When to have surgery for endometriosis

There are a number of situations why surgery for the treatment of endometriosis may be needed. When considering surgery you need to discuss this clearly with your doctor and ensure ALL your queries and worries are answered.

From endographics.org

The prospect of undergoing surgery can cause a lot of worry and concern for obvious reasons. Having surgery can really take its toll on your body and you need be fully informed about the treatment you will be given. The type and method of surgery for endometriosis is important and ideally you need to seek out treatment from an experienced endometriosis excision surgeon.

This type of surgery is more effective as it involves cutting out the lesions at the root and not leaving any of the disease behind and this type of surgery has a long term higher success rate.

Some of the situations where surgery may be required include:

Drug treatment has not proved sufficient to reduce the disease
Your symptoms have returned after a course of drug treatment
Reconstruction of organs may be needed as treatment for infertility
Your endometriosis is severe, and includes adhesions and is affecting other important organs such as the bowel or intestines. (Surgery to your intestines and bowel carries risks as further damage can be caused to these organs during surgery.)

What are the advantages of surgery?

Surgery is seen as the only way to remove large or deeply embedded endometrial growths, cysts and adhesions
Surgery can sometimes restore the structure of the reproductive organs to help restore fertility
Some women do gain immediate relief for the pain of endometriosis after surgery, but in many cases the pain and symptoms return
laparoscopy is the only definitive method of obtaining a true diagnosis for this disease

What are the disadvantages of surgery?

Having an anaesthetic always carries risks
The surgeon can only remove those endometriosis deposits which can be seen, so microscopic deposits can’t be removed
It is sometimes difficult to recognise endometriosis during surgery
The endometriosis may be too close to sensitive organs, such as the bowel, and cannot be removed for fear of damaging the organ
Surgery might cause further adhesions
Endometriosis may still recur

Excision versus Ablation Surgery

Not only is it super important to be aware of both types of procedures and to understand what they are, it is also important to ask your surgeon which one they perform before you go ahead with surgery.

Ablation is the most widely performed surgical technique however; excision is currently classed as the gold standard amongst true endometriosis excision specialists and experts.

Excision involves cutting out any visible endometriosis laparoscopically through small incisions in the abdomen. When performing excision surgery, surgeons are able to excise the entire endometriosis lesion, including its root, while avoiding any damage to the uterus or other organs in the pelvis.

The most important factor in the success of endometriosis excision is a highly skilled surgeon. Surgeons with special training in endometriosis are better equipped to handle the intricacies of excision surgery.

Surgery by Multiple Surgeons

Excision surgery may need to be performed by more than one surgical specialist. Ideally endometriosis would be done by multiple surgeons at once depending on the stage and locations of endometriosis. For example, if endometriosis has infiltrated the bowel, then a multidisciplinary team consisting of an advanced laparoscopic gynecological excision surgeon working side-by-side with a specialist colorectal (bowel) surgeon.

Deep infiltrating endometriosis (DIE) on the rectum or sigmoid colon requires precise skills to excise the disease without damaging vital pelvic nerves or bowel function.

It is important to ask your consultant or doctor exactly what type of surgery you are undergoing for your treatment. Ask for a detailed explanation to ensure you know what your surgeon intends to do during surgery. You will find more advice about questions to ask before having surgery HERE

surgery considerations with endometriosis

Considerations of Surgery

Endometriosis surgery is generally safe, but serious complications can sometimes happen. The main risks include organ damage, bleeding, and infection. Additionally, surgery can cause scar tissue which can lead to further complications with adhesions. Each operation can create internal scar tissue and pelvic adhesions, which may cause more pain or complicate future procedures. This information here is not provide alarm, but to provide you with much needed educational advice bout the pros and cons of having surgery for endometriosis.

Before having surgery, it is important to confirm your doctor is a trained specialist in endometriosis removal (excision vs. ablation).

Leaving endometriosis untreated is generally not recommended if you have symptoms, because the condition does not resolve on its own, and for many women pain and internal scarring can worsen over time. Leaving endometriosis unmanaged can worsen symptoms of chronic pelvic pain, ovarian cysts, and difficulty getting pregnant.

Is having surgery for endometriosis worth it? Yes, removing endometriosis via specialized excision surgery is often worth it for women with severe chronic pain, organ obstruction, or fertility struggles.

Surgery can help resolve issues with pain, help to restore organs and removing scar tissue and lesions can help improve your chances of getting pregnant naturally.

Aftercare and Recovery

Recovery after surgery for endometriosis usually takes four to six weeks to return to normal daily routines, but full internal healing takes six to eight weeks (or longer for complex cases). The exact timeframe depends on whether you had a minor diagnostic procedure or extensive excision surgery involving other organs.

The after-effects of anaesthetic can also linger for quite some time and it is not uncommon to feel depressed after surgery.

While the anaesthetic drugs temporarily alter brain chemistry and mood-regulating chemicals for a few days, post-surgery depression is usually caused by a mix of physical and emotional factors rather than the anaesthetic alone.

Recovery from surgery can really take some time and you need to be gentle on yourself. Being prepared beforehand really helps reduce the stress of coping with everyday needs when recovering at home. This article provides more advice about preparing for surgery with many tips to help with your recovery.

Endometriosis and Pain after Surgery

Endometriosis and the lingering pain that can follow surgery - If you’ve had endometriosis surgery and are still feeling that nagging pain, you’re not alone!

After going through the emotional and physical rollercoaster of diagnosis, treatment, and surgery, it can be incredibly disheartening to still experience discomfort. You might be wondering, “Why am I still in pain?”

Here’s the thing: Endometriosis is a complex condition. Even after surgery, there can be residual pain due to scar tissue, hormonal imbalances, or even the body’s natural healing process. It’s like your body is still trying to find its balance after all that it’s been through. And let’s be real—healing isn’t always a straight line; it can feel more like a winding road with bumps along the way.

with healing thoughts - Carolyn

When to have surgery for endometriosis

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