Scar endometriosis

Over recent months I have seen an unusual number of patients with endometriosis in various scar sites.  The most common situation follows the performance of a caesarian section with a deposit of endometriosis within the operative field.  More rarely and usually without prior surgery (including laparoscopy) the umbilicus can be affected.  Interestingly I have not…

When should the bowel surgeon get involved with endometriosis involving the bowel?

The answer seems simple. The bowel surgeon should be involved early in the process. I agree. The bowel surgeon should ideally have the seen the patient in a pre-operative consultation to discuss the planned procedure, results and potential complications.  The intra-operative timing is the critical thing. If the gynaecologist has minimal surgical skills then invariably…

Dilemmas and controversies in the management of ovarian endometriosis and infertilty

A recent consensus statement on endometriosis and infertility indicates that some women may benefit from a combination of assisted reproduction and surgery.  Unfortunately the data are limited and somewhat conflicting. This is not uncommon when surgery is involved as there is inevitably a degree of operator (or surgeon) dependence. It is self-evident with diseases such…

Endometriosis and ovarian cancer

A recent report published in Lancet Oncology has raised again the possibility that endometriosis and certain types of ovarian cancer may be closely linked.  The authors admit that further analysis is required although suggest that people should consider ongoing surveillance.   Unfortunately there are significant problems with the data particularly the patient recollection of a…

Bleeding gums and endometriosis

I had a fascinating discussion with a dentist recently in relation to gum disease (periodontal disease) and other chronic inflammatory diseases.   Several research studies have associated gum disease with other chronic inflammatory diseases such as diabetes, cardiovascular disease, rheumatoid arthritis and now possibly endometriosis.  There are various grades of severity of periodontal disease and…