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Endometriosis Recurrence after Hysterectomy

From the Endometriosis Articles List

I am considering having a TAH/BSO for endo, but my doctor told me that it can come back after the surgery. Why go through all the struggle if it’s going to return?

It is true that endometriosis may exists following a hysterectomy and oophorectomy. Often, however, it is not so much that endometriosis returns, but rather that it was not all removed during surgery.

Endometriosis occurs when endometrial like cells implant in various places outside the uterus including the ovaries, fallopian tubes, ligaments, bowel, bladder, pelvic side wall, exterior of the uterus, and other areas of the pelvic cavity. Endometriosis can also implant outside the pelvic region including on the diaphragm, lung, and brain. The implants can be difficult to locate and remove, especially when they exist on delicate organs such as the bowel.

Unfortunately, at this time there is no medically-proven cure for endometriosis though excision surgery may offer the most optimal results. There are documented cases of endometriosis persisting despite a complete hysterectomy and oophorectomy. The The Incidence of Endometriosis in Posthysterectomy Women concludes that "endometriosis will be found at laparoscopy in a significant number of women with chronic pelvic pain status post hysterectomy with or without BSO."

The key for successfully treating endometriosis is the skillful locating, recognizing, and excising of the implants. For some, a hysterectomy with or without an oophorectomy may also be necessary.

The decision to have a hysterectomy is a major one. Each woman has to consider her own circumstances and health situation to determine what is best for her. One of the best things a patient can do is learn all she can about her endometriosis so she can make the most informed decisions. The Endometriosis Resources and Endometriosis Information page here on the site are a good places to start.

If you are considering having a hysterectomy for endometriosis, HysterSisters.com members who have experienced this same condition advise you to seek at least a second (or third and fourth) medical opinion prior to scheduling surgery. If at all possible, consulting with an Endometriosis Specialist can be wise. If there are any other treatment options available, you might want to try them first.

If you do decide to proceed with a hysterectomy, having the most skilled doctor you can find to do the surgery so that as much endometriosis as possible may be recognized and removed could offer you the most optimal outcome. If you decide to have your ovaries removed, you would also benefit from working with a doctor who is very knowledgeable regarding both endometriosis and HRT (hormone replacement therapy). Although estrogen is the fuel for endometriosis, hormones are also beneficial and critical for many aspects of overall health including the functioning of the heart, bones, skin, eyes, libido, and more.

If endometriosis persists following surgery, more than likely you will notice because of pelvic pain, bloating, or a change in bowel movements. The symptoms will probably be similar to what you experienced prior to your hysterectomy. However, experiencing pelvic pain or bowel issues does not necessarily mean that endometriosis is the culprit. It is easy for endometriosis patients to assume that any pain from the bottom of the rib cage to the thighs must be endometriosis, but there can be a whole range of conditions that can cause pain in this area of the body. Women with endometriosis often have other co-existing health issues that may need to be diagnosed and treated. Keeping a detailed symptom diary can be critical for determining the cause of symptoms.

It is important to remember that not all women will have problems with endometriosis after their surgery. Each patient must choose the best for her and then hope for the best. While there is no guarantee that one’s future will be free from endometriosis after surgery, there also is no guarantee that it will not be endometriosis-free.

This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.


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North Colorado Medical Center/ MCR
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970 353 1335
Emily Cunningham, M.D.
1720 Nicholasville Road
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Lexington KY 40503
Debra Richardson, M.D.
Gynecological Oncology Clinic - SW Med
2201 Inwood Road Suite 106
Dallas TX 75390
Melodie Wilson, M.D.
3650 Joseph Siewick Dr. #203
Fairfax VA 22033
Beverly Love, M.D.
46 Sgt. Prentiss Dr.
Natchez MS 39120
Linda Nicoll, M.D.
NYU Faculty Practice GYN
NYU Trinity Center - 111 Broadway 2nd Floor
New York NY 10006

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April 21,2014


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