Surgical treatment of endometriosis
Have you undergone the ensometriosis surgical treatment and still can not stand the pain? Another endometrial cyst has appeared? Have you been having fertility problems although you underwent a surgery? Did you go through caesarean section and the tumour appeared in the scar? Have you been told that you had lesions on the intestine or bladder that could not had been removed?
If your answered "Yes" to any of the above questions it is most likely that you require another surgical treatment.
The decision where to surgically treat endometriosis is fundamental. It is essential to be well-prepared for it so the final effect of the surgery would be the best possible, the chances for pregnancy the highest and the risk of another operation in the nearest future possibly the lowest. Do not waste time. The lesions will grow with time increasing the risk of complications during subsequent operations!
Before the surgery
Thorough interview gives oportunity to estimate the location of the lesions. For example, frequent urination, or painful urination during menstruation, may indicate the presence of endometriosis on the bladder. Similarly, painful discomfort during defecation or simply spinal pain radiating to the lower limb can be an evidence of solid adhesions or deep infiltrating endometriosis on the colon.
Additional examinations. Gynecological and ultrasound examinations are indispensable before the surgical treatment. However, sometimes, other typesof additional examinations may be helpful. For example, in case of suspicion of deep-infiltrating endometriosis in rectovaginal area during the gynecological examination or ultrasonography, it is worth to perform also the magnetic resonance imaging (MR). It leads to accurate evaluation of the final segment of the large intestine and the size of the endometrial lesion in that area. It also helps to estimate the risk of partial intestine resection, which must also be properly prepared. Magnetic resonance is also extremely helpful to estimate the severity of adenomyosis and to choose the right treatment. Laparoscopy enables only observation of seruosa covering the uterus, but at the same time it does not show what is located underneath. Another helpful examinations for suspected infiltration of the intestine or bladder are colonoscopy, which enables to look through the final segment of the large intestine with the camera, and cystoscopy - bladder examination. Performance of those types of examinations give certainity whether endometriosis infiltrating the bladder or intestine "got through" to the mucous membrane.
The choice of appriopriate institution in which you will undergo your surgical treatment of endometriosis is one of the most important decisions you need to take to guarantee the successfull treatment. Before you decide it is worthwhile to pay attention to the following aspects:
Appriopriate equipment. Germans say: “Gutes Werkzeug ist halb getane Arbeit” (“the right equipment is half the work done”). When it comes to endometriosis it is mainly good optics and visibility that enable identification of the smallest endometrial lesions and appriopriate equipment enableing effective removal of these lesions. Such tools include laser and plasma knife, which allow to perform precise vaporization (evaporation) of endometrial lesions without destroying adjacent tissues. What is important, with their use it is possible to remove lesions from delicate organs (eg gut, bladder, ureter, liver) without damaging them. Therefore, it is crucial to select a clinic that has relevant equipment.
Adequate staff. The gynecologist's narrow cooperation with an experienced surgeon and urologist plays a key role in bladder or bowel infiltration. As Miracolo we work closely with both urologists and surgeons in the center of endometriosis in St. Joseph Hospital in Dortmund.
Time. This inconspicuous factor significantly affect the quality of treatment. Operations of endometriosis are often time-consuming, interdisciplinary procedures. Therefore, the role of good preparation needs to be emphasized again, as it enables accurate estimation surgery's duration and the need of surgical or urological interventions.
Thorough operation. Precise excision of possibly all endometrial lesions. By ecxcision or vaporization of the lesions we reduce the risk of recurrence at the same area to minimum. Electrocoagulation always carries the risk that the charred tissue still contains active endometriosis glands which can shortly regenerate after the operation.
We encourage you to read more about our treatment offer.
After the operation
If you will not take any action after the operation there is no doubt that the disease will come back again! Each operation carries risk of adhesions. Each endometrial cyst enucleation causes deminishing of ovarian reseve and fertility reduction! Ovaries observed after 2 o3 operations of endometrial cysts look as scarred bands of connective tissue and maintain only their limited function.It is not always possible to preventthe organism from the reccurence. However there are several possibilities, which can reduce its risk to minimum:
Nutrition therapy. Is nutrition somehow connemcted with endometriosis? There are several scientifical publications indicating a high similarity of endometriosis with autoimmune diseases. There are also many publications concerning the influence of impaired immune system (resulting from intestinal dysbiosis arising from poor nutrition), stress and toxins on the formation of autoimmune diseases and endometriosis. This is often the only effective weapon that can be used after surgery due to the fact that most endometriosis patients suffer from infertility. Hormone therapy holds the ovulation in these patients which prevents pregnancy.
Hormone therapy. Hormone therapy aims at slowing down the growth of endometrial lesions. Due to the frequent and distressing side effects we only apply hormone therapy (in parallel with nutrition therapy) in cases of an aggressive forms of endometriosis.
We encourage you to learn more about our nutrition therapy.