Endometriosis is a complex condition that impacts 10-15% of women globally, yet many aspects of its care and treatment are often overlooked. Dr. Anshumala Shukla-Kulkarni, Head of Minimally Invasive Gynecology and Laparoscopic and Robotic Surgery at Kokilaben Dhirubhai Ambani Hospital, Mumbai, highlights critical mistakes to avoid in managing endometriosis.
1. Late Diagnosis
Delay in diagnosis is a significant issue in endometriosis care. Many women dismiss symptoms such as chronic pelvic pain or painful menstruation as normal, and seek medical attention only when infertility becomes an issue. The disease often begins in adolescence, but it’s commonly misdiagnosed or overlooked due to the difficulty in distinguishing it from regular menstrual pain. Early identification through standardized screening protocols and routine gynecological assessments is essential. Increased public awareness and education are crucial to recognizing endometriosis at an earlier stage and preventing prolonged suffering.
2. Fragmented Care and Lack of Multidisciplinary Support
Endometriosis affects multiple organs, requiring the expertise of various specialists. Comprehensive care must involve a multidisciplinary team, including gynecologists, urologists, colorectal surgeons, pain specialists, fertility experts, and radiologists. However, many healthcare systems struggle to provide integrated care, which leads to fragmented treatment and longer suffering for patients. Treatment plans should be tailored according to the patient’s stage of endometriosis, considering factors such as the location, size, depth of the endometrial implants, and the degree of scar tissue.
3. Inadequate Pain Management
Pain management for endometriosis is often inadequate, with many women relying solely on painkillers. This approach overlooks more advanced techniques that can significantly improve a patient’s quality of life. Comprehensive pain management should include hormonal treatments, nerve block procedures, physiotherapy, psychological support, and lifestyle modifications. Inadequate pain management often results from delayed diagnosis, as well as a hesitancy among doctors to perform laparoscopy to confirm the disease. Addressing the excess prostaglandins that contribute to pain and inflammation is essential for effective treatment.
4. Neglecting Advanced Surgical Techniques
For severe cases, surgery may be necessary, but traditional surgical procedures often come with long recovery times and potential complications. Advanced surgical techniques like robotic-assisted surgery, minimally invasive laparoscopic procedures, and nerve-sparing techniques offer better outcomes and faster recovery. Unfortunately, access to these advanced methods is limited, and there is a need to raise awareness about their benefits. Incorporating these cutting-edge techniques into treatment plans can significantly improve the prognosis for women with severe endometriosis.
5. Overlooking Fertility Preservation and Support
Infertility is a common struggle for women with endometriosis, but fertility support is often not integrated into their treatment plans. Specialized Assisted Reproductive Technologies (ART), including in vitro fertilization (IVF) and egg freezing, should be made accessible to these women. In addition, fertility counseling and individualized reproductive care plans should be offered to every patient. Endometriosis causes inflammation and scar tissue around the ovaries and fallopian tubes, altering the hormonal environment and immune system, which can impair egg quality and inhibit implantation. Timely intervention to preserve fertility and provide reproductive health support is crucial for many women with endometriosis.
Conclusion:
Raising awareness about endometriosis, offering timely diagnosis, and adopting a holistic approach to care can significantly improve the quality of life for affected women. A cohesive, multidisciplinary approach that includes comprehensive pain management, advanced surgical options, and fertility preservation is key to achieving better outcomes for those living with endometriosis.
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