Endometriosis is a common inflammatory condition where tissue similar to the lining of the uterus (endometrium) is found outside the uterus.
The tissue can form lesions, nodules and cysts which are mostly found in the pelvis, the Pouch of Douglas, ovaries, bowel, ligaments and bladder. It can be common for adhesions (fibrous scar tissue which causes internal organs or tissue to stick together) to form. Cysts on an ovary (endometriomas) may also develop in more advanced stages of the disease.
Common symptoms include
- Pelvic Pain
- Unusual Menstrual Bleeding
- Difficulty Getting Pregnant.
Endometriosis can usually be effectively managed through medication and/or surgery and lifestyle modifications.
Laparoscopic surgery aims to remove (excise) the endometriosis lesions and adhesions if they are found and restore normal anatomy (if it has been distorted). Whenever possible, laparoscopy will be undertaken in preference to laparotomy (open surgical procedure). It is acknowledged in the literature that surgical excision of the endometriosis is the gold standard treatment. It is important therefore that the gynaecologist has the appropriate surgical expertise to fully excise the endometriosis.
A hysterectomy is sometimes recommended where symptoms have significantly affected a woman’s quality of life and where future fertility has been ruled out. The ovaries may also be removed (oophorectomy). In these cases, it may be necessary to commence hormone replacement therapy (HRT) after surgery. A hysterectomy is not a cure for endometriosis but many women find relief particularly if endometrial tissue was found in the muscles of the uterus (adenomyosis). It is vital that all areas of endometriosis are excised at the same time. Discussion of any surgery should involve the woman so that she is fully informed and involved in her health decision making.
Recovery from laparoscopy
Recovery from laparoscopy is much quicker than from traditional surgery.
- The patient usually returns home the same day
- can resume normal activities within a few days
- The patient is generally advised to avoid strenuous exercise or activity for about a week and to avoid drinking carbonated beverages for a day or two to prevent gas pains and vomiting.