Why Surgery?

Surgery_ (1)

I wanted to spend a little time addressing the questions seen in my most recent photo as I hear them alot. There are a few reasons surgery is often the best choice for suspected endo warriors please read below and feel free to comment or message me with any further questions.

Only way to get a definitive diagnosis

First of all, surgery is the only way to defensively diagnosed endometriosis. In rare occasions endometriosis can be seen on ultrasound or MRI by a vary well trained radiologist but often, even stage four endo can not be detected on any imaging modality. If lesions are seen, doctors still can not be 100% sure the areas imaged are endometriosis and the extent of the disease can not be observed. Definitive diagnosis requires submission of a sample to a pathologist via surgery. There are a few other conditions that can image similarly to endo including some kinds of cancer. In my case it was impossible to accurately tell the cancer cells from endometriosis until I was in surgery. No matter your situation, surgery is the only way to get an undeniable diagnosis. That being said, a lot of medical professionals will conclude that a women likely has endometriosis based on probability and symptoms.

Only treatment method scientifically shown to give long term relief to some patients.

Excision surgery has been the only western medicine method giving long lasting relief to some sufferers. Birth control can temporarily mask symptoms but can cause other health issues and once the patient stops taking birth control their symptoms are often worse then ever, GNRH-agonists can help but also can only be taken for short periods of time due to their severe side effects, pain meds again only mask the underlying issues and can cause dependency. Surgery done by an excision specialist has been show to help between 60 to 70 percent of women experience long lasting relief. For women with advanced endometriosis surgery may not fix all the symptoms but it can control both damage to surrounding oreagons and some of he pain.

Can detect secondary issues masked by other treatments.

This one is pretty self explanatory. I’ll give and example my Dr. told me about once. Once he had a women with a history of severe crippling endometriosis who went to the ER. The ER Dr. gave her some pain meds her pain meds and told her some women just have painful periods. Out of desperation she researched some doctors in the area. After one exam my Dr. got her into surgery within a day. As soon as he placed his surgical instruments he found she had a splenic torsion due to adhesions cause by endo. This condition can turn very dangerous very quickly. Had he not done surgery she could have died within weeks or even days. A less severe case is when my Dr. discovered that my adhesions had caused the ligament that supports my uterus to snap almost completely in half. It was hanging on but a thread. If it had torn any more I likely would have experienced a utearan prolapse. Had I not had surgery and tried to control my endo via other means before a surgeon assessed my situation I likely would have ended up in the ER with my uterus in my lap.

Trying other methods to control endometriosis before surgery may not be the best answer.

Often OB/GYNs will still suggest pain meds, birth control, IUDs, GNRH-agonists etc before suggesting surgery. This may not be the best option. Pain meds, birth control, IUDs, etc can all mask symptoms but do not address the underlying cause. There is some argument to if birth control can slow the progression of endometriosis but it is wide known that is does not stop progression. Either way your symptoms may be a bit better temporarily while your on one of these treatments but if you ever discontinue use your pain will likely be worse then before. It is suspected that some birth controls may actually make endometriosis worse but the evidence to support this hypothesis is still limited. GNRH-agonist have been shown to slow progression of endometriosis and possibly even shrink areas but still, it does not eliminate endometriosis. These drugs also often have severe side effects and should not be considered unless a patient has had surgery, knows definitively they have endometriosis, and are out of other options. There is some evidence that diet can slow progression as will. Yet, as of now there is no treatment that has been found to consistently reverse or even stop progression of the disease. Even if something does come about that can get rid of endometriosis the secondary adhesions, scarring, rips, and trauma would still need to be repaired.

In my next posts I will be answering a few other common questions asked when considering surgery including “Are all surgeries the same?”, “how do I find the right surgeon?”, “how should I prepare for surgery?”, and more… please stay tuned!

Please leave any comments or questions bellow