Ovarian Endometriosis

Ovarian endometriosis is also associated with severe pain, regardless of the cyst’s size. However, it’s not uncommon to see large endometriomas causing no pain.

However, the relationship between ovarian endometriosis and pain is not always straightforward. It’s possible for severe pain to accompany even small-sized cysts, while large endometriomas may exist without any pain.

Typically, ovarian endometriosis is bilateral, leading to what’s commonly referred to as “kissing ovaries.”

These can occur in various sizes and often associate with deep endometriosis. However, isolated and unilateral cases of ovarian endometriosis may also occur.

Ovarian endometriosis usually presents with chronic pelvic pain, dysmenorrhea, and dyspareunia. Some women may experience irregular menstrual cycles, heavy bleeding, or even infertility.

It’s important to note that the severity of symptoms doesn’t always correlate with the extent of the disease; some women with extensive endometriosis may remain asymptomatic.

For diagnosis of ovarian endometriosis, it involves a combination of clinical examination, imaging techniques, and, at times, surgical intervention.

Transvaginal ultrasound is typically the first-line imaging modality due to its wide availability and excellent sensitivity.

Magnetic Resonance Imaging (MRI) serves as a more precise tool for detecting deep infiltrating endometriosis. Ultimately, a definitive diagnosis can only be established through laparoscopic surgery and histological examination of the excised tissue.

Dr. Jay Mehta and his colleagues follow a stepwise protocol resulting in 85-90% accuracy in endometriosis mapping, which requires a high level of expertise.

Dr. Jay Mehta is a renowned fertility specialist with extensive experience, expertise in endometriosis treatment & the results he has shown. He is considered one of the top endometriosis doctors in Mumbai.

For small ovarian endometriomas, especially those smaller than 3cm, medical management in the form of continuous oral contraceptive pills or dienogest is typically recommended.

Patients are kept on a 6-month follow-up to monitor the disease progression.

Surgery is typically indicated for ovarian endometriosis larger than 5 cm, or if the endometrioma is multiloculated or multicystic. Severe pain associated with ovarian endometrioma is another indication for surgical management.

The ideal surgical approach for treating ovarian endometrioma is laparoscopic surgery, considered the gold standard for diagnosing and treating endometriosis.

A well-performed laparoscopic surgery, especially in 3D, gives the doctor an excellent depth perception of the disease in the pelvis, ensuring complete disease clearance and minimal recurrence post-surgery.

One of the most common mistakes patients make is opting for a non-specialized surgeon for their first endometriosis operation. Unfortunately, this can lead to the need for a second surgery performed by an expert.

By this time, fertility may already be compromised due to poor surgical technique in the initial procedure. It’s important to choose a surgeon with expertise to ensure the best possible outcome.

It’s absolutely crucial to never underestimate the impact of choosing the right doctor for endometriosis treatment. It can make a huge difference.

Dr. Jay Mehta and his team operate more than 500 cases of Endometriosis across India annually. Dr. Jay is a very experienced fertility & endometriosis specialist in Mumbai.