Endometriosis: Surgical Options and Their Impact on Quality of Life
What Is Endometriosis?
Endometriosis is a condition in which the uterine cells grow in other parts of the body such as the:
- Ovaries
- Fallopian tubes
- Lining of the pelvic area
- Bowel
- Rectum
- Bladder
These are the most common places, but endometriosis may develop in other parts of the body too. The World Health Organization (WHO) defines it as “a chronic disease associated with severe, life-impacting pain during periods, sexual intercourse, bowel movements and/or urination, chronic pelvic pain, abdominal bloating, nausea, fatigue, and sometimes depression, anxiety, and infertility.”
Endometriosis can occur at any time between the first menstrual cycle and menopause. It is estimated that globally about 10% of women of reproductive age suffer from this condition.
Treatment for Endometriosis
If endometriosis is diagnosed at an early stage, your gynecologist may prescribe medication to control the symptoms. No treatment will cure the condition. Medication is used to postpone the surgical option or to allow a patient time to build up strength for the operation or to get treatment for other medical issues that could affect the surgery. Medication may not be suitable for women who are trying to become pregnant.
Also Read: List of Common Urogynaecology Surgical Procedures
Surgical Options
There are two approaches to endometriosis surgery:
- Laparoscopy – This is the most common procedure used today. It is a minimally invasive procedure that requires only a small incision (or in some cases, more than one) to be made in the abdomen. A tiny tube with a camera is inserted to allow the surgeon to view the exact location and extent of the problem. Minute surgical instruments are then inserted and used to remove the growth. Minimally invasive surgery offers the advantages of smaller incisions, reduced scarring, reduced blood loss and pain, faster recovery and lower chances of infection.
- Laparotomy – This is the more traditional open surgery approach. It is used when the surgeon decides that the severity and extent of the condition will make a minimally invasive procedure less effective. Laparotomy requires a large incision to be made across the abdomen after which traditional surgical tools and procedures are used.
The Laparoscopy Procedure
The typical laparoscopic procedure for endometriosis can be summarized as follows:
- You will be placed under general anesthesia
- A small incision is made in the abdomen
- Gas will be used to inflate the belly to give the surgeon a better view and space to work
- A laparoscope will be inserted through the incision to give the surgeon a real-time view of the organs in the abdominal cavity
- Special minute surgical instruments will be inserted through the incision to remove the affected tissue
- The laparoscope and surgical instrument will be removed
- The incision will be closed
Recovery from Surgery
The duration of recovery from laparoscopic surgery depends on the severity of the condition and factors that affect overall patient health. Typically, recovery takes a few weeks to a few months. During that period you will be given medication to control any pain and told about precautions to be taken and activities to avoid and for how long.
After recovery, you should be able to resume your normal activities and lifestyle. You will be informed of any actions that you should continue to avoid.
Life After Surgery
While you will be able to return to your normal activities after the surgery, you should be aware that there is a possibility of the condition recurring which may require the surgery to be repeated. This is something you need to be aware of, but it should not affect your normal life.
Your menstrual cycle is likely to resume from 4 to 6 weeks after the surgery. It is possible that the first post-operative period may be painful with increased cramping and a heavier flow. This is normal and your periods should return to normal after a few cycles. Discuss any discomfort with your doctor.
Another factor to bear in mind is that if you are trying to become pregnant, studies show that the chances of becoming pregnant significantly increase after endometriosis surgery. If you do become pregnant, the surgery for endometriosis should not affect your pregnancy or cause any problems. Your OB/GYN will give you specific advice on this matter. If you are not looking to become pregnant, you should reevaluate your birth control options and choices.
Some women report that because of the severe pain and discomfort that endometriosis causes, even after the surgery, they feel uncertain and depressed. This is not something to hide. It is just a complication and similar to physical ones, this can be treated. If you feel depressed or uneasy after the surgery, tell your doctor who may refer you to a mental health professional.
Also Read: The Importance of Regular Gynaecological Examinations
On Going Wellness
Returning to your normal life after surgery does not mean that you should take your health for granted. The following tips can help you remain healthy after your surgery.
- Drink lots of fluids
- Get enough exercise and do it regularly
- Get enough sleep and rest
- Do not let yourself become overweight
- Do not smoke
- Control alcohol intake
- Eat a diet that is rich in vitamins C and E, omega 3 and citrus fruits.
- If you have been prescribed hormonal supplements, continue to take them as advised.
- If you suffer from stress, anxiety or tension, use yoga, meditation or similar techniques to relieve the mental pressure.
If you have been diagnosed with endometriosis or suspect that you may be suffering from the condition, it is essential that you be examined by the highly experienced and qualified gynecologists and surgeons you will find at the gynecology department of a large multispecialty hospital. Besides the best doctors, this is where you will find the most advanced treatment and surgical procedures to provide you with the most effective medical solutions to the condition. Additionally, if there should be any associated medical issues that need to be treated either along with or before the endometriosis surgery, this will be available at this hospital which will make the overall treatment and recovery easier and less stressful.
Endometriosis is not a condition that can be ignored. It is also not one that should cause fear or panic – it is an increasingly common gynecological ailment and with the right treatment and surgery, normal life can resume.
Frequently Asked Questions
1. What is endometriosis?
Endometriosis is a condition where uterine cells grow outside the uterus, often causing severe pain, especially during periods, sexual activity, or bowel movements.
2. What are the common surgical options for endometriosis?
The two main surgical options are laparoscopy, a minimally invasive procedure, and laparotomy, an open surgery used in more severe cases.
3. How does laparoscopic surgery for endometriosis work?
Laparoscopy involves a small incision, inserting a camera to locate the endometrial growths, and using tiny instruments to remove the affected tissue.
4. What is the recovery time after endometriosis surgery?
Recovery time can range from a few weeks to several months, depending on the severity of the condition and the patient's overall health.
5. Can endometriosis recur after surgery?
Yes, there is a possibility of recurrence, and in some cases, additional surgery may be needed.
6. Does endometriosis surgery affect fertility?
Surgery can improve the chances of becoming pregnant. However, it is essential to discuss individual risks and benefits with a healthcare provider.
- Sep 20, 2024