Endometriosis and Surgery

Endometriosis is a condition that affects a woman’s reproductive system which can cause pain and infertility. Although there is currently no known cure for Endo, there are treatments which can ease the symptoms commonly associated with Endometriosis.

Research shows 80% of surgeries have resulted in pain relief in women with severe Endometriosis who have not responded to hormonal treatment. Surgery may be considered if the sufferer has severe pelvic pain, if medication isn’t relieving the symptoms, if they’re having trouble getting pregnant or if there is a growth in the pelvic area that needs to be removed.

Surgery for Endometriosis aims to remove as much visible Endo as possible and to repair any damage caused by the condition. Surgery can be complex and difficult, therefore surgeons need specialised skills and expertise to perform these operations, and experienced specialist surgeons are required for severe Endometriosis.

Procedures for treating symptoms of Endometriosis includes the following:

Laparoscopy

This procedure is also known as keyhole surgery and is considered the gold standard for diagnosing Endometriosis. A thin telescope is inserted into the pelvic cavity for the surgeon to see the organs in the pelvis and any endo which may be present. This type of surgery is relatively safe, and complications which do arise are minor and can be resolved quite quickly.

Laparotomy

This procedure requires the surgeon to make a larger cut in the lower abdomen. Laparotomies are rarely used nowadays and are only performed if Endometriosis is severe and extensive, or if a laparoscopic surgery is not an option due to previous abdominal surgery.

Hysterectomy

This procedure requires the removal of the uterus. This may be performed if long-term recurrent Endo is also associated with chronic pain that has not responded to other treatments or multiple surgeries. An Oophorectomy is the removal of one or both ovaries and is usually done at the same time as a hysterectomy.

Hysterectomies and oophorectomies are only recommended for women who don’t want to have any children, when their quality of life is significantly impaired, and when all other treatments have failed.

Surgical Techniques

There are two surgical techniques used to remove endometrial implants.

Excision

Excision is more time consuming and requires more skill, however, is more effective. This technique removes Endo implants by cutting them away from the surrounding tissue with scissors, a very fine heat gun, or a laser beam. This technique does not damage the implants so the surgeon is able to send a biopsy of the tissue to confirm if it is Endometriosis or something else.

Coagulation

Coagulation destroys the implant by burning it with a fine heat gun or vaporising them with a laser beam. Care must be taken to ensure the entire implant is destroyed so it can’t regrow, and to ensure that only the implant is destroyed and no underlying tissue such as the bowel or bladder.

Post Surgery

Each woman is different when it comes to their recovery time due to their levels of health prior to surgery, the type of surgery performed, as well as the severity of Endo present.

Most women who have had a laparoscopy are able to return home after their procedure, and some women who have had a more complex procedure may be required to stay overnight.

You may experience a bit of pain and discomfort, and the surgeon may advise against driving, swimming, bathing (showering is ok), or any sexual activity straight away.

 

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