What is endometriosis surgery?
Endometriosis surgery can diagnose and treat endometriosis — a condition in which tissue that typically grows inside of your uterus grows outside of it instead.
Is endometriosis surgery a major surgery?
In most cases, no. Historically, surgeons performed open surgery — which requires a large incision across your abdomen — to remove endometriosis. Today, however, almost everyone who needs endometriosis surgery can have laparoscopy, a minimally invasive surgery which only requires small incisions.
What are the different types of endometriosis surgery?
Endometriosis surgery involves the removal of endometriosis. There are two different approaches:
- Laparoscopy. This minimally invasive procedure is the most common approach to endometriosis surgery. Endometriosis laparoscopic surgery treats mild to severe cases by skilled surgeons trained in this method. During the procedure, they’ll make a small incision in your abdomen so they can insert a tiny tube with a camera (laparoscope) through it. In some cases, they may need to make more than one small incision.
- Laparotomy. Healthcare providers don’t use this open surgery approach as often as they used to. Laparotomy is more invasive than laparoscopy. It involves making one large incision across the abdomen, rather than a few small incisions. Your surgeon might perform laparotomy when the condition is severe or when you don’t qualify for laparoscopy.
Who needs endometriosis surgery?
A healthcare provider can help determine whether or not you need endometriosis surgery. Surgery may be beneficial if:
- You have chronic (long-standing) or severe pelvic pain.
- You need to remove areas of endometriosis in your pelvic area.
- Medication no longer relieves your endometriosis symptoms.
- You have difficulty getting pregnant.
What should I expect before endometriosis surgery?
Your healthcare provider will give you specific instructions on how to prepare for endometriosis surgery. Here are some general guidelines:
- Make arrangements for a trusted friend or family member to drive you to and from your appointment.
- Avoid eating and drinking after midnight the night before your surgery.
- Ask your healthcare provider if you should stop taking any medications, such as blood thinners.
- If you smoke, quit smoking at least three weeks before your endometriosis surgery.
- Stock your pantry with lots of fluids and light foods like soup and gelatin.
What happens during endometriosis surgery?
As mentioned above, there are two types of endometriosis surgery: laparoscopy and laparotomy. However, the majority of people who need this surgery will undergo laparoscopy.
During laparoscopic endometriosis surgery:
- An anesthesiologist will place you under general anesthesia and monitor your vital signs.
- A surgeon will create a small incision (cut) in your bellybutton or another part of your abdomen (in some cases, they might need to make more than one incision).
- They’ll use gas to inflate your belly so the laparoscope has a clear view.
- Your surgeon will insert the laparoscope through the incision.
- They’ll use the laparoscope to find areas of endometriosis.
- They’ll attach special instruments to the laparoscope to remove any affected tissue.
- After your surgeon removes the endometrial tissue, they’ll remove the laparoscope and the instruments.
- Finally, they’ll close the incisions with stitches.
What happens after endometriosis surgery?
If you had laparoscopy, you’ll probably go home from the hospital on the same day. But you’ll need to rest in a recovery area until your medical team clears you. You’ll likely feel tired for a few days. But you should be able to return to normal routines in about two weeks, though it could take longer for some people.
People who undergo laparotomy usually need several weeks to recover because the procedure is more invasive. Your healthcare provider will give you a list of detailed post-operative guidelines.
Risks / Benefits
Does surgical treatment improve pain?
Most people notice significant relief with simple removal of the endometriosis. However, 20% of those who undergo surgery won’t respond and will need further medical treatment. Of those that respond, there may be a recurrence (return) of pain over time.
What factors determine whether endometriosis comes back after surgery?
Whether endometriosis comes back (recurs) after surgery depends upon three factors:
- How severe the disease was at the time of surgery.
- How completely the surgery removed the lesions.
- Whether you had medical suppressive therapy after your surgery.
Lesions that appear after surgery may be new or pre-existing. For this reason, it may be difficult for your provider to tell whether your disease has come back or is progressing. Many studies also report symptoms as a sign of new disease.
Is laparoscopy more effective than laparotomy?
Laparoscopy is superior to laparotomy because it results in fewer surgical complications, such as bleeding, infection and possible injuries to other abdominal organs. Laparoscopy also offers faster recovery and less downtime compared to laparotomy.
What are the risks or complications of endometriosis surgery?
