Written By: Longjam Dineshwori | Updated : June 24, 2021 8:35 PM IST
Doctors are seeing a sharp rise in endometriosis (a multi-system disorder) cases with many women complaining of painful menstruation, cramping, painful sex, constipation, loose motions, bloating, back pain, leg pain, pain while urinating, pain while passing stools, and rectal bleeding. But there are also many women who are asymptomatic, and some suffer in silence due to the lack of awareness. About 25 % of endometriosis cases suffer from fertility issues but more than 90% suffer from pain, according to Dr. Abhishek Mangeshikar, Consultant Laparoscopic and Robotic Gynaecologist, ACI Cumball Hill Hospital, Mumbai.
He explained - Endometriosis affects girls and women of reproductive age and is attached to any organ associated with reproduction. It can be described as an abnormal growth of tissues resembling the uterine lining outside the uterus. The cause of endometriosis is unknown although there are many theories. The common symptoms are intense pelvic pain, infertility, long menstrual cycles, nausea, or vomiting.
"The endometriosis is quite common now and affects more in women than breast cancer. However, many have not heard of it and the disease has not got the attention it deserves typically because it is not terminal. Many women may complain of excessive pain during periods, but it is mistaken to be normal and they are asked to be stronger due to the lack of awareness," he added.
Dr. Abhishek explained the different stages of endometriosis this way:
Dr Mangeshikar said he had seen hundreds of patients with endometriosis (in person and teleconsultation) since the last 9 months. However, during the second wave, only those patients with severe pain who needed emergent surgery and procured the necessary documents for them to travel during lockdown were treated.
"We operated 10 cases successfully during the 2nd wave. I have limited the number of surgeries to emergency and semi-emergency cases so as not to utilize limited resources during Covid and we successfully managed 56 cases of advanced endometriosis during this time," he stated.
Timely diagnosis, appropriate treatment and considerable knowledge about the disease will help women to improve their quality of life, Dr Mangeshikar noted.
The expert elaborated: Endometriosis needs its own subspecialty and advanced disease is outside the realm of routine OBGY practice and must be dealt with by specialized endometriosis centers. Surgery needs to be done by a well-trained, well-coordinated team of specialists and treatments need to be tailored toward the patient and not just towards the disease. Every case is different and treatment has to be tailored.
Due to the COVID 19 pandemic, doctors at the ACI Cumball Hill Hospital are doing pre-op counseling, diagnosis, and surgical planning via virtual consultations where the patients' MRI imaging can be screen shared and they can explain their diagnosis very well. The patients needing surgery are admitted one day prior to their surgery and they are discharged usually with 24 72 hours depending on their recovery and complexity of the surgery. They can return home directly after being discharged from the hospital.
A 20-year-old young lady from Mangalore, who is currently in her 3rd year of MBBS, suffered from severe pain during menstruation and ovulation causing debilitation and loss of quality of life. She reported excruciating pain for at least 10 days out of a month which compromised her ability to perform in a course as demanding as MBBS. She had visited many gynaecologists who prescribed her over-the-counter pain medication while some even told her to get married and did not taking her pain seriously.
At the ACI Cumball Hill Hospital, after reviewing her imaging, the doctors found an endometriosis cyst (chocolate cyst) in the ovary which was attached to her rectum and pelvic sidewall. She was recommended a laparoscopic excision of the endometriosis where the disease is cut out or excised which has much better results than the traditional technique of burning the disease.
A laparoscopy gives the patient the benefit of undergoing major surgery through very tiny abdominal incisions which makes recovery very fast. She was discharged from the hospital in 24 hours. "Earlier, my life was miserable due to period pain. But now it has drastically reduced, and I can do my daily chores with ease," said the patient.
There are many patients like this woman who are fighting this problem while some suffer in silence as many cases go unreported, the hospital pointed out in a statement.
