If the diagnosis is confirmed, then treatment can commence. It is commonly recommended that deposits of endometriosis are surgically destroyed or removed, aiming to leave behind healthy structures which function normally and result in reduced levels of pain. In this way, patients can usually avoid having their womb, tubes or ovaries removed, although in severe cases this is sometimes necessary. Having this sort of surgery not only helps with pain but can also help with the chances of falling pregnant. Surgery, of course, is not without some risks and these would be explained to you.
Some patients with endometriosis require highly skilled laparoscopic (keyhole) surgery for the treatment of their disease and such treatment is available through Gynaechoice.
Another treatment option includes hormonal therapy. This treatment can be successful in reducing your pain symptoms although it can be associated with side effects. Plus, when treatment is discontinued, symptoms usually recur.
Endometrial ablation is an increasingly common technique and the number performed in the UK has increased by about 70% in the last three years. It is at its most effective as you approach the age of the menopause which is around 51, and least effective in women under the age of 35.
The technique involves removing or destroying the lining of the uterus and preventing its re-growth. The endometrium, or uterine lining, can be removed through a telescope, known as a hysteroscope, which is passed through the cervix. If there are any fibroids or polyps within the uterus and they are sitting on the lining of the uterus, these can also be removed at the same time through the telescope. This is usually performed as a day case operation, under a general anaesthetic, with return to normal activities after 48 to 72 hours.
Since endometrial ablation causes permanent damage to the lining of the uterus, it is not compatible with having further pregnancies. It is very unlikely that you would conceive, having had an endometrial ablation performed, but you should take active contraceptive precautions to prevent pregnancy following this procedure. If you are uncertain whether your family is complete then you should not have an endometrial ablation performed.
It is common to have a bloodstained discharge following endometrial ablation which may last for a few days or even several weeks. This is quite normal but if you develop a raised temperature, an offensive smelling discharge or have a lot of pain, then there is a possibility that you have developed an infection of the lining of the uterus. You should either contact us or your GP for a course of antibiotics which will usually clear it up quickly.
In a small number of women, cyclical or monthly pelvic pain can occur some months, or years, after the procedure. This is usually because a small area of the endometrium has started to re-grow and produce some menstrual bleeding but the blood becomes trapped in the inside of the uterus which is scarred because of the endometrial ablation procedure. Sometimes this can be released by carrying out a hysteroscopy and releasing the scar tissue within the uterus, but occasionally it does necessitate hysterectomy. Overall, however, in excess of 90% of women are satisfied in the long term after an endometrial ablation procedure and there is a good body of scientific evidence to support this conclusion.
You may find some useful help at www.endometriosis-uk.org.
