Surgical & Medical Answers

Many factors play a part in the treatment of endometriosis, particularly if a woman wants to have a baby. If a woman wants to become pregnant, then the treatment will take a different course than if she is past the age of childbearing and wants to be relieved of the pain and symptoms of endometriosis without desiring a baby.

For women who are past the age of 35, doctors may, if the disease is very bad, advise a hysterectomy to clear the pelvic cavity and deal with the issue long term. If the woman is younger, then conservative surgery or surgery to restore reproductive structures is often the primary course of treatment.

When Surgery Is The Best Decision

If a woman's ovaries and tubes have become distorted because of endometriosis, the first surgery performed is the most effective. Fertility is less likely to be restored with surgeries performed after the initial attempt, which is why a very skilled endoscopist is the best choice for such a procedure. This will help to ensure the chances of pregnancy afterward.

In most cases, when the ability to procreate is high on the agenda, the most common surgical procedure performed is using a laparoscopy with the focus on the removal of pelvic adhesions surrounding the ovaries, tubes, and uterus. Surgical removal of endometriotic implants (small growths of endometriosis) and the removal of ovarian endometriomas (ovarian cysts) are also priority in the treatment. This type of surgery consists of cauterizing (burning), coagulation (blood clotting), excision (removal by cutting), or vaporization (liquefying). It is recommended that excision, or cutting to remove the endometriosis, be the method of choice since most of the disease is far deeper than it first appears.

Surgery Success Rates

There are many other types of surgeries done to ease the pain of endometriosis. However, some of them do render a woman incapable of bearing children. The success rates for pregnancy following surgery generally range between 35-40 percent for severe cases of endometriosis and 55-65 percent for milder cases of the disease. Of women who do manage to conceive, 30 percent conceive within three months post-op, 50 percent within six months, and 86 percent within 15months. There does not seem to be much of a difference based upon the type of surgery used-laparoscopy, laparotomy, laser, or electrosurgical techniques.

A Good Mix Of Procedures Can Ensure An Excellent Outcome

In women with severe cases of endometriosis, medical therapy combined with surgery offers the greatest degree of success. When treatment using drugs specially designed to address hormonal dysfunction is coupled with skilled surgery, women with severe cases of endometriosis have not only found relief from the disease, but have also been able to enter into an ART program and have children.

There is no "one size fits all" answer to endometriosis. However, with constant research and the willingness of skilled professionals to work with women suffering from the disease, there are more and more success stories being told every day.

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