What you need to know

Endometriosis is when tissues similar to the lining of the uterus (called “lesions”) develop in other areas of the body, leading to complications such as pain and infertility. After endometriosis surgery, your surgeon can stage your endometriosis as a function of the extent of the lesions. There are four stages of endometriosis; Step 4 is the most serious.

Jump at the main dishes to remember.

What is stage 4 endometriosis?

Most endometriosis surgeons use the revised system of the American Society of Reproductive Medicine (ASRM) to classify endometriosis. Stage 4 endometriosis – a score greater than 40 in the revised ASRM system – is the most serious with regard to the extent of endometriosis lesions. It is characterized by:

People with stadium endometriosis can also have a complete obliteration of what is known as “cul-de-sac” (also called “Schech of Douglas”)-the area between the back of the uterus and the rectum. Cul-de-sac is generally open. When the scar tissue of endometriosis erases the cul-de-sac (blocks the opening), it is automatically classified as stadium endometriosis, even if there are no additional results.

According to a study, 57% of people with stadium endometriosis had an erased cul-de-sac.

Endometriosis staging

The stavification of endometriosis is not linked to the severity of the symptoms. Instead, it is determined by the number, location, size and depth of the endometriosis lesions observed during the diagnosis (surgery).

Your surgeon will also seek the presence of adhesions (scar fabric) and endometrioms (cysts on ovaries). This is added in a system based on points to stage the disease.

The revised stages of the ASRM of endometriosis include:

• Step 1:: Minimal (1 to 5 points)
• Step 2:: Soft (6–15 points)
• Step 3: Moderate (16–40 points)
• Step 4:: Severe (over 40 points)

Stage 4 endometriosis symptoms

Since the staging of endometriosis is based on the extent of the lesions of endometriosis rather than on the severity of the symptoms, a person suffering from stage 4 endometriosis could have very serious symptoms or not at all.

Some symptoms of endometriosis, at all stage, include:

• Bloating
• Chest pain or breath
• Diarrhea or constipation
• Fatigue
• Heavy and irregular menstrual bleeding
• Infertility
• Pain in the pelvis, abdomen, legs, lower back and elsewhere
• Painful soles
• Painful sex
• Painful urination
• Severe pain with rules

What causes endometriosis?

Although there are multiple theories of the probable causes of endometriosis, ranging from genetics to environmental factors, scientists do not know exactly what causes endometriosis. Theories include:

• Metaplasia: The main theory among endometriosis surgeons is that anomalies during fetal development lead to specific cells transformed into endometriosis. This theory explains why endometriosis can be found in adolescents or young girls who do not yet put themselves.
• Retrograde menstruation: This theory is that during menstruation, part of the mucosa of the uterus flows back, implants on the organs and becomes endometriosis.

The theory of retrograde menstruation has been criticized because the lesions of endometriosis are similar, but not the same as the fabric that lines the uterus. In addition, almost all people who menstruate retrograde menstruation, but only 10% of them have endometriosis.

In addition, endometriosis lesions have also been found in the fetus that do not put themselves.

How is stage 4 endometriosis diagnosed?

Like all other stages of endometriosis, stage 4 endometriosis is diagnosed during a laparoscopy (“lock hole surgery”, in which small incisions are made rather than a large open incision). Imaging, such as an imagery by ultrasound or magnetic resonance (MRI), can provide clues to the presence of endometriosis, but surgery is the only way to diagnose the condition definitively.

For the diagnosis, your surgery must involve the cut tissue (called “excision”) and examined under a microscope to confirm the diagnosis.

During surgery, a surgeon will measure the extent of your endometriosis and compare it to the staging criteria of the revised ASRM system. After your surgery, the surgeon will diagnose you and, if they confirm endometriosis, stage the state.

Processing options

Endometriosis is diagnosed during a laparoscopy and can be treated during this procedure.

Ideally, your surgeon will cut endometriosis lesions, scar tissue and cysts that can cause your symptoms or an impact on your fertility. Surgery can be particularly useful for people with stage 4 endometriosis, as it eliminates extensive lesions and restores normal anatomy.

After surgery, many people feel better and do not require additional treatment.

In some cases, surgery may not adequately treat symptoms, or for personal reasons, you can choose not to undergo surgery. If this is the case, the additional processing options include:

Remember that none of these elements will imply the lesions themselves; Instead, they will help manage the symptoms caused by endometriosis.

Can you get pregnant with stadium 4 endometriosis?

You can get pregnant with stadium endometriosis, although it may be more difficult. In addition to causing chronic pain and a significant impact on the quality of life of a person, endometriosis can also make pregnancy more difficult. About 30% to 50% of people with endometriosis experience infertility.

The ASRM system revised in four stages does not precisely predict the success of pregnancy. Research has revealed minimum differences in the success rates of pregnancy between the four stages.

People with stadium endometriosis can face additional challenges to get pregnant due to more physical blockages of scar tissues and endometriosis lesions. People with stage 4 endometriosis are also more likely to have endometrioms, which have proven to reduce the ovarian reserve, the number of eggs remaining in your ovaries.

Remember to see a gynecologist specializing in endometriosis excision surgery and fertility for the best result. Your supplier can also advise you to try fertility treatments such as in vitro fertilization (IVF).

Main to remember

• In the revised ASRM staging system, stage 4 endometriosis is the most serious form of the disease.
• You can have large lesions of deep endometriosis, one or more ovarian cysts and a lot of scar tissue inside.
• Having stage 4 endometriosis does not necessarily mean that you will have serious symptoms or cannot get pregnant.