Endometriosis Treatment Clinic

The Clinic offers:

  • • identification of endometriosis ( including specialized diagnostic modalities required )
  • • qualification for pharmacological treatment
  • • qualification for operative treatment in St. Sophia’s Hospital using the most advanced laparoscopic techniques

The Clinic provides NHF-funded and self-paid services from 8 am to 6 pm ( on selected days of the week ).
1What is endometriosis?
Endometriosis is defined as the presence of the uterine mucous membrane (endometrium) outside the uterus. Endometriotic implants are most frequently located within the abdominal cavity affecting the ovaries, Fallopian tubes, uterine ligaments, the internal area between the vagina and the rectum, the outer surface of the uterus and the true pelvis peritoneal space.

It is not uncommon for endometriotic implants to develop on the bladder walls or inside the vagina. Incidentally, endometrial tissue can be found outside the abdominal cavity – on the arm, in the lungs or even in the brain. Each endometriotic lesion is subject to cyclical hormonal changes; every month, during menstruation, the displaced endometrial tissue is shed, but it has nowhere to go since it cannot be expelled via vaginal route. This results in internal bleeding and blood product degradation which triggers inflammatory reaction in the surrounding organs and the formation of scar tissue and adhesions.
1What is adenomyosis?
Adenomyosis is a condition when endometrial tissue grows into the muscle wall of the uterus causing its enlargement.
1What are the causes of endometriosis?
The exact cause of endometriosis remains unknown. There are many theories about its etiology, however none of them explains the process comprehensively and coherently enough. Among potential causes of the disease are genetic predisposition and the immune system dysfunction. Although endometriosis is an incurable disease which can significantly interfere wit a woman’s fertility, its pain symptoms usually subside after the cessation of hormonal activity.
1What are the symptoms of this disease ?
The most common symptom of endometriosis is abdominal and lower back pain occurring during menstruation. Some women experience ongoing pain throughout their entire menstrual cycle. They often complain of intestinal pain, back pain, painful urinating or pain during or after an intercourse.

Other symptoms may include a diarrhea, constipation, bloating, irregular or heavy menstrual flow, fatigue and significant deterioration in the quality of life. Since endometriotic foci can also develop in extra-pelvic locations, some symptoms may be atypical and uncommon, e.g., coughing of blood during menstruation when the endometriotic lesion is located within the chest area or leg paresis if the implant affects the nerves supplying the lower extremity.
1What are the consequences of endometriosis?
Late diagnosis and inappropriate treatment of endometriosis may result in a range of complications considerably impairing comfort of everyday life. In unique cases the disease may pose a risk of immediate threat to life. In extreme cases, in consequence of negligence, delayed diagnosis or atypical presentation of the disease, the treatment team have to perform an artificial anus exteriorization surgery or even a hysterectomy. Unsuitable pharmacological treatment may also have a devastating effect on a woman’s health.
1How to diagnose endometriosis?
It is extremely important to obtain a complete medical history and not to neglect the patient’s pain symptoms. Ovarian endometriosis can be diagnosed during a clinical examination in a gynecology examination room. It is usually visible and identifiable on an ultrasound, magnetic resonance imaging or computer tomography scan . The remaining forms of endometriosis are not evidently visible during imaging examinations which makes them more difficult to diagnose. Many of them, however, can be identified upon a meticulous transvaginal or transrectal speculum examination.
In inconclusive cases, a laparoscopic surgery remains the only reliable method to diagnose endometriosis.
1Methods of treatment
Currently, there are two methods of endometriosis treatment used in Poland:
  • pharmacological – it most commonly involves a drug-induced amenorrhea (lack of menstruation) and alleviation of pain.
  • surgical – conservative or radical. Conservative treatment is recommended in women of reproductive age and involves adhesiolysis (lysis of adhesions), excision or ablation of endometriotic lesions or the resection of the endometriotic lesions in the neighboring organs. A radical (destructive) operative treatment is indicated in patients who do not desire future pregnancies and suffer significant pain. The procedure involves a total hysterectomy / bilateral oophorectomy (removal of both ovaries) which results in surgical menopause. Depending on the site of the endometriotic lesions, the progression of the disease and the operating doctor’s surgical skills, the procedure is performed using laparoscopy (which is the method of choice) or laparotomy. Unfortunately, recurrence occurs in about 20% of previously operated patients and repeat operations are frequently required.
  • Alternative methods supporting endometriosis treatment include among others: physical activity / physiotherapist-led exercise targeted at pelvic floor muscles, post-operative rehabilitation, osteopathy, psychotherapy, plant-based diet, adequate vitamin and microelement supplementation, etc.

OUR CLINIC DOCTORS

Radosław Maksym, MD

gynecologist, obstetrician


Arbesa Qinami, MD

gynecologist, obstetrician