमेट्रियोसिस द्वारा डॉ एम के गुप्ता - Apr 5th, 2012 9:58 pm
डॉ एम के गुप्ता
डॉ एम के गुप्ता
Dear Mr Panwar

If your patient does not have any improvement with medical treatment, she should now go for laparoscopic surgery.

Endometriosis is a female health disorder that occurs when cells from the lining of the womb (uterus) grow in other areas of the body. This can lead to pain, irregular bleeding, and problems getting pregnant (infertility).

Laparoscopy is easily the most common procedure used to diagnose and take away mild to moderate endometriosis.

Rather than using a large abdominal incision, the surgeon inserts a lighted viewing instrument called a laparoscope through a small incision. When the surgeon needs better access, he or she makes one or two more small incisions for inserting other surgical instruments.

For any laparoscopy, the abdomen is inflated with gas (co2 or nitrous oxide). The gas, that is injected having a needle, pushes the abdominal wall from the organs so the surgeon can easily see them clearly. The surgeon then inserts a laparoscope via a small incision and examines the internal organs. Additional incisions may be used to insert instruments to maneuver organs and structures for better viewing. The process typically takes 30-45 minutes.

If endometriosis or scarring must be removed, your surgeon will use one of various techniques, including cutting and removing tissue (excision) or destroying it with a laser beam or electric current (electrocautery).

Laparoscopy is usually done at an outpatient facility. Sometimes a surgery requires a hospital stay of 1 day. You will likely be able to return to your normal activities in 1 week, maybe longer.

Following the procedure, the surgeon closes the abdominal incisions with a few stitches. Usually there is little or no scarring.

Every month, a ladies ovaries produce hormones that tell the cells lining the uterus (womb) to swell and get thicker. Your body removes these extra cells from the womb lining (endometrium) when you are getting your period.

If these cells (called endometrial cells) implant and grow outside the uterus, endometriosis results. The growths are called endometrial tissue implants. Women with endometriosis typically have tissue implants around the ovaries, bowel, rectum, bladder, and on the liner of the pelvic area. They can exist in other areas of the body, too.

Unlike the endometrial cells found in the uterus, the tissue implants away from uterus remain in place when you get your period. They often bleed a little bit. They grow again when you are getting the next period. This ongoing process results in pain and other the signs of endometriosis.

The cause of endometriosis is unknown. One theory would be that the endometrial cells shed when you are getting your period travel backwards with the fallopian tubes in to the pelvis, where they implant and grow. This is called retrograde menstruation. This backward menstrual flow occurs in many women, but researchers think the immune system may be different in females with endometriosis.

Endometriosis is common. Sometimes, it may run in the household. Although endometriosis is typically diagnosed between ages 25 - 35, the condition probably begins about the time that regular menstruation begins.

A lady that has a parent or sister with endometriosis is a lot more likely to develop endometriosis than other women. You are more likely to develop endometriosis should you:

Started your period at a young age

Never had children

Have frequent periods or they last 7 or more days

Closed hymen, which blocks the flow of menstrual blood throughout the period


Pain may be the main symptom of endometriosis. A woman with endometriosis might have:

Painful periods

Pain in the lower abdomen before and during menstruation

Cramps for any couple of weeks before menstruation and through menstruation; cramps might be steady and vary from dull to severe)

Pain during or following sexual activity

Pain with bowel motions

Pelvic or back pain that could occur at any time throughout the menstrual cycle

Note: There may be no symptoms. Some women with a large number of tissue implants in their pelvis don't have any pain whatsoever, while some women with milder disease have severe pain.
Signs and tests

The care provider will work a physical exam, together with a pelvic exam. Tests which are done to help diagnose endometriosis include:

Pelvic exam

Transvaginal ultrasound

Pelvic laparoscopy


Treatment depends on the following factors:


Severity of symptoms

Severity of disease

Whether you would like children in the future

If you have mild symptoms and do not ever want children, you may choose to have regular exams every 6 - 12 months therefore the doctor can make sure the condition isn't getting worse. You can handle your symptoms by using:

Exercise and relaxation techniques

Nonsteroidal anti-inflammatory drugs (NSAIDs), for example ibuprofen (Advil) and naproxen (Aleve), acetaminophen (Tylenol), or prescription painkillers to relieve cramping and pain.

For other women, treatments include:

Medications to control pain

Hormone medications to prevent the endometriosis from getting worse

Surgery to remove areas of endometriosis or even the entire uterus and ovaries

Treatment to prevent the endometriosis from getting worse often involves using oral contraceptives continously for 6 - 9 months to prevent you from having periods and make up a pregnancy-like state. This is called pseudopregnancy. This therapy uses estrogen and progesterone oral contraceptives. It relieves most endometriosis symptoms. However, it does not prevent scarring or reverse physical changes that have already occured because of the endometriosis.

Other hormonal treatments can include:

Progesterone pills or injections. However, side effects can be bothersome and include weight gain and depression.

Gonadotropin-agonist medications for example nafarelin acetate (Synarel) and Depo Lupron to prevent the ovaries from producing estrogen and convey a menopause-like state. Side effects include hot flashes, vaginal dryness, and mood changes. Treatment methods are usually limited to Six months because it can result in bone density loss. It might be extended up to 1 year in some instances.

Surgery might be recommended if you have severe pain that doesn't improve with other treatments. Surgery can include:

Pelvic laparoscopy or laparotomy to identify endometriosis and take away all endometrial implants and scarring (adhesions).

Hysterectomy to get rid of the womb (uterus) for those who have severe symptoms and do not wish to have children later on. One or both ovaries and fallopian tubes can also be removed. If you do not have each of ovaries removed at the time of hysterectomy, your symptoms may return.

Expectations (prognosis)

Hormone therapy and laparoscopy cannot cure endometriosis. However, these treatments might help relieve some or all symptoms in lots of women for a long time.

Elimination of the womb (uterus), fallopian tubes, and both ovaries (a hysterectomy) provides you with the very best opportunity for a cure. Rarely, the condition can return.

Endometriosis can lead to problems getting pregnant (infertility). Not all women, especially those with mild endometriosis, will have infertility. Laparoscopy to get rid of scarring related to the condition might help enhance your likelihood of getting pregnant. If it does not, fertility treatments should be thought about.

With regards
M.K. Gupta
re: गर्भाशय में एंडोमेट्रियोसिस द्वारा विष्णुदास - Sep 8th, 2012 2:40 am
मेरी पत्नी एपिसिटोमी के पास स्कार एंडोमेटोसिस से पीड़ित है। उसने सभी हार्मोनल उपचार की कोशिश की। लेकिन कोई फायदा नहीं। गंभीर दर्द ने उसके जीवन को पंगु बना दिया है। स्केयर टिश्यू को हटाने के लिए भारत में कोई भी विशेषज्ञ सर्जन मौजूद है।
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