Wednesday, November 18, 2009

5 Days to Surgery

Getting close to surgery day. I'm interested to know what they're going to find in there.

Cysts? (Well I know there's one big endo cyst already). Blocked Fallopian tubes? Lesions? Adhesion? What is it all anyway?

Lesions/Implants: This is the one I've found hardest to find information for. Lesions are abnormal tissue growth caused when normal tissue is damaged. The term is lesion is very broad and covers thousands of varieties, for example, chickenpox, tumours/cancer, ulcers, hives, and acne. The most common places endometrisiosis lesions are found are ovaries, the outside wall of the uterus, fallopian tubes, pelvic cavity, and reproductive organ ligaments.
The diagnosis of endometriosis is done by the biopsy of these lesions, (although, endometriosis can be unofficially confirmed by visual inspection of the lesions but not with everyone).

"Endometriosis lesions react to hormonal stimulation and may "bleed" at the time of menstruation. The blood accumulates locally, causes swelling, and triggers inflammatory responses with the activation of cytokines. It is thought that this process may cause pain."-Wikipedia

Q.
What does endometriosis look like?
A. The presence of endometriosis is characterized by blue-gray lesions on the peritoneal surface, over the pelvic peritoneum or pelvic structures. This distinct appearance can be attributed to the encapsulated menstrual blood and menstrual debris. However, the appearance is critically dependent upon the longevity of the tissue implanted. The initial appearance may be just an irregularity or discoloration of the peritoneal surface. Initially, these lesions may appear tan or hemorrhagic in colour. After establishment of viable endometrial transplant and menstrual shedding, the presence of entrapped menstrual debris gives the tissue the typical blue-gray and powder burn appearance.
Many times the lesion of endometriosis may not have any colour at all. These lesions are called nonpigmented endometriosis.-bioscience.org

Adhesions: These are fibrous bands that look like cobwebs that form between tissue and organs, causing them to stick together abnormally, such as the ovary to the pelvic wall. This causes pain and discomfort but can also lead to infertility. These all need to be removed during surgery and prevented from recurring. The cause is uncertain but it's likely caused due to a mini menstruation from the legions mentioned above. Since that's happening in the wrong place the blood has nowhere to go and is trapped, causing inflammation resulting in adhesions.

Blocked Fallopian Tube: Or as I like to call them, The Symptomless Satan.
This is where there is an obstruction in the fallopian tube that is preventing an egg to travel down. It is the cause of infertility for 40% of infertile women. This can be caused by endometriosis, pelvic inflammatory disease (PIT), appendicitis and previous surgery and... Umm... Chlamydia (among others). Surgery can be used to remove the obstruction. There are rarely any symptoms.

Endometrioma, endometrioid cyst, endometrial cyst, or chocolate cyst of ovary: Heads up- this part is pretty gross and not for the faint hearted.

Legions of cell, menstrual flow and debris are transported from the uterine cavity and cause cyst on the outside of the ovaries. These contain a brown liquid (oh my f**king god...). If they remain small (less than 3cm) they can be fine, with no symptoms but if they get big they cause pelvic pain and discomfort. The can go up and down in size- they’re even reports of baseball/grapefruit sized ones- eek! If they rupture the... err... contents... can spill into the pelvic cavity and cause organs to bind together, causing infirtility.
Mine is on my right ovary. Last December it was 5cm according to the scan, then they checked it in 6 months and it hadn't gone away, hence my surgery.

I found this video of an endometrioma (cyst) during laparoscopy, I wasn't brave enough this time either, but you might be! http://www.operationalmedicine.org/ed2/Video/Chocolatecyst.mpg




The most helpful by far was:

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