Specialists in Endometriosis Treatment in Barcelona

Endometriosis is a chronic, inflammatory condition in which tissue similar to the endometrium (the lining of the womb or uterus) grows outside the uterine cavity. While it most commonly affects the ovaries, fallopian tubes, and the tissue lining the pelvis, it can occasionally spread to other parts of the body.

The core issue is that this displaced tissue behaves exactly like the tissue inside the womb: it thickens, breaks down, and bleeds with each menstrual cycle. However, because this blood has no way to leave the body, it becomes trapped, causing severe inflammation in the surrounding areas. Over time, this can lead to the formation of cysts (endometriomas), internal scarring (fibrosis), and bands of tissue causing organs to stick together (adhesions) which are the real culprits behind chronic pain and its impact on a woman's daily life.

Identifying symptoms early is crucial to prevent irreversible damage to ovarian reserve, other affected organs, and overall quality of life:

• Severe dysmenorrhoea: Pelvic pain and cramping before and during your period that do not respond to standard over-the-counter painkillers, frequently presenting as progressive and disabling.
• Dyspareunia: Pain during or after sexual intercourse.
• Painful bowel movements or urination: Clinically, this manifests more intensely during the menstrual period. Pain may also occur in other locations and can appear post-surgery in scar tissue, as sometimes seen after a caesarean section.
• Infertility: Many women discover the condition after struggling to conceive.
• Chronic fatigue and digestive symptoms: Including nausea or bloating. These digestive issues are not always directly caused by endometriosis itself; it is a complex condition that is often linked to other digestive problems, such as food intolerances or irritable bowel syndrome (IBS).

Deep endometriosis: When the condition affects other organs

Deep endometriosis is defined by the presence of tissue implants that penetrate more than 5 mm beneath the peritoneal surface. This condition most frequently affects the uterosacral ligaments, though it can also involve key organs such as the rectovaginal septum, bladder, or bowel. Achieving an early diagnosis relies on combining a detailed medical history and targeted physical examination with specialised imaging tests, such as dedicated pelvic ultrasound or MRI scans.

Currently, the medical approach prioritises pharmacological treatments, limiting surgical interventions to strictly indispensable cases. The primary goal is to halt disease progression while maximizing the function of the affected organs. When surgery is unavoidable, it demands high technical expertise and generally requires a multidisciplinary medical team to ensure patient safety.

No two patients are the same; that is why, at Turó Park Clinics, we understand that the management of endometriosis requires a logical, step-by-step approach. Consequently, our first line of treatment is usually medical therapy, aimed at curbing the oestrogenic stimulus that activates the lesions caused by the condition.

The major advantage for our patients is the continuity of care: if the initial drug treatment proves insufficient or the lesions affect vital organs, the same specialist who has prescribed the treatment and monitored your clinical progress will be the one to lead the surgical strategy. This ensures a thorough and personalised understanding of your case.

→ Drug treatment and hormonal blockade

Under the supervision of Dr Celia Marcos and Dr Mª Eulalia Fernández Montolí, experts in gynaecological endocrinology and endometriosis, they design bespoke treatment plans:

• Combined oral contraceptives and progestogens: Their main function is to prevent monthly bleeding (caused by the shedding of the endometrial tissue), both inside and outside the uterus. By halting this process, local inflammation is drastically reduced and pain is alleviated.
• GnRH Antagonists and Analogues: These form the second pillar of medical treatment. They are used when standard contraceptives are ineffective, contraindicated or if symptoms persist. They may be prescribed alongside add-back therapy (hormone replacement therapy) to alleviate the side effects of oestrogen deprivation, such as hot flushes.

→ Specialist laparoscopic surgery and a multidisciplinary approach

When drug treatment is insufficient, loses its effectiveness or vital organs are directly affected, laparoscopic surgery is the first-line treatment. This minimally invasive procedure focuses on the complete removal of lesions to drastically reduce the likelihood of the disease recurring. By prioritising laparoscopy, we are able to minimise the formation of internal adhesions and ensure a much quicker and more comfortable recovery for the patient.

Although many procedures are of moderate complexity, we are occasionally faced with highly complex cases that require a multidisciplinary team (comprising gastrointestinal surgeons and urologists). In specific cases, our team jointly assesses the patient and plans the procedure in a coordinated manner to ensure maximum safety.

→ Regenerative therapies for intimate health and pain

Under the supervision of Dr Eulalia Fernandez, we have advanced tools to address complex issues such as dyspareunia (pain during sexual intercourse) or vaginal dryness – symptoms caused by the condition itself that affect women’s day-to-day lives. To alleviate these symptoms on an outpatient basis, in the clinic itself and without the need for surgery, we combine the most advanced medical technology:

• Fractional CO₂ Laser (MonaLisa Touch): A technology that regenerates intimate tissue from within, helping to restore the vagina’s elasticity and natural lubrication.
• Targeted injections for pain relief: If you suffer from persistent pelvic pain, we administer small, personalised injections of local anaesthetic or neuromodulators directly into the exact sites of pain to provide effective, targeted relief.

→ A multidisciplinary approach: nutrition and holistic wellbeing

We recognise that endometriosis affects health in a systemic way. For this reason, we complement medical and regenerative therapies with a specialised support team.

• Nutrition and Gastroenterology: For the management of food intolerances and anti-inflammatory diets.
• Advanced pelvic floor physiotherapy: We complement the above treatments by using non-invasive technologies such as electrical stimulation (TENS) and radiofrequency. These techniques help to soothe the nerves in the area, reduce inflammation and relax the pelvic muscles, which often tense up reflexively as a result of chronic pain.

→ Fertility and Endometriosis: Protecting your future

At Turó Park Clinics, protecting your fertility is an absolute priority in the treatment of endometriosis. We are fully aware that this condition can complicate the journey to pregnancy due to the inflammation it causes in the pelvis or the depletion it causes in the egg reserve, which can be affected by various factors that go far beyond simply having or not having ovarian cysts. To help you fulfil your dream of becoming a mother, we assess your fertility with a personalised plan:

• Guidelines for fertility preservation: We assess the need for egg freezing (oocyte vitrification). This option is specifically recommended prior to endometrioma surgery, particularly if the procedure is bilateral or if the patient has a history of low ovarian reserve. In this way, we ensure that high-quality eggs are preserved for the future.
• Protection of healthy ovarian tissue: In cases where surgery is unavoidable, precise surgical techniques are employed that are specifically designed to protect healthy tissue and prevent a reduction in ovarian reserve. This is achieved by separating tissue with the utmost care, controlling bleeding and prioritising the use of laser technology or advanced cutting and coagulation techniques, whilst avoiding the use of a conventional electrosurgical knife as far as possible.