How to treat recurrent endometriosis

After the onset of endometriosis, if it is a recurrent disease, the patient's body will also experience various discomfort symptoms, such as excessive menstruation, dyspareunia, heavy stools, etc., so timely examination and treatment are required. Generally, the treatment of recurrent endometriosis is also carried out according to the basic treatment, and adjustments will be made later if there are special circumstances.

Signs of endometriosis recurrence

1. Dysmenorrhea. Dysmenorrhea is the most typical and common symptom of patients with endometriosis. It is mostly secondary and progressively worsens.

2. Excessive menstruation. Endometriosis has a great impact on the patient's menstruation. When the symptoms of excessive menstruation reappear, it is likely to be a symptom of recurrence of endometriosis, such as increased menstrual volume and prolonged menstrual period, which are closely related to female ovarian dysfunction.

3. Pain during sexual intercourse. Some cases of endometriosis may also cause pain during sexual intercourse in patients. This is because when endometriosis is located in the rectouterine pouch and the vaginal rectal septum, it will cause swelling of the surrounding tissues, causing pain during sexual intercourse in patients.

4. Heavy and distended stools. When endometriosis affects the patient's bladder, it will cause frequent urination and painful urination; when it affects the patient's rectum, it will cause symptoms such as heavy and distended stools.

5. Infertility. Pay attention to the symptoms of recurrence of endometriosis. Some endometriosis may cause infertility in patients, and the infertility caused by endometriosis has become the main cause of female infertility.

Diagnosis and treatment of recurrent endometriosis

The cause of endometriosis is unclear, and current epidemiological surveys show that the annual recurrence rate is about 10%. The recurrence rate is high. However, there is currently a lack of a unified and clear diagnostic standard for the recurrence of endometriosis. For example, if an ovarian endometriosis cyst is found during a follow-up examination 2-3 months after endometriosis surgery, some people may think it is a recurrence, but it may actually be a cystic effusion. Therefore, we must first clarify whether it is a recurrence, give the patient some time to observe, and avoid over-medicalization. Recurrence refers to the reappearance of clinical symptoms after endometriosis has been relieved by surgery and/or drug treatment, and the symptoms return to the pre-treatment level or worsen, or endometriotic cysts appear again.

The treatment of patients with recurrent endometriosis basically follows the principle of initial treatment, but it must be individualized, that is, an individualized treatment plan should be developed based on comprehensive consideration of the patient's age, fertility requirements, symptoms, signs, and previous treatment history. If the patient is older and near menopause, radical surgery can be chosen; if the patient is young and infertile, reproductive medicine methods may be needed to treat it; if the main symptom is pain, surgery can be the main treatment, with postoperative auxiliary drug treatment.

In addition, it also depends on the location of the endometriosis. The treatment measures for endometriosis in different locations are different. For elderly patients (age > 35 years) who wish to have children and have recurrent ovarian endometrial displacement cysts, their fertility should be evaluated first, and a decision on whether to undergo surgery should be made after they have completed childbearing or protected their fertility function. If the recurrent ovarian endometrial displacement cyst is large and CA125 is significantly elevated, surgical treatment is still required to rule out the possibility of malignancy. If the patient wants to have children, and the recurrent cyst is not large and the symptoms are not obvious, another surgery will cause certain damage to the ovarian reserve function, so childbearing should be completed first.