A condition that is often diagnosed with a delay of several years (it takes on average 10 years for women to be diagnosed), endometriosis affects a large number of the female population. With symptoms including heavy periods, painful cramps and infertility, the condition is often misdiagnosed and there are still many misconceptions around it.
What exactly causes endometriosis remains unclear, but today there are treatments that can help women with the condition feel better. Laparoscopic surgery, in many cases, is the only treatment that actually helps, both to relieve the symptoms and to diagnose the condition itself.
Below, we have listed a series of the most frequently asked questions on endometriosis and laparoscopic surgery. If you are looking for more information on surgical treatments for endometriosis or are unsure of your diagnosis, contact us anytime. Our Gynecological Center at KCM Clinic specialises in helping women identify and treat endometriosis in a safe, highly professional, and caring environment
What is endometriosis?
Endometriosis is a condition that happens when tissue similar to the lining of the uterus (or “endometrium”) grows outside the uterus. The abnormal tissue can be found around the ovaries, the fallopian tubes, or the outer wall of the uterus. Inflammation occurs as a result, causing scar tissue or cysts that often lead to pain and discomfort.
Can endometriosis be cured?
Unfortunately, there is no definitive cure for endometriosis. However, there are treatments available that can help you treat or minimise your symptoms.
Why Is Endometriosis Surgery Done?
Endometriosis surgery is a medical procedure aimed at addressing the symptoms of endometriosis, a condition characterized by the growth of tissue resembling the lining of the uterus outside the pelvic cavity. The primary objective of this surgery is to provide relief from symptoms such as pain, inflammation, and scarring. It is important to note that endometriosis surgery is generally reserved for severe cases or situations where laparoscopy, a less invasive procedure, is not feasible or appropriate for an individual patient. By carefully assessing each case, doctors ensure that surgery remains a beneficial and suitable course of action to address the specific needs of the patient.
When Is It Time for Endometriosis Surgery?
When it comes to the management of endometriosis, doctors may propose various approaches such as adopting lifestyle modifications, utilizing oral medications, and incorporating physical therapy. In instances where alternative treatments prove ineffective in alleviating symptoms, endometriosis surgery is usually advised. The decision to undergo surgery generally hinges on the presence of specific symptoms in a patient, including:
Persistent and severe pelvic pain: If medication is not effective in managing pain, surgery may be an option to remove the endometriosis tissue that is causing the pain.
Infertility: In some cases, endometriosis can make it difficult for a woman to get pregnant. Surgery may help to improve fertility by removing the endometriosis tissue that is blocking the fallopian tubes or causing inflammation.
Growths in the pelvic area: Endometriosis can cause growths, such as endometriomas, to develop in the pelvic area. These growths can cause pain and other symptoms. Surgery may be necessary to remove these growths.
Recurring symptoms: If all other treatments for endometriosis fail and symptoms keep coming back, surgery may be a good option to help in getting long-term relief from endometriosis.
What to Expect After Endometriosis Surgery
Once endometriosis surgery is completed, individuals can experience a certain degree of relief. Doctors will typically prescribe specific medications to alleviate post-surgical pain and discomfort.
The typical recovery period after the surgery is around two weeks, although the duration can differ among patients due to a variety of factors.
After surgery, the doctor will provide patients with a comprehensive list of dos and don’ts to be followed for a timeline prescribed by the surgeon.
It is important to schedule a follow-up appointment with the doctor within 2-6 weeks after surgery to ensure proper healing. During this visit, the doctor will develop a long-term treatment plan specifically tailored to the patient’s needs if they have been diagnosed with endometriosis.
Is Endometriosis Surgery a Major Surgery?
In most cases, endometriosis surgery is typically not classified as a major procedure. The most prevalent form of surgery for endometriosis is laparoscopy, a minimally invasive technique that involves small incisions. With laparoscopic surgery, patients often go home on the same day since it is typically an outpatient procedure.
Nonetheless, there are situations where endometriosis surgery may be more extensive, necessitating a larger incision. This approach, known as laparotomy, is considered a major surgical procedure, and hospitalization for a few days is generally required after the surgery.
