If you or anyone you know struggles with painful periods and have been diagnosed with adenomyosis, Dr Imtiaz Ahmad performs non-surgical adenomyosis treatment which can solve your miseries.
Adenomyosis: The Biology Behind it
In order to fully understand adenomyosis, it is important to first break down the word itself. Adeno meaning glands, while myosis can be further divided into myo for muscle and osis referring to condition. A more specific term for adenomyosis is also adenomyometritis, but it is not as commonly used. The uterus, which is part of the reproductive system in the females, is normally made of three layers of tissue; endometrium(inner), myometrium (middle muscular layer) and Perimetrium (outer epithelial layer). Each layer serves an important function in maintaining the integrity of the reproductive system. Altogether, adenomyosis is a condition wherein the tissue of the endometrium comprised of luminal and glandular cells rapidly divide (hyperplasia) and extend or invaginate into the myometrial layer.
A key point to remember while discussing adenomyosis is to not confuse it with endometriosis. The two conditions may co-exist amongst others and present similar symptoms, but they are different to one another in terms of their pathophysiology. While endometriosis is the growth of endometrial tissue in places near to but outside of uterus and adenomyosis exists only within the uterine muscular layer. Adenomyosis treatment may be necessary in cases where symptoms start interfering with day-to-day matters. This majorly includes severe pain between periods.
When to see a doctor?
Every 1 in 31 women who have adenomyosis remain largely asymptomatic, and therefore undiagnosed. Those who do experience discomfort are also often misdiagnosed due to non-specificity of symptoms, especially in the case of a co-existing problem like uterine fibroids. Nevertheless, adenomyosis may present itself in the form of painful menstruation (dysmenorrhea) accompanied with prolonged bleeding (menorrhagia) and discomfort during sexual intercourse, too. This is commonly known as dyspareunia. On the imaging, the specialist might be able to see an enlarged uterus, but it will be felt by the patient as pressure around the lower abdominal region.
How will you be Diagnosed?
Diagnosis of Adenomyosis usually follows a trans vaginal ultrasound imagining which may be able to reveal the unusually thick lining of the myometrium. Sometimes, it is difficult to distinguish between adenomyosis and fibroids. In that case, an MRI reveals the incidence of adenomyosis. Most of the time,adenomyosis is confirmed after hysterectomy has been performed. This may be when the specialists are not sure of the condition, but the symptoms are too painful or when they suspect that the tissue may also comprise cancerous cells in which case it would be adenocarcinoma.
Women with severe adenomyosis symptoms are usually looking for a period pain treatment. The definitive treatment of adenomyosis is through hysterectomy, which is the complete removal of the uterus. This may be okay for some women but a very upsetting news for most. Since adenomyosis occurs under the influence of estrogen, it is usually at the peak reproductive age. The condition often resolves itself after menopause due to the same reason. Hence, women who still want to conceive may be appalled by hysterectomy. Moreover, the surgical process of removing the uterus is invasive and is slowly becoming obsolete.
Advancement in interventional radiology has now made it possible to alleviate period pain with a non-surgical and noninvasive approach. Adenomyosis treatment now follows a systematic approach which offers little to no post operative complications or care and maximum patient compliance is guaranteed.
Endovascular Adenomyosis Treatment
Three-dimensional precision guided endovascular treatment is a non-invasive approach to provide adenomyosis treatment and alleviate period pain without putting the fertility at risk. The rationale behind the treatment is to precisely block the arteries supplying blood to adenomyosis which is essentially just endometrial tissue. The entire procedure comprises not only uterine artery embolization but also, a complete set of steps to increase patient compliance and comfort. These include post embolization syndrome management, superior hypogastric nerve plexus block and intra-arterial pain management. As a prerequisite, complete health analysis is done to assess the medical fitness status of the patient before moving on to the treatment. Once the procedure is completed, you should also expect a thorough follow-up for up to one year. In cases where the goal is to restore fertility, a more thorough follow up should be expected.
The procedure employs live imaging to accurately locate the blood vessels supplying blood to adenomyosis. The imaging also helps assess the number of arteries involved and their sizes. This makes the procedure accurate and reduces complications. The blood supply to these growths is blocked using miniature but programmed and specially engineered permanent devices. To begin, mild conscious sedation is achieved. Following, microcatheters are introduced in the patient’s body through the femoral/radial artery in the leg or wrist. This is achieved without causing any pain as a result of topical cold spray anesthesia followed by local anesthesia. Once the blood vessels are located, the FDA approved medical particles are then administered through the catheter. These embolic agents are small micron-sized particles that are engineered/programmed to block the blood supply to only adenomyosis while sparing the normal uterine wall. Medical particles/drugs used in the endovascular treatment are highly specific and are only issued to Licensed/Registered practitioners in United States of America. In this way, embolization is successfully achieved.
Adenomyosis treatment is now available in Pakistan byDr Imtiaz Ahmad, who is an interventional radiology specialist and endovascular surgical specialist. He offers his services in two major cities of Pakistan: Karachi and Lahore. If you or your loved one is suffering from severe period pain and other symptoms that point toward adenomyosis, a consultation by Dr Imtiaz Ahmad or his team of highly qualified consultants available daily is the first step to bring an end to your misery.