Frequently Asked Questions

What should I do if I have been having pelvic pain for more than 6 months and it isn’t responding to over the counter painkillers?

If the pain persists for more than six months, ask for a diagnostic laparoscopy.

If my pain continues after having a diagnostic laparoscopy which came back as normal , what should I do then?

If the results of your diagnostic laparoscopy are normal, however your pain continues, you may have endometriosis which was not picked up in the diagnostic laparoscopy. Request a repeat diagnostic laparoscopy by a consultant with a special interest in endometriosis.

I have been told that my symptoms are due to IBS, could this be the case?

Many woman who are labelled with and treated as if they have IBS (irritable bowel syndrome) in fact may have endometriosis. Request a diagnostic laparoscopy before accepting that you have IBS.

I have been told that my disease is stage 2, what does this mean?

Based on the severity of the disease endometriosis is divided into four stages, (least severe) stage 1 - stage 4 (most severe). Ask your doctor to explain the extent and stage of your disease.

I have been told that I have endometriosis found during a routine surgical procedure, and it is not causing any symptoms. My Consultant has told me that I will not be receiving any treatment for it. Is this acceptable?

If there are no symptoms, and endometriosis is diagnosed incidentally during other procedures, it may be left untreated especially if the disease is early. If not treated endometriosis may progress, regress or stay static.

What is the best method to surgically remove endometriosis?

Keyhole surgery is the most efficient way to both diagnose and treat endometriosis as it allows better visibility and access. At open surgery (laparotomy), endometriosis cannot be removed from the pelvis due to poor access and magnification, thus patient almost always has endometriosis in the pelvis at the end of open surgery. All stages of endometriosis (1 - 4) including all degree of bowel involvement and adhesions can be treated by keyhole (laparoscopic) surgery. Ask your doctor to refer you to gynaecologist who can undertake your surgery by keyhole means.

I have been diagnosed as having advanced disease (stage 2-4) and have been given medical treatment, is this the best method of treating my disease.

Medical treatment is mainly suppressive. It does not have any place in the management of infertility or to cure pain in cases of advanced disease. Ask for keyhole surgery under these circumstances.

What is the best surgical method of removing endometriosis?

Although laser treatment has been used extensively to treat the condition, surgical excision (peeling off and removing endometriosis) is the most modern treatment option with a better outcome and several advantages, so it is always best to ask for an excision especially if your disease is advanced. It is sound surgical principle to leave the normal tissue behind and remove only the diseased tissue. Surgical excision technique follows this principle by removing the endometriosis only, preserving normal organs such as the uterus and ovaries, and thus preserving fertility.

I have been diagnosed as having endometriosis and my surgeon is talking about me having to have a hysterectomy. Is this the only treatment?

No, hysterectomy should not be undertaken unless the uterus is diseased. In most cases of endometriosis the uterus and ovaries are normal. There is no evidence that removal of organs such as the uterus and ovaries are necessary and/or will cure the condition and so:-

  • Consider a hysterectomy very carefully; if you have a hysterectomy, you will not be able to have children in the future.
  • If a hysterectomy is required it must be accompanied with removal of endometriosis (excision).
  • If your uterus is diseased and/or good explanation has been given for hysterectomy, request that the endometriosis is removed (excision) during the same operation.
  • Consider very carefully before agreeing to both ovaries being removed (oophorectomy) if you are under 50 years of age. The ovaries can often be saved with a proper excision operation. In addition, endometriosis involving ovaries with large cysts can be treated by the removal the cyst only (cystectomy) and not of the ovaries, and you should therefore request your ovaries to be preserved; even if large cysts are present. Removal of the ovaries results in artificial menopause.

What type of doctor is the best to treat my endometriosis?

The complexity of endometriosis demands its management to be undertaken by a consultant surgeon with a special interest in endometriosis. Ask your doctor to refer you to a consultant with a special interest in endometriosis.

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