Surgical Treatment for Endometriosis

Endometriosis - What It Is

Endometriosis is defined as the growth of endometrial tissue outside of the uterus. Endometrial tissues are the cells which are shed each month during menstruation. When these cells locate outside of the uterus on other organs within the pelvis, they are termed endometrial implants.  While at times there are no symptoms or indications of anything wrong, for many women endometriosis is a painful issue. Endometriosis is most common among women of reproductive age and is one of the leading causes of abdominal pain in women. It is also the cause of most laparoscopic surgeries and hysterectomies. As a matter of fact, a confirmed diagnosis of endometriosis can only occur by laparoscopy or surgery.

Endometriosis is more common in women who are experiencing infertility than fertile women. However, endometriosis does not fully prevent conception. Treatment options for infertility which is associated with endometriosis are varied but the general consensus amongst doctors is that surgical treatments are superior to hormonal or medical treatments when it comes to enhancing fertility. There is also the possibility of assisted reproduction in the event surgery does not produce the necessary results for conception.

When Endometriosis Becomes Severe

When the symptoms of endometriosis are very severe or if there has not been a satisfactory response to medicinal treatment, surgical treatment is recommended. If there is an anatomic distortion of the pelvic organs - which can happen with the scarring due to endometriosis - or if there is an obstruction of the bowel or urinary tract, surgery is the preferred method of dealing with the situation. There are two classifications of surgical therapies for endometriosis. One is called conservative, wherein the uterus and ovarian tissue is preserved. The other is termed definitive, which involves a hysterectomy - the removal of the uterus - with or without the removal of the ovaries.

Laparoscopy or Hysterectomy?

A laparoscopy is the usual method for carrying out a conservative surgery. The use of laser or the excising of the endometrial implants is done this way. If there is a problem with distorted anatomy, then a laparotomy, which is the opening of the abdominal wall using a larger incision, may be necessary. A hysterectomy is the surgical removal of the uterus and is considered to be major surgery.

Even though surgical treatments can be effective in pain reduction, there is still an estimated recurrence rate of 40 percent. After surgical treatment, many doctors recommend that women continue to take oral medications to maintain symptom relief.

Endometriosis Does Not Mean The End

More common in infertile women than in fertile women, endometriosis does not necessarily spell the end of conception. Many women with mild to moderate endometriosis will be able to conceive and it is estimated that about 70 percent of women with endometriosis will be able to conceive within three years without any specific intervention or treatments.