Endometriosis is a benign, chronic condition in which tissue similar to the lining of the uterus grows outside the uterus. The extent of the disease can vary considerably – from small superficial lesions to deep infiltrating endometriosis involving different organs within the pelvis.

Pain is a common symptom and is often related to the menstrual cycle. However, endometriosis may also cause few or no symptoms and may only be discovered during an evaluation for infertility.

Possible Symptoms

Common symptoms include:

• severe pain during menstruation
• chronic or recurrent lower abdominal and pelvic pain
• pain during sexual intercourse
• pain during bowel movements or urination, particularly during menstruation
• heavy or irregular bleeding
• difficulty becoming pregnant
• cycle-related bowel or bladder symptoms

The severity of symptoms does not always correspond to the extent of the disease. Even small endometriosis lesions can cause significant pain.

Diagnosis

Evaluation begins with a detailed medical history and careful assessment of symptoms. A gynecological examination and, in particular, targeted transvaginal ultrasound can provide important information about endometriosis, ovarian endometriomas, or deep infiltrating disease.

In certain situations, additional imaging such as MRI may be useful.

In selected cases, laparoscopy (keyhole surgery) may be performed for further evaluation and, at the same time, surgical treatment.

Individualized Treatment

Not every case of endometriosis requires surgery. The appropriate treatment depends on several factors, including the type and severity of symptoms, the extent and location of the disease, and the desire for future pregnancy.

Depending on the individual situation, treatment options may include:

• medical pain management
• hormonal treatment
• clinical monitoring where appropriate
• surgical treatment
• a treatment strategy adapted to fertility goals when pregnancy is desired

The aim is to reduce symptoms effectively while avoiding unnecessary surgical procedures.

Minimally Invasive Surgical Treatment

When surgery is medically indicated, it is generally performed using minimally invasive laparoscopy or – in appropriately selected complex cases – robot-assisted surgery.

The aim of surgery is to remove visible endometriosis lesions as completely as possible, release adhesions, and preserve healthy tissue and important anatomical structures wherever possible.

Particularly in deep infiltrating endometriosis, precise surgical planning is essential, as the disease may involve the bowel, bladder, ureters, or other structures within the pelvis.

As an experienced surgeon in minimally invasive and robotic gynecological surgery, Dr. Arsenakis has the surgical expertise to assess complex findings and plan the appropriate treatment strategy.

Endometriosis is more than period pain. Targeted diagnostics and appropriate treatment can make an important difference in reducing symptoms and improving quality of life.