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.

Surgical treatment

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.

Zastanawiasz się, czy Ty też masz endometriozę?

Im wcześniej zdiagnozujesz tę chorobę, tym większe szanse na jej całkowite wyleczenie. To nie tylko lepszy komfort życia z powodu braku dolegliwości miesiączkowych, ale przywrócenie Twojemu ogranizmowi naturalnej płodności.