Treatment options for incisional endometriosis

We all know that the female body structure is very complex. Often due to some reasons or after cesarean section, it is easy to cause some problems in the uterus. Among them, incisional endometriosis is a common gynecological disease after cesarean section. It has a relatively large impact on women’s physical health, so it must be treated in time. Let us learn about the treatment methods of incisional endometriosis.

Treatment options for incisional endometriosis

1. Medication

Drugs are used to counteract or suppress cyclical endocrine stimulation of the ovaries. Initially, testosterone-type male hormones were used, but they had serious side effects and were not strong enough, so they were gradually abandoned. Later, it gradually developed into pseudo-pregnancy therapy and pseudo-menopause therapy.

(1) Pseudo-pregnancy therapy is the use of powerful progestin contraceptive drugs, which are taken continuously for a long time in larger doses to stop menstruation. The endometrium and ectopic endometrium undergo a pregnancy-like reaction under the action of the drugs, so it is also called pseudo-pregnancy therapy. There are many drugs used for this therapy, and they are still being developed. The main ones for oral administration include progesterone acetate, provira, and nemethicone, while the ones for intramuscular injection include progesterone caproate. This treatment must be continued for at least six months before the ectopic endometrium can stop moving and eventually shrink, thus producing therapeutic effects.

(2) Pseudomenopause therapy In the 1970s and 1980s, foreign countries mainly used a drug called danazol, which is a derivative of androgen and has a good effect. It is also being used in my country, but it has relatively large side effects. Since the 1980s, a drug called goserelin has been widely used abroad. It can strongly suppress the function of the ovaries, making them almost completely ineffective, thereby achieving the purpose of treatment. Moreover, since this drug is a long-acting sustained-release preparation, it only needs to be injected subcutaneously once a month, which is very convenient. This type of drug can cause the endometrium to atrophy similar to that of menopausal women, so it is called pseudomenopause therapy.

2. Surgical treatment

It is generally believed that chocolate cysts occurring on the ovaries are often larger in size, or endometriotic nodules occurring in other parts of the body with a diameter of more than 2 cm are difficult to control with drugs and require surgical treatment; or if the condition does not improve after six months or even a year of drug treatment, surgical removal should also be considered. If the patient is young and has no children, surgery usually only removes the endometriosis, while preserving the uterus and normal ovarian tissue. It's called conservative surgery. This surgery preserves the possibility of fertility, but the chance of recurrence is greater. If the patient already has children and is older (35), the uterus can be removed at the same time as the endometriotic lesions are removed, while preserving the normal ovarian tissue. In the long run, this method is better than conservative surgery, but it cannot absolutely prevent recurrence. If the patient is near menopause, or the endometriosis is too extensive to be completely eradicated, the uterus and ovaries should be removed during surgery.

The above is an introduction to the treatment of incisional endometriosis. Many women with gynecological diseases always think that it is no big deal and will not take the initiative to seek treatment. They often wait until the disease becomes serious or brings us more and more pain before they think of treatment. In fact, this is an irresponsible behavior towards physical health, because all diseases are best treated only in the early stages of the disease.