How Can Surgery Help My Endometriosis

How Can Surgery Help My Endometriosis - Large

If you have severe pain or fertility problems from endometriosis, and medicines or hormone therapy haven’t helped, surgery may provide a solution. It will not cure the condition, but it may offer effective short-term relief from pain or increase your fertility, if you are trying to become pregnant.

With surgery, most women experience relief from endometrial pain. But it may return in time. About 40 to 80 percent of women have pain again within two years of surgery. If your condition is severe, the pain is more likely to return. Taking birth control or other medications following surgery may extend the time that you’re pain free.

Following all types of surgery, evidence supports using an intrauterine device (IUD) containing progestin to reduce pain. Mirena® is approved by the FDA for this use.

Heather Hilkowitz, MD, Hilltop Obstetrics & Gynecology, describes treatments for endometriosis.

Click play to watch the video or read the transcript.

What are the treatments for endometriosis?

Endometriosis fortunately has a wide range of treatments available for patients who deal with this condition. It might be something as simple as just managing their pain and discomfort with their cycles. Pregnancy in fact is actually a great treatment for if fertility is on the horizon just getting pregnant may do a great job of suppressing the endometriosis from growing further and controlling the patient's pain not only during the pregnancy but also for many months afterwards. If patient is not ready to get pregnant yet again we can suppress the hormones with a very various different types of medications that can be given either orally or even injectable medications for more serious cases. And patients with these types of treatments have not work sometimes surgery is in order and that depends on what the patients fertility goals are. If they’re trying to get pregnant surgery to treat endometriosis can really optimize their chances of conceiving. Whereas a patient in a different stage of life who’s done having her children may really benefit from a hysterectomy. Every patient is different and fortunately there are a lot of different ways out there to approach treating this condition.


Types of Endometrial Surgery

Your doctor may recommend different techniques for surgery:How Can Surgery Help My Endometriosis - In Content

Laparoscopy. Your surgeon makes small incisions in your stomach and inserts a laparoscope (thin, lighted tube) to show where the endometrial tissue is attached in the pelvic area. The surgeon either will cut out these growths, called lesions, with surgical instruments or use a laser to destroy them with intense heat.

If you have visible scar tissue, your surgeon may also remove that during the procedure.

Laparoscopy is the most frequently recommended procedure to improve fertility in women with minimal or mild endometriosis. The surgeon removes or vaporizes growths around the reproductive organs. Studies show improved pregnancy rates following laparoscopy.

Laparotomy. Your surgeon makes one larger incision in your stomach. This option works for larger endometrial implants that can’t be removed with the laparoscope. It also is useful in removing the abnormal tissue from your other pelvic organs, such as your intestine.

it may offer effective short-term relief from pain or increase your fertility

Hysterectomy. In extreme cases, you and your doctor may decide you need a hysterectomy to relieve symptoms. Your surgeon will remove your uterus and sometimes your ovaries and fallopian tubes to halt the spread of endometriosis.

The condition is less likely to come back if the surgeon also removes tissue implants at the time of the hysterectomy.

There’s a small chance, about 15 percent, that pain will come back, even after a total hysterectomy. The reason is most likely because endometrial patches of tissue weren’t visible or weren’t reachable during your surgery.

Some doctors have tried cutting nerves that connect to the uterus or ligaments securing the uterus, but clinical trials have shown these procedures to be ineffective at relieving pain from endometriosis. The American College of Obstetricians and Gynecologists does not recommend these procedures to manage the condition.

Heather L. Hilkowitz, MD

Heather L. Hilkowitz, MD

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