Do I Need Surgery for Endometriosis?

If the pain from your endometriosis is severe and medication doesn’t help enough, you may consider surgery. Your surgeon can find the endometriosis inside your body and remove some of the tissue.

There are other things to think about, including whether you want to get pregnant in the future. Some endometriosis operations can permanently affect whether you can have children, so you should talk about that with your doctor so you know what options are a good fit for you.

When Is It Time for Surgery?

Whether you should have surgery may depend on your age and your condition. You may want to consider it if:

  • You have severe pelvic pain.
  • Medication doesn’t tame your symptoms.
  • You have trouble getting pregnant.
  • You have a growth in your pelvic area that needs to be removed.

Laparoscopy Surgeries for Endometriosis

If your doctor recommends surgery, the goal is to remove the endometriosis and any scar tissue from your body. Methods include:

Laparoscopy . Doctors can diagnose and treat endometriosis with this procedure, which uses a thin instrument called a laparoscope. It has a light attached to it, along with a lens that lets your doctor see inside your pelvic area to look for endometriosis.

Diagnostic laparoscopy. During the procedure, your doctor will inflate your abdomen with gas and make a small cut to insert the laparoscope. This is the most reliable way to diagnose the condition. Your doctor may remove a small sample of tissue during the procedure to confirm the diagnosis.

Operative laparoscopy. If your doctor finds endometriosis, she can remove some of the tissue growths during the procedure. She can cut them or burn them off using a laser or another technique.

What to Expect After Laparoscopy

Most women have less endometriosis pain after this procedure. But many start to feel discomfort again, so the results may not last.

If the affected areas, or “lesions,” are deep inside your body, you may be more likely to get relief if your doctor cuts the tissue out. Some research suggests that these procedures tend to be more successful if your endometriosis is moderate, instead of mild.

You’ll probably be able to go home the day of the laparoscopy, but you might need to stay overnight if your surgery is complicated or takes a long time. You might be tired for a few days after the procedure, and your doctor may advise you not to drive for 2 weeks. You may also need to avoid sex and activities like swimming or bathing in a tub for about 2 weeks.

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Laparotomy

This is major surgery, with one large cut in your belly. Doctors usually only use it when you have severe endometriosis that they can’t treat with laparoscopy.

During laparotomy, your doctor may remove your ovaries, fallopian tubes, and uterus (hysterectomy) if they’ve been damaged or if they have endometriosis on them -- and you’ve agreed in advance to this.

Even after this type of surgery, your endometriosis can come back, along with its pain. It happens to up to 15% of women who have a total hysterectomy and both of their ovaries and fallopian tubes removed.

Laparoscopy is just as effective as laparotomy at saving your fertility and relieving pain. In both types of surgery, about 20% to 30% of women will have their endometriosis return within 5 years.

The advantage of laparoscopy is a faster recovery that’s less painful. You will probably have to stay in the hospital for several days after a laparotomy, and you may need several weeks to recover. During your recovery at home, you may be restricted from doing some everyday activities.

WebMD Medical Reference Reviewed by Nivin Todd, MD on November 8, 2017

Sources

SOURCES:

Mayo Clinic: “Endometriosis -- Treatment.”

National Institutes of Health: “What are the treatments for endometriosis?”

UpToDate: “Patient education: Endometriosis (Beyond the Basics).”

Endometriosis.org: “Surgery,” “Laparoscopy: Before and after tips,” “Hysterectomy.”

Cleveland Clinic: “Surgical Treatment for Endometriosis.”

Mount Sinai Hospital: “Exploratory Laparotomy.”

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