Endometriosis Centre

What is endometriosis?

Endometriosis is a condition in which tissue similar to the endometrium (which is the inner layer of the womb)  grows outside the uterus.Endometriosis is the 2nd most common gynaecological condition. It is well known  that 1 out of 10  women of reproductive age suffer from endometriosis and it is as common as diabetes.In our country knowledge around this subject is frequently inaccurate and some times false.

The most common symptoms are:

  • Painful periods: menstruation can cause a certain level of discomfort or pain.If pain doesn’t resolve with simple pain killers then the likelihood of having endometriosis rises significantly.
  • Pain during or after sexual intercourse
  • Gastrointestinal symptoms like diarrhea or constipation
  • Infertility: out of 10 women that are having difficulty in getting pregnant, 5 of them will have some form of endometriosis.
  • Non-cyclical pelvic pain

What is the purpose and significance of an Endometriosis Centre?

 The purpose of the Endometriosis Centre is to provide high quality of specialized care to women suffering from endometriosis in order to improve their quality of life and increase their chances of a future pregnancy.

Managing endometriosis requires most of the times the cooperation of doctors of various specialties (endometriosis surgeon,colorectal,urologist,thoracic surgeon etc).The role of the team (Multidisciplinary Team/MTD) and the smooth collaboration between its members has proved to be a very important factor for the success of an endometriosis operation.In Western societies,it is clear now that endometriosis cases must be referred to specific centers  where the right expertise and means to treat the disease are available.This can be easily understood with the following example:if, for example,a woman has ovarian cancer, she will address to the gynaecological Oncologist and not to the general Gynaecologist.The later is specialized in treating the female cancer and can achieve (along with his team) a better result that the general Gynaecologist.

Unfortunately, in Greece there was not such a specialized Centre with the relevant experience. This fact reflected upon patients who were put in a vicious cycle of multiple failed surgeries without any improvement.

Endometriosis Centre in Mediterraneo Hospital

Mediterraneo Hospital is the first Hospital in south east Europe that introduces the term of an Endometriosis Centre and MTD meeting. The procedures in the Endometriosis Centre in Mediterraneo Hospital are the same with the busiest Endometriosis Centres in UK (CEMIG St. Peter’s, Surrey, UK και CEMIG HCA, The Lister, London, UK) with which there is continuous collaboration and cooperation.The Endometriosis Team in Mediterraneo Hospital has successfully dealt with very complex endometriosis cases.

What is the different aspect of my endometriosis surgery that will take place in Mediterraneo Hospital?

As opposed to routine daily practice in Greece ,where ablation plays the major role (that means coagulating the lesions),the Endometriosis Centre in Mediterraneo Hospital is the only tertiary referral Hospital in south-east Europe where only excision of endometriosis is applied.That means that all endometriosic tissue is completely removed from the body.This technique is  used in the busiest Endometriosis Centres of the world.This technique offers a definite and successful treatment of endometriosis ,minimizing at the same time the rate of recurrence.

When using ablation (coagulation) on endometriosis lesions,the surgeon destroys the surface of the lesion by using heat or laser.In that way only the top of the lesion is destroyed whereas the deeper part of the lesion stays intact and active.The result is that after a couple of months  this lesion is growing again and  patient’s symptoms appear again.Also,when using ablation,the heat can travel to normal tissue as well and destroy it.This will result in formation of scar tissue and further pain.

By using the excision technique, all the endometriotic lesion is removed until healthy tissue is reached and no endometriosis is left behind after the end of the operation. This way there is minimal chance of future recurrence.Excision offers also the advantage of sending the specimen to the pathologist for confirmation of the disease.

At the Endometriosis Centre of Mediterraneo Hospital, only excision technique is used. Excision is the most successful technique to treat endometriosis but on the other hand this technique has a big lurning curve,requires more skill and more surgery time but has the advantage of the highest cure rate and least recurrence rate.

Are the procedures done via laparoscopic (keyhole surgery) or classic open route?

Endometriosis surgeries are conducted only via the laparoscopic route.The laparocopic camera offers a magnification of the pelvis and abdomen and assists in recognizing even the smallest leasions so that they can be removed with safety and nothing to is left behind.The magnification that the camera offers,together with the small fine instruments that are used,contribute by far to the protection of small nerves and vessels,minimizing this way the chance of a complication.The most important  goal in an endometriosis surgery is that all the lesions are recognized and removed with safety.This can be achieved only by a Gynaecologist who is extensively trained in endometriosis and who has the right team for successful support in complex and long surgeries.

What should I expect during my first appointment in the Centre of Endometriosis in Mediterraneo Hospital?

In your first appointment it would be useful to bring along any previous and relevant exams that you have had and also any video of previous gynaecological surgery that you have underwent.During the appointment a detailed and thorough discussion will take place between you and the Endometriosis Specialist where you will have the opportunity to address all your thoughts and concern.You will be asked to fill in a special endometriosis questionnaire where various parameters of your daily life are addressed.Transvaginal ultrasound and clinical examination are the first two important tools that will lead the path towards understanding your condition better.Depending on findings you will may be asked to have an MRI or/and a kidney-ureter-bladder ultrasound.Further tests may be asked depending on the extend of the disease.You will may also be  asked to see another member of the team of a different specialty (for example if the bowel is involved then you may have to consult with the colorectal surgeon as well).When the preop assessment is ready ,your case will be discussed in the team meeting (MTD) so that the best decision is taken.After that you will have again a consultation with the Endometriosis Specialist in order to discuss all the findings and make a plan.

What if I live abroad?

The medical team as well as the administrative services of Mediterraneo Hospital are highly experienced in dealing with patients from abroad. We will guide you in every step of the procedure with safety and efficacy.