Treatment methods and indications for surgery
The choice of treatment tactics is influenced by: localization of the process and severity of the course, concomitant diseases, severity of symptoms. To a large extent, the decision on the method of treatment depends on the age of the patient and the need to restore the ability to bear children. When prescribing treatment, the goal of therapy is not only to rid the woman of the disease itself, an important role is given to the removal of negative consequences, among which the most common are the presence of adhesions in the pelvic area and ovarian cysts.
An excerpt from the television program “Doctor I...”. The story of patient Konstantin Viktorovich Puchkov, who experienced the happiness of motherhood after surgery for stage 4 endometriosis.
Currently, there are conservative and surgical treatment methods for endometriosis. The modern approach involves removing pathological lesions as much as possible and prescribing medications. In women of childbearing age with common forms of the disease, radical surgery is performed if all other methods have not brought the expected result.
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Consequences
The most common complication in sick women is the inability to become a mother now or in the future. According to doctors, every second woman who suffers from infertility has endometriosis. Infertility occurs in 40-60% of patients.
The reasons for its occurrence are usually:
- Disruption of the ovulation process.
- Formed adhesions in the area of the ovaries and fallopian tubes.
- Due to disruption of the menstrual cycle, endometrial deficiency occurs.
- Inflammation around endometrial lesions leads to the formation of adhesions, which disrupt the functioning of internal organs and cause pain.
- Too many inflammatory hormones that prevent the egg from attaching properly to the walls of the reproductive organ.
Laparoscopic surgery for external endometriosis shows all the skill of the surgeon.
Foci of endometriosis often affect various organs and tissues of the abdominal cavity and pelvis. For optimal treatment results, all lesions must be removed, taking the most radical approach to endometriotic lesions, while at the same time preserving all organs and tissues without causing damage to them. This is especially true for young women planning pregnancy. Therefore, the operation is effective when it is performed by a surgeon with experience in interventions not only in gynecology, but also in urology and proctology.
Unfortunately, if the operation is performed by a doctor who is certified only in gynecology, then he does not have the legal right to operate on the large and small intestines, ureters and bladder. Hence the fear and inability to cope with these difficult situations. It’s good if the clinic has a fairly experienced surgeon of a related specialty who is skilled in laparoscopy, but if not, then, as a rule, the lesions are left and the operation is not radical. Many years of experience in four specialties (surgery, gynecology, proctology and urology) allows me to perform such operations with the highest quality and safety for the patient. Patients from all over the world often come to me after unsuccessful 3-4 operations for deeply infiltrative endometriosis affecting many organs and systems. After competent surgical treatment, even with stage 4 endometriosis, they enjoy a completely different quality of life and become happy mothers.
How do pieces of mucous membrane get to other places?
This happens in different ways. In some people, endometrial ectopia occurs in the embryonic period at the stage of tissue and organ formation. For some reason, the intrauterine development program failed, and the result was endometriosis!
It also happens that some of the cells of certain tissues and organs are taken and transformed into endometriotic cells under the influence of hormones and other biological stimulants. And during menstruation, endometrioid cells easily enter the bloodstream and travel through the circulatory system to settle in one place or another in the body.
It’s good when a woman has only one of the mechanisms described above for the development of endometriosis, but what if suddenly all three? Then the disease will progress especially actively and persistently, which means you need to seek help from a doctor as early as possible. All necessary examinations can be completed at a medical clinic, or you can do nothing and wait for the disease to go away without the intervention of a doctor.
Unique laparoscopic technique of Professor K.V. Puchkov:
- Use of European and American materials and equipment
- Minimal tissue trauma
- Effective pain relief
- Radical removal, rather than “cauterization,” of endometriosis foci
- Preservation of the reproductive system (uterus, tubes, ovaries)
- Prevention of adhesions, use of anti-adhesive gels
- Restoration of reproductive function
- Possibility of simultaneous correction of other problems within one operation (for example, removal of uterine fibroids and endometriosis)
- Excellent cosmetic effect (no scars or scars)
- Fast recovery after surgery
Read more about the disease and the unique method of surgical treatment of endometriosis
Recovery and postoperative period
- After laparoscopic surgery, 3 5 mm long incisions remain on the skin of the abdomen.
- From the first day, patients begin to get out of bed and take liquid food.
- Discharge from the hospital is carried out within 1-2 days, depending on the severity of the disease and the extent of the surgical intervention performed.
- Restoration of work capacity occurs on the 10th - 14th day after surgery.
- Sexual activity is not advisable for a month.
- In order to prevent relapse of endometriosis, a course of hormonal therapy may be prescribed for 3-6 months.
- Possibility of pregnancy 6-8 months after surgery
- Dynamic observation by a gynecologist (examination and ultrasound after 1, 3 and 6 months) and related specialists (proctologist, urologist) is necessary.
