Surgery for Endometriosis
When facing a diagnosis such as endometriosis, there are quite a few avenues of treatment. You may be presented with hormonal options like birth control to eliminate your periods or medication which puts you into temporary menopause, or perhaps you are contemplating surgery. The most important thing when considering treatment for your endometriosis is to discuss it fully with your doctor as they are the ones that are fully versed in your specific case. However if you are having doubts or feeling conflicted, it’s important to do your own research, advocate for your beliefs, and find a gynecologist and holistic health care professional (like a practitioner in Traditional Chinese medicine) to assist you.
Surgery is considered the gold standard of treatment for endometriosis, specifically excision surgery. This is done through a minimally invasive laparoscopic (key hole) surgery. It is also the only way endometriosis is 100% for sure diagnosed (if the excised lesions are histologically confirmed, that is). While ablation or cautery of endometriosis is used most often, it does not fully remove the lesions of endometriosis. Instead it burns off the top portion while leaving the root to continue to grow (ablation has a recurrence rate of 74% 20 months post surgery). If your surgeon only performs ablation/cautery of endometriosis, you must seek out someone else who is more well versed in treating endometriosis (Nancy’s Nook Facebook group has a great list of excision specialists all over the world). Many OBGYNs treat endometriosis but only a few have specialized training and are up to date in the treatment of endometriosis.
Contrary to what your doctor may say, there is no hormonal medication that shrinks, reduces, puts into remission, or stops the spread of endometriosis. Having a baby does not cure endometriosis and nor does a hysterectomy (removal of uterus and/or ovaries).
Excision surgery is one of the best options for endometriosis because it fully removes the cysts and lesions. Studies show that patients with laparoscopic excision of endometriosis show an improved quality of life 4 months after surgery, 73.9% of patients had a reduction in pelvic pain following excision of bowel and bladder endometriosis, significant reduction in symptoms following colorectal resection for endometriosis, and painful intercourse is successful treated with surgical excision of endometriosis.
Left untreated, the lesions can grow and injure organs such as the bowel, ovaries, fallopian tubes, and bladder. The lesions secrete hormones and inflammatory chemicals which cause imbalance hormones and pelvic inflammation which causes pain and possibly infertility. Untreated endometriosis can also cause nerve damage and chronic pain.
The gold standard for the treatment of endometriomas (also called chocolate cysts, or endometriosis on the ovary) is laparoscopic surgery with excision of the endometrioma. Full excision of the endometrioma, as opposed to ablation/cautery or drainage will lead to permanent removal of the disease to eliminate recurrence. However, removal of healthy ovarian tissue or compromising blood flow to the ovary are both risk factors for surgery that may have a detrimental effect on the ovarian reserve.
Endometriomas may pose a concern when a patient is undergoing IVF (in vitro fertilization). Some women who had surgery for endometriomas suffer from poor ovarian response, which directly affects treatment results. In addition, endometriomas themselves may be a cause of diminished ovarian reserve. If there is significant pain or symptoms, or significantly large endometriomas that may pose a challenge when retrieving eggs during an IVF cycle. In this case, removal of the endometrioma may be warranted before starting IVF.
Although surgery definitely has its risks and is not for everyone. It’s important to speak to your doctor to be fully aware of all of the risks of surgery so you can choose the best course of treatment for yourself. At Acubalance, we recommend a specific acupuncture, laser, and naturopathic protocol for before and after surgery to reduce complications, speed recovery, and reduce inflammation, pain, and scar tissue.
There’s also plenty of things you can do naturally to treat your endometriosis symptoms. For my patients with endo, I combine low level laser therapy, acupuncture, herbal therapy, and supplementation. Although there is no natural cure for endometriosis, there is so much you can do diet and lifestyle wise to reduce inflammation, balance hormones, and reduce symptoms.
As someone with surgically confirmed stage 3 endometriosis myself, I know both the pain of the disease and the confliction when choosing which direction to take for treatment. If you want to talk about your options or prepare for your own surgery, give Acubalance a call at 604-678-8600 to book either a free 15 minute phone consultation or book your initial appointment where we can chat more in depth about your particular case.
Allison Locke, R.TCM.P CLT, RYT, FABORM