Endometriosis surgery is relatively safe. However, as with any procedure, there are possible complications, including:
- Possible injury to nearby organs such as your bladder and bowel.
- Fistula (an abnormal connection between two organs).
- Blood vessel damage.
Recovery and Outlook
What’s the outlook for people who undergo endometriosis surgery?
While many people find success with medication and surgery, these treatments do have side effects and they don’t work for everyone. Researchers are continuing to investigate new and improved treatment strategies. One area of study is focusing on the role of the immune system in the development of endometriosis.
How long does it take to recover from endometriosis surgery?
People with advanced cases of endometriosis may need six weeks or longer to recover. If you have mild endometriosis, you may heal quicker.
When can I go back to work or school after endometriosis surgery?
Unless you have a physically demanding job, you’ll probably be able to return to work or school two weeks after endometriosis surgery. If your job requires a lot of physical activity, you may need to wait longer. Be sure to ask your healthcare provider what to expect in terms of your recovery.
When to Call the Doctor
When should I contact my healthcare provider?
Following endometriosis surgery, you should call your healthcare provider if you notice:
- Redness or swelling around the incision sites.
- A fever of 101°F or higher.
- Pain that worsens or doesn’t improve with medication.
- Pus draining from the incision site.
- Heavy bleeding from your vagina.
- Feeling as though you can’t empty your bladder.
Can endometriosis come back after surgery?
Surgery is usually successful in relieving pain, but there’s a chance the pain could return. Hormones produced by your ovaries stimulate endometriosis. To combat this, your healthcare provider may recommend medication (such as birth control pills, or progesterone-only medications) to suppress your ovaries and control endometriosis.
How quickly can endometriosis grow back after surgery?
Endometriosis can grow back soon after surgery if the disease isn’t completely removed or if your ovaries aren’t suppressed.
Does endometriosis surgery help fertility?
In many cases, endometriosis surgery can improve your chances of getting pregnant naturally. However, if you don’t get pregnant within a reasonable timeframe following your procedure, having surgery again probably won’t help.
Treating early stage endometriosis to improve fertility is controversial. If you have questions about endometriosis and fertility, talk with a healthcare provider about personalized treatment.
A note from Cleveland Clinic
Endometriosis can be a painful and frustrating condition. If you think you may have endometriosis, schedule a consultation with your healthcare provider. They can design an individualized treatment plan to ease your symptoms and improve your quality of life.
How long does it take to recover from endometriosis surgery? ›
You'll likely feel tired for a few days. But you should be able to return to normal routines in about two weeks, though it could take longer for some people. People who undergo laparotomy usually need several weeks to recover because the procedure is more invasive.What happens after endometriosis is removed? ›
What to Expect After Endometriosis Surgery. You might be tired for a few days after a laparoscopy. Your doctor may tell you not to drive for 2 weeks. They might also tell you not to have sex or do activities like swimming or bathing in a tub for about 2 weeks.What not to do after endometriosis surgery? ›
DO NOT drive a car for 48 hours after your laparoscopy, because the anaesthesia causes drowsiness. You don't need to stay in bed, but it's best to rest and take it easy for the remainder of the day. After 24 hours, there is no limit on your physical activity as long as you're not taking narcotic medication.What is the success rate of endometriosis surgery? ›
Between 45 and 75% of women who undergo the surgery are able to conceive after healing. Many of these pregnancies are even achieved naturally.How serious is endometriosis surgery? ›
Laparoscopy is a type of minimally invasive surgery. It uses a small, slender camera called a laparoscope and only requires small incisions to see into the abdomen. Laparoscopy is performed under general anesthesia. That means that you'll be asleep while the procedure is being performed and won't feel pain.Is endometriosis surgery worth it? ›
Surgery can be performed to improve endometriosis-related pain by removing the abnormal endometriosis tissue and scar tissue that forms as a result of the lesions. In most cases, endometriosis surgery is recommended when other less invasive treatments have failed to manage your pain.Does Endo belly go away after surgery? ›
Will the bloating go away after endo surgery? Yes, endometriosis surgery often resolves the underlying cause of your abdominal swelling. You may have some post-surgical swelling and discomfort, so your relief won't be immediate.What is the best surgery for endometriosis? ›
Even in severe cases of endometriosis, most can be treated with laparoscopic surgery. In laparoscopic surgery, your surgeon inserts a slender viewing instrument (laparoscope) through a small incision near your navel and inserts instruments to remove endometrial tissue through another small incision.How do they cut out endometriosis? ›
One procedure used to treat endometriosis is laparoscopic surgery to remove scar tissue, endometriosis and cysts that build up as a result of endometriosis. During the procedure, a surgeon will insert a tube with a small camera on the end into a small incision in the abdomen to find and remove the endometriosis.How do you poop after endometriosis surgery? ›
Take a mild stimulant such as Senna 17.2 mg one to two times per day until you have regular bowel movements. If you still have not had a bowel movement after 2-3 days of taking Colace and Senna, take 1 generous tablespoon of Miralax (polyethylene glycol 3350) daily.