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Patient reviews
Pologova Galina
Text and subsequent video review of a patient with stage 4 endometriosis who became a mother
I express my gratitude to Konstantin Viktorovich and his entire wonderful team for the opportunity to become a mother!
After a short correspondence, in January 2015, Konstantin Viktorovich invited me for an examination through laparoscopy, as a result, extensive endometriosis of the pelvic peritoneum behind the uterus was removed, which had prevented me from getting pregnant for 10 years! In May 2015, the long-awaited pregnancy already arrived! In February we became parents of a wonderful daughter!
Thank you! Life is created with your hands!
Best regards, Elvira Sultanova! City Ufa. [email protected]
Ikonnikova Olga
Good afternoon My name is Olga Ikonnikova, Novosibirsk.
I want to tell you my story called: “Endometriosis and infertility or Dreams come true!”
3.5 years ago, my husband and I began planning to have a child. I decided to undergo a full examination, and I was regularly observed by a gynecologist; an ultrasound revealed a small endometroid cyst in the right ovary. She underwent drug treatment, but did not achieve a good result. The cyst began to grow and soon appeared in the left ovary.
In April 2011, I was taken by ambulance to the hospital. There was apoplexy of the left ovary, in other words, the release of blood from the ovary into the abdominal cavity. The doctors performed a laparoscopic operation, after which they didn’t even tell me that I already had severe endometriosis.
During further examination, the gynecologist ordered a test for patency of the fallopian tubes. Adhesive processes were detected. I contacted the family planning and reproduction center in Novosibirsk, where in December 2011 a laprascopic operation was performed to clean the fallopian tubes and remove cysts from both ovaries. And only after this operation the doctor made a diagnosis: Infertility, external genital endometriosis, stage III-IV. Endometriotic cyst of the right ovary, retrocervical endometrium III-IV, adhesive periadnexitis, perimetritis. Adhesive process in the pelvis, stage IV. In January 2012, it was decided to administer diferelin, which was supposed to stop the inflammatory process. An ultrasound was done in March 2012. Result: Large endometroid cyst.
As the doctor said, I won’t be able to get pregnant, either naturally or through IVF, and medicine in Novosibirsk is powerless. What I experienced cannot be expressed in words. But I decided not to give up and asked the doctor what could be done, he advised me to contact Konstantin Viktorovich Puchkov.
I turned to Konstantin Viktorovich in the form of a letter sent to his email address, found on the Internet with my problem. The next day the answer came. I was pleasantly surprised by such efficiency, especially when you are waiting for help.
At the beginning of April 2012, I was already operated on. The operation was successful and after 4 days I was already back in Novosibirsk. The rehabilitation period lasted until August and then it was allowed to try to get pregnant. Of course, it didn’t work out right away. I bought ovulation tests and took hormone tests, but pregnancy did not occur. I was very upset, but in my heart I believed that it would definitely work out. Doctors in Novosibirsk began to insist on IVF, saying it was not too late. I called Konstantin Viktorovich, outlined the situation, to which he told me that we should not agree for now and that we would wait until February 2013; if pregnancy does not occur, then we will think about what to do next. Konstantin Viktorovich’s words turned out to be prophetic; it was in February that I found out that I was PREGNANT.
The pregnancy was going well. In October 2013, I became the mother of a long-awaited baby. I gave birth to a boy, weight 3820 g, height 55 cm. Dreams come true!!!
Recently I read a statement about doctors on social networks. Popular rumor says that doctors are divided into 3 categories: 1. Doctor from God. 2. Well, with God. 3. God forbid.
So Konstantin Viktorovich is a Doctor from God who approaches the problem not only with knowledge of the matter, but also with soul. High professionalism, patience, tact and humanity - that’s what I saw in this man. I wish you health, only successful operations, good luck in your work and of course great happiness! God bless you! Thank you!
Also, many thanks to all the staff of the Swiss University Hospital for their sensitivity, sincerity and understanding. Contact Konstantin Viktorovich and know that you are in good hands! Don't despair, everything will be fine!!!
Ikonnikova Olga, Novosibirsk. [email protected]
“Laparoscopic operations in gynecology”, K. V. Puchkov, A. K. Politova
What examination do you need to undergo?
Even a routine gynecological examination in a chair allows the doctor to suspect endometriosis by the enlargement of the ovaries and the presence of characteristic nodular formations. There are many of them, touching them causes discomfort in the patient. They are localized in the area of the uterosacral ligaments or between the rectum and vagina, increasing closer to menstruation and decreasing after their end.
Ultrasound examination using a vaginal probe will help clarify the diagnosis, and laparoscopy may be required for its final confirmation. This procedure allows you to view your pelvic organs through a flexible, fiber-optic tube. The device is inserted through a small hole in the lower abdomen. Don't be afraid, it won't hurt: the procedure is performed under local anesthesia. The latest equipment for ultrasound examination, as well as expert doctors from the Zdorovye medical clinic network, will help you quickly and accurately make a diagnosis.
Photo: tutatama / freepik.com
