Will I need surgery for endometriosis?

Endometriosis is a condition in which tissue that is similar to the tissue that lines the inside of the uterus (known as endometrial tissue or the endometrium) grows outside the uterus. The most common spots for endometriosis are the ovaries, the fallopian tubes, the bowel, and the areas around the uterus. This endometrium growth can result in pelvic pain, excessive bleeding, and, in some cases, difficulty getting pregnant.

Types of treatment options

Although there is no known cure for endometriosis, there are many treatment options available. These include nonsteroidal anti-inflammatory drugs (NSAIDs) to birth control to other types of hormone treatment. These treatments may help reduce symptoms, slow disease progression, and prevent complications.

In some cases, surgery may be recommended. But just as symptoms will vary from person to person, so will treatment options. Some people with endometriosis will require surgery, while others will not.

Surgery as a recommendation

Your healthcare provider (HCP) might recommend surgery if you have severe endometriosis that’s causing you a lot of pain and if medication hasn’t helped. If you’re having trouble getting pregnant, surgery may be recommended to determine if endometriosis is the cause, because a surgical biopsy is the only definitive way to diagnose endometriosis. In most cases, if endometriosis is diagnosed during surgery, it can be treated at that time as well.

Laparoscopy: a minimally invasive surgical option

One type of surgery used to diagnose and treat endometriosis is laparoscopic surgery. This minimally invasive approach is also known as "keyhole" surgery. That's because during the surgery, a surgeon will thread a thin viewing tube (called a laparoscope) through a small incision (like a keyhole) in the abdomen. The laparoscope has a light source and a camera that project a magnified image of the pelvic cavity onto a computer screen. This way, the surgical team can have a clear view of the organs in the pelvis and of any endometriosis that may be present.

A surgeon may make one or two additional incisions on the lower abdomen to provide more openings for surgical instruments. This laparoscopic approach is less invasive than open surgery, in which a large abdominal incision must be made.

Laparoscopic surgery may involve removing endometriosis growths, adhesions, and/or scar tissue. The type of surgery will depend on a number of different factors, including the location and size of the endometriosis. There is no one treatment option that is best for all patients. Your HCP will help you determine which approach is best for you.

Because these procedures involve operating on and around delicate organs, it’s important to have an experienced and qualified surgeon on your healthcare team.

Other types of surgeries

In some cases, more traditional abdominal surgery using a larger incision may be performed to remove widespread endometriosis. And in cases of advanced endometriosis, surgery to remove organs affected by or damaged by endometriosis may be necessary. But as with all other treatment options, it depends on your particular situation and requires conversations with your healthcare team.

It’s different for everyone

Remember that no two cases of endometriosis are the same. Working with HCPs you feel comfortable with, seeking out a second opinion if necessary, and having a trusted surgeon on your healthcare team can help you feel confident in making informed decisions about your health.