What will I need after endometriosis surgery? ›
Therefore, there is no douching, tampon, sexual intercourse, swimming, or tub soaks for 2 weeks after this procedure. There may be some light vaginal bleeding and mild cramps. This should resolve within days to a week. The cramping should be mild and you should not require anything more than an Advil or Tylenol.How long will I be off work after laparoscopy? ›
Most women feel able to return to work one to three weeks after a laparoscopy. If you have had a diagnostic laparoscopy or a simple procedure such as a sterilisation, you can expect to feel able to go back to work within one week.What is considered severe endometriosis? ›
The extent of endometriosis is evaluated during laparoscopy. A clinical staging system is used to describe the extent of endometriosis, adhesions, and endometrioma cysts in the ovary. A score of 1-15 indicates minimal or mild endometriosis and a score of 16 or higher indicates moderate or severe disease.Is endometriosis considered a disability? ›
Endometriosis is a chronic condition that can have a significant impact on everyday life and activities. But it isn't viewed as a disability by most medical professionals or the law.What is endometriosis belly? ›
Endo belly is a term used to describe the uncomfortable, often painful, swelling and bloating associated with endometriosis. Endometriosis is a condition in which tissue similar to the lining inside the uterus, called the endometrium, is found outside the uterus where it doesn't belong.What makes endometriosis worse? ›
Endometriosis tissues are affected by hormones in the same way as endometrial tissues inside the uterus. Hormone changes that occur with a menstrual cycle can make endometriosis pain worse. Treatments that include hormone therapy can alter hormone levels or stop your body from producing certain hormones.How do I prepare for endometriosis surgery? ›
Don't eat or drink anything after 11:30 pm. You may have CLEAR liquids (such as clear apple juice, water, Gatorade) up until 2 hours before your surgery. Remove all jewelry, including any and ALL piercings (leave them at home) If you can't remove them, your surgery will be cancelled.Do you put on weight after endometriosis surgery? ›
Hormone medications and surgical treatments, such as a hysterectomy, may cause weight gain. If you're concerned about these options, talk with your doctor.Why does it hurt to pee after laparoscopy? ›
The pelvic floor muscles are the muscles that support your uterus and bladder and keep them from falling. After surgery, some women tighten these muscles (due to pain from the surgery) and this may make urination more difficult.Are you put to sleep for endometriosis surgery? ›
They may also remove cysts, implants, and scar tissue caused by endometriosis. A laparoscopy for endometriosis is a low-risk and minimally invasive procedure. It's typically performed under general anesthesia by a surgeon or gynecologist. Most people are released from the hospital on the same day.
Do and don'ts after laparoscopy? ›
Wash the area daily with warm, soapy water and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
- Don't drink alcohol or drive for at least 24 hours after surgery.
- You can bathe any time after surgery.
- You can remove the bandage the morning after the surgery. ...
- You can typically return to work three days after surgery. ...
- Do not be concerned if your urine is green.
Dried or dehydrated foods: Some examples of dehydrated foods are beef jerky, dried fruits, prunes, and specific potato chips. A dairy product like milk: Avoid milk and other full-fat dairy product like sour cream and ice cream. Sweets: Try avoiding sweets like candies, cakes, pastries, and additional sugar content.Does endometriosis pain go away immediately after surgery? ›
In fact, your first period after surgery may be worse than before surgery. Some lucky folks will have immediate pain relief including menstrual cramps, but it is difficult to predict who will react either way. Once 3-6 months goes by, most of the endometriosis pain should be gone.How do you sleep after endometriosis surgery? ›
The doctors do not recommend sleeping on the stomach after the surgery. This position can hurt your spine and can also pressurize the hip area. Try to control your sleeping habits if you are a stomach sleeper. It is best to sleep on your side or back.