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Endometriosis is a systemic inflammatory disease process in which tissue similar to the lining of the uterus (endometrium) grows outside of the uterus. This most commonly occurs in the pelvis, but lesions can also appear in other parts of the body, including the bowel, bladder, diaphragm, or even the lungs. Endometriosis is quite common, affecting one in ten women in the United States, and can cause chronic pelvic pain and infertility. Symptoms of endometriosis can range in severity from minor to debilitating. Common symptoms of endometriosis include lower abdominal pain, bloating, and pain with or after intercourse.
It may also cause urinary symptoms such as bladder pain or discomfort, urgency, frequency, or burning with urination, and bowel symptoms such as chronic constipation or pain or discomfort with bowel movements.
As endometriosis is a silent disease process which is often difficult to identify, many patients see many medical providers before receiving a diagnosis. Commonly, patients are diagnosed with Irritable Bowel Syndrome rather than endometriosis to explain their symptoms.
It is common and not necessarily a cause for concern to have had surgery and still be experiencing symptoms.. Often, treating endometriosis’s associated underlying nerve inflammation and pelvic floor muscle spasms will help resolve any remaining post-operative symptoms. Endometriosis is a complicated chronic condition with effects that vary widely from person to person depending on where the endometriosis lesions are located. One constant is that endometriosis causes nerve pain and inflammation. Endometriosis-associated nerve inflammation and pelvic muscle spasms contribute heavily to the symptoms of endometriosis.
At Pelvic Rehabilitation Medicine, we treat this with ultrasound-guided peripheral nerve block and trigger point injections. These are safe, effective, externally-guided same day outpatient treatments that work to decrease the pain and inflammation around the pelvic nerves and relax the spastic pelvic muscles associated with endo. There is no subsequent downtime, meaning patients can go straight back to work and regular activities after the procedure. While a treatment plan may include medications directed at nerve pain and muscle spasms, we are also able to use a variety of non-pharmaceutical techniques such as mindfulness and meditation courses, as well as lifestyle approaches focusing on nutrition, sleep, and exercise.
Unfortunately, the only fully effective method of achieving remission from endometriosis lesions, pain, and dysfunction is endometriosis surgery, which we are able to perform in-house at multiple Pelvic Rehabilitation Medicine locations. While some care providers use ablation surgery, in which lesions are burned away, this procedure carries much higher risk of not removing all lesions and resulting in recurrence of pain and dysfunction.
At Pelvic Rehabilitation Medicine, our doctors only perform endometriosis excision surgery – the gold standard of treatment – in which lesions are directly cut away to ensure full removal of the disorder. Our surgeons on staff are experts in endometriosis excision surgery, and have significant experience in helping patients find relief from endometriosis, even in cases where the disorder is at a significantly advanced stage.