What are the different types of endometriosis surgery?
There are two main types of endometriosis surgery: laparoscopy and laparotomy.
This is a minimally invasive surgery that involves making several small incisions in the abdomen. A surgeon inserts a laparoscope, a thin, tube-like instrument with a camera, through one of the incisions. The camera allows the surgeon to see inside the abdomen and pelvis. Other instruments are inserted through the other incisions to remove the endometriosis implants.
This is a more traditional surgery that involves making a larger incision in the abdomen. This type of surgery is usually only necessary if the endometriosis is severe or if the surgeon needs to remove other organs, such as the uterus or ovaries.
In addition to these two main types of surgery, there are also a few other procedures that can be used to treat endometriosis. These are:
This is a procedure that destroys the endometriosis implants without removing them. This can be done using heat, cold, or laser energy.
This is a procedure that removes the endometriosis implants. This is the most effective way to treat endometriosis, but it can also be more invasive than ablation.
Drainage of endometriomas
A procedure that drains the fluid from endometriomas, which are cysts that can form on the ovaries. This can help to relieve pain and improve fertility.
The type of surgery that is best will depend on the severity of the endometriosis condition, symptoms, and a patient’s fertility goals.
What Should I Expect Before Endometriosis Surgery?
Before an endometriosis surgery, individuals should prepare themselves well. The following tips and guidelines are recommended:
The individual will need to meet with their doctor to discuss the surgery and their expectations. The doctor will provide a detailed explanation of the procedure and address any inquiries the individual may have.
Certain tests and pre-surgery assessments will be required. These tests are essential for the doctor to evaluate the individual’s overall health and determine their suitability for the surgery.
Prior to the surgery, the individual will be required to stop the usage of certain medications. The doctor will offer guidance on which specific medications should be discontinued, considering a range of factors.
Personal items should be packed for the hospital stay. These may include a robe, slippers, toiletries, and a change of clothes.
Is Laparoscopy More Effective than Laparotomy?
A recent study found that laparoscopic surgery is a good alternative to laparotomy for suitable patients. Laparoscopy has several benefits, including a shorter recovery time and a lower risk of complications, making it the better choice in most cases. This is because laparoscopy uses smaller incisions, which means less pain and scarring, and a faster return to normal activities. However, in some cases, laparotomy may be necessary for patients who are not suitable for the less invasive surgery.
What are the Risks or Complications of Endometriosis Surgery?
The risks and potential complications associated with endometriosis surgery should be carefully considered and discussed with a healthcare provider before undergoing the procedure, as they might include:
Infection: There exists a risk of infection in the bladder, uterus, or cuts on the abdomen.
Bleeding: A small risk of bleeding during or after surgery is present.
Organ damage: There is a rare but possible risk of damaging organs such as the bladder, bowel, ureter, uterus, fallopian tube, ovary, blood vessels, or nerves.
Adhesions: “Sticky” areas of endometriosis tissue that can join organs together may form as a result of endometriosis surgery.
Ovarian cysts: Surgery for endometriosis may occasionally lead to the development of fluid-filled cysts in the ovaries.
Bladder and bowel problems: Treating endometriosis affecting the bladder or bowel can be challenging and may require major surgery.
Fertility problems: Endometriosis can cause fertility issues due to damage to the fallopian tubes or ovaries.
Complications from anesthesia: There is a risk of complications related to anesthesia during the surgical procedure.
Can Endometriosis Return after Surgery?
Endometriosis can return after surgery, and the rate of recurrence depends on several factors, including the severity of the disease at the time of surgery, how completely the lesions were removed, and whether medical suppressive therapy was used after surgery. Factors that increase the risk of recurrence include the presence of ovarian cysts at the surgery, the large size of endometriotic lesions, and involvement of other organs. Symptoms of endometriosis returning after surgery can include painful or heavy periods, pain during sex, painful bowel movements or urination, and infertility. To prevent endometriosis from returning after surgery, your healthcare provider may recommend medication
How Quickly Can Endometriosis Grow Back After Surgery?
