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Endometriosis is a gynaecological disorder wherein the endometrium (the inner lining of the uterine cavity) implants outside the uterus in other parts of the body.
Gynecological Endoscopic Surgeon, Endometriosis Specialist, Fertility Specialist, Gynecological Oncosurgeon and Robotic Surgeon
D.N.B. , F.C.P.S. , D.G.O. (BOM) ,
D.G.O. (CPS) ,
D.F.P , M.I.C.O.G. , M.B.B.S.
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Endometriosis can occur in various sites within the pelvic cavity, including the ovaries, fallopian tubes, outer surface of the uterus, and the peritoneum.
A clinical examination for endometriosis involves a pelvic exam to check for tenderness, masses, or abnormalities in the reproductive organs. It may suggest endometriosis, but a definitive diagnosis often requires imaging or laparoscopy.
Ultrasound can help detect endometriosis by identifying cysts, lesions, or abnormalities in the reproductive organs. However, it may not always detect deeper or smaller endometrial implants.
Infertility caused by endometriosis is typically treated with medications, surgery, or assisted reproductive technologies like IVF. Treatment options depend on the severity of the condition and the individual’s fertility goals.
Infertility due to endometriosis should be treated aggressively with surgery & assisted reproduction (IUI or IVF)
Wait & watch policy may result in disease recurrence / progression, repeat surgery & irretrievable damage to ovaries
Treatment of endometriosis is multi pronged and includes a combination of medical & surgical treatment
Confirmation of diagnosis
Total excision or at least debulking (Reduction in size) of endometriosis
Better anatomy of all the organs to improve response to further treatment (Especially infertility treatment)
Removal of all adhesions (Organs getting stuck to one another) to restore anatomy of the organs
Excision of the disease
Methods to reduce the likelihood of adhesions forming again
Separation of bowel from adhesions to uterus, vagina & other organs
Release of adhesions around the ovaries & Fallopian tubes to increase chances of spontaneous pregnancy
Excision of ovarian cysts (Endometrioma) taking care to avoid damage to ovaries
Excision of endometriosis involving bowel, bladder & ureters (Deep Infiltrating Endometriosis)
Removal of endometriosis involving other tissue or organs (Deep Infiltrating Endometriosis)
It may not be possible to remove microscopic disease
It reduces inflammation (Swelling of the tissues)
It reduces the likelihood of recurrence of endometriosis
Medical therapy includes short & long term therapy
Short term therapy is to reduce inflammation and prior to starting infertility treatment
Short term therapy can cause bone loss & menopausal symptoms if given for longer than 6 months
Short term therapy includes:
GnRH analogues (Interfere with ovarian function)
Aromatase inhibitors eg. Letrozole (Interfere with the female hormone oestrogen production)
Long term medication include:
Oral contraceptive pills
Progesterone like medications including Dinogest & norethisterone
Most of these drugs can be given for many years in a healthy woman without any contraindications to these medicines
The principle is to give the short term medicines for 3 months since they are very potent in suppressing endometriosis
For long term use, any of the medicines mentioned in the previous slide can be used
The aim of medical treatment is to reduce the number of menses in a lifetime since this correlates with the risk of recurrence of endometriosis.
This is possible without any fear of adverse effects.
Medical therapy can be started as a primary therapy (Without surgery) in:
Adolescent girls with early disease to delay or possibly avoid surgery
Recurrent disease to avoid damage to ovaries
Early disease with mild symptoms
Endometriosis is a disease which can be diagnosed early if we keep a lookout for symptoms (Progressively worsening pelvic & menstrual pain)
There is no known way to prevent endometriosis, but early diagnosis and treatment may help reduce the risk of complications, such as infertility or long-term pain.
What Our Patients Say About Us Real experiences shared by those we've cared for.
Dr. Nagendra Sardeshpande performed laparoscopic surgery to treat endometriosis. He is highly skilled and one of the foremost experts in this field. He was always available to answer all our questions and made us feel comfortable and confident before, during and after the surgery. His dedication to the field and patient care is commendable. He visited the patient even during his busy schedule of traveling to different places for surgery and provided excellent care and line of treatment. We would highly recommend him for any gynaecology related issues.
Dr. Sonalee and her cousin, Dr. Tushna, are both excellent gynecologists. Dr. Sonalee has years of experience in her field and is the best gynecologist I’ve ever had. They are both very friendly and helpful. Her husband, Dr. Narendra, also practices at the clinic.
I would like to express my sincere thanks and gratitude to Dr Nagendra Sardeshpande who is expert in Obstetrician-Gynecologist, hysterectomy laproscopy surgery. Recently, my wife underwent with fibroid removal surgery from her ovaries in Medeor Hospital in Dubai. Thanks god she has been in the right hand of doctors Dr Elizabeth Mathew and Dr Nagendra. I strongly recommend anyone who wants to carry out any gyneco related surgery, please contact him. Excellent surgeon, pleasing personality and concern with patient. Great Doctor. Personal thanks and great salute to doctor
It’s a really simple and great hospital. The hospital staff is also cooperative and calm-minded. I recently had my wife’s fibroid operation there.
