What is a laparoscopy?
Laparoscopy is a surgical procedure that allows me to view your ovaries, fallopian tubes, uterus and pelvic cavity, to check for abnormalities. It is a type of keyhole surgery that is performed under general anaesthetic in an operating theatre.
Small incisions are made just below your navel and pubic hairline, and a laparoscope is passed (a small diameter telescope) through your abdominal wall. A tubal patency test to check that your fallopian tubes are open can then be performed by injecting a dye through the uterus and observing whether or not it spills through the ends of your tubes.
Who is laparoscopy suitable for?
Laparoscopy is a useful test for the diagnosis and treatment of conditions like endometriosis, pelvic pain and ovarian cysts. It is often an important part of a fertility evaluation, but it is usually one of the last tests we do, as it is more invasive.
If it has already been established that you need further treatment, such as IVF, you may not need to have a laparoscopy.
What is hysteroscopy?
Hysteroscopy uses a similar small telescope called a hysteroscope to check the uterine cavity for polyps, fibroids, adhesions or congenital anomalies. It can also be used to remove some of these abnormalities. Like Laparoscopy, it is carried out under anaesthetic in the operating theatre.
In a hysteroscopy, your cervix will be dilated to allow the telescope to pass through it into the lower end of the uterus. This gives me a clear view of the lining of the uterus.
What is endometriosis?
Endometrial cells form the inner lining of your uterus and sometimes these cells grow outside the uterus, usually in the pelvis and ovaries but also in the wall of the uterus. This is known as endometriosis, it is a relatively common condition, especially in women over 30 who have not had children.
Causes of endometriosis
The exact cause of endometriosis is unknown. A common theory is that during menstruation, the tissue shed from your uterus flows back along the fallopian tubes, instead of out through your vagina. It then attaches itself to the pelvis and this tissue then goes through the same cycle as it would in the uterus bleeding at the same time you have your period.
This process is known as retrograde menstruation, and it actually happens in almost all women. The difference for women without endometriosis is that the tissue is absorbed and broken down but for women with endometriosis, the tissue attaches itself and starts to grow which can cause scarring and pain in the pelvis It can also lead to a tubal blockage.
Symptoms of endometriosis
The main symptoms of endometriosis are pain and infertility. You may experience pelvic pain, painful periods, pain during intercourse and premenstrual spotting.
Surgery is used to treat endometriosis and this is usually done via a laparoscopy, as mentioned above in order to confirm the diagnosis and remove the endometriosis at the same time.
Often, patients conceive naturally after surgery. But laparoscopy also increases your chances of success with other treatments, such as IVF.