Endometriosis can grow back after surgery, and the recurrence rate is about 20-30%. However, research is finding that recurrence rates are higher than once thought, possibly as high as 50 percent. The rate of recurrence is usually greater as more time goes by. To prevent endometriosis from returning after surgery, hormonal treatment can be used. Women who do not wish to become pregnant are usually treated with a combination of oral contraceptives and non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain. Recurrent endometriosis can be treated with a second surgery.
What treatments are available for endometriosis?
From conservative therapies to surgery, there are several treatment options that your doctor may recommend. You might need to try different treatments or a combination of more than one to understand what works in your case. Here’s an overview of the treatments used for endometriosis:
- Hormonal therapy: In order to slow down endometrial tissue growth, your doctor may prescribe hormonal medication, including birth control pills, progestin therapy, danazol treatment, or aromatase therapy. Pain associated with the condition should diminish or disappear.
- Pain medication: Analgesics, anti-inflammatory drugs or narcotic/opioid analgesics are prescribed for pain management associated with endometriosis.
- Pelvic-floor therapy, massage therapy, heat therapy, acupuncture, and exercise might also help in some cases. These treatments are often combined with other therapies.
How is endometriosis treated surgically?
There are a couple of surgical options to treat endometriosis:
- Laparoscopy: a minimally-invasive surgery performed to remove scar tissue and cysts
- Laparotomy: open surgery to remove scar tissue and cysts. Today, it is only performed when the condition is severe or patients don’t qualify for laparoscopy
- Hysterectomy: a procedure that involves removing the uterus
Laparoscopy surgery for endometriosis is by far the most recent, least invasive, and preferred surgery option. Please consider that your surgery options should be discussed with your doctor carefully. It is usually preferable to try conservative treatments before undergoing surgery, and not all surgeries work for all cases.
When is it time to consider laparoscopic surgery for endometriosis?
When conservative treatments have not really helped, surgery might be the only option to help you minimise your symptoms or increase your chances of getting pregnant. Laparoscopic surgery for endometriosis is, in fact, the only surefire way for your doctor to diagnose the condition. The surgeon can then directly remove endometriosis scarring and lesions.
What is laparoscopic surgery for endometriosis?
Laparoscopic surgery for endometriosis is a minimally-invasive surgical procedure performed to remove scar tissues or cysts caused by the condition.
The procedure can last anywhere from 30 minutes to 6 hours; the duration will depend on the amount of tissue that needs to be removed. Laparoscopic surgery for endometriosis is carried out under general anaesthesia. The surgeon will access your lower abdomen by making a few small incisions in your belly. Then, the tissue will be removed using special surgical instruments. When surgery is over, the incisions will be closed with stitches.
For a detailed step-by-step explanation of the procedure, check out our article “Laparoscopic surgery for endometriosis: How does it work?”.
How do you prepare for a laparoscopic surgery for endometriosis?
If you’re considering a laparoscopy for endometriosis, the first step is having a consultation with one of our patient coordinators. They will ask you questions about your medical history, your overall health, and if you’re taking any medications regularly. Patients diagnosed with endometriosis and who are eligible for laparoscopy will be treated at the Gynecological Outpatient Clinic at KCM Clinic. You might be asked to perform some tests to get a comprehensive diagnosis. You will be given a detailed pre-op guide before your procedure.
What is the recovery after a laparoscopic surgery for endometriosis?
You will stay at our clinic for one night and you will be discharged the day after your laparoscopic surgery for endometriosis. Recovery time after a laparoscopy is much quicker compared to laparotomy, where a large incision is made.
A few hours after the procedure, you will be able to drink liquids and walk around. Always remember to take things slow and do only what you feel like you can handle. You will be able to consume easily digestible foods after around 12 hours. The doctor will prescribe painkillers to ease your recovery but pain after the procedure should be considerably reduced.
You can return to your daily activities after around 3 days, but wait until 7 to 10 days before you go back to your normal life fully. Do not lift any heavy weights or do any strenuous exercise for at least six weeks after surgery. You will receive a detailed post-op guide by our specialists with tips and guidelines for you to follow once you are back home.
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