Hysterectomy & Alternatives

You May Have Endometriosis After a Hysterectomy

January 2, 2018

What Is Endometriosis?

According to the National Institutes of Health,”endometriosis is a disease in which tissue that normally grows within the uterus grows outside the uterus. It can grow on the uterus, fallopian tubes, intestines, or bladder. Rarely, it develops in other Areas of the body.”   This tissue expansion may result in very mild symptoms in some women to acute symptoms that could result in nausea, missed days of work, and important pain.

Although symptoms of endometriosis usually do vary widely between individual women, the next issues often lead women to seek treatment and a diagnosis:

  • Pain, usually in the abdomen, lower back, or pelvic regions
  • Infertility
  • Heavy periods and bleeding between periods
  • Painful menstrual cramps

Pros and Cons of Hysterectomy for Endometriosis

Even though there is no cure for endometriosis, it is nevertheless among the most frequent reasons that women have a hysterectomy (surgical removal of their uterus) each year. Before considering a hysterectomy for endometriosis, it is important to think about the probable outcomes and the alternatives to surgery as a hysterectomy might or might not relieve the pain of endometriosis.

In some cases, multiple surgeries may be required, and in many cases pain relief isn’t complete.

Research suggests that relief of endometrial pain is significantly higher if surgery involves removal of the uterus. As per a study conducted by Johns Hopkins researchers, women who had a hysterectomy which did not include removing the uterus were far more likely to have endometriosis that resulted in pain in the years after operation.

In that study, 62 percent of women who kept their ovaries had endometriosis pain along with 31% had a second surgery.

The results were far different for women who had their ovaries removed through the hysterectomy procedure. Ten percent of these girls experienced pain from endometriosis after operation and less than 4 percent had another surgery.

It could seem that having your ovaries removed with hysterectomy is the clear response, but for a girl who might still want kids, this implies permanent sterility. Additionally, if the ovaries are removed, menopause will start in the days after surgery and hormone replacement therapy may be necessary. Further risks are related to having the ovaries removed, a process called an oophorectomy.

Alternatives to Hysterectomy for Endometriosis

Endometriosis is not cured by a hysterectomy. Painful symptoms may reoccur and often do. For this reason, laparoscopic and nonsurgical treatments are often considered prior to a hysterectomy.

Alternative treatments for endometriosis may include:

  • Pain drugs, including over the counter remedies like Ibuprofen
  • hormone treatments (frequently in the form of birth control drugs )
  • laparoscopy, where a surgeon inflates the abdomen slightly and then inserts small tools through a small cut to view and remove the endometrial growth
  • laparotomy, in which conventional surgical methods are used to eliminate the adrenal development and, in some cases, ovaries
  • surgery to sever pelvic nerves, where the uterus stays intact while nerves have been cut to relieve pain

    The selection of treatment will always be individualized. It’s based on a number of factors including health, age, severity of the pain and endometriosis. The treatment of a patient who wishes to have children may be very different compared to treatment of a woman who does not Want kids, as some treatments can further impact fertility.  

    Before assessing and treating endometriosis, your physician may run imaging tests like an MRI or ultrasound to confirm that there are no other complicating conditions. Typically, doctors will begin with a traditional treatment like medication before attempting any kind of invasive surgical treatment.

    A Word From Verywell

    It will be Essential to Be clear with your health care provider about your goals (child bearing, pain relief, reduced bleeding) and also What You Would like to accomplish with therapy.   Your treatment, if you Want children, might potentially be quite different compared to the treatment You Get if you are not interested in becoming pregnant.  

    The process that works best to get Somebody Who is anemic and seeking a way to reduce bleeding may not be the ideal treatment for someone who wants to have less pain.