Surgery for Endometriosis

Endometriosis affects 176 million of women worldwide. It’s the leading cause of infertility and chronic pelvic pain. The only way to confirm endometriosis is by a surgical procedure known as laparoscopy. This surgery also facilitates the treatment of the disease.

Imaging tests such as CT scans, MRI and pelvic sonograms are not sufficient as a diagnosis. They do however help with surgical planning. Currently, a number of predictive “biomarkers” (molecules that may be present with the disease) are being researched, but there is no conclusive answer yet.

Symptoms often start early in life but may be ignored by caregivers and healthcare practitioners. A young female with early stage endometriosis is typically prescribed birth control pills to alleviate menstrual cramps. This doesn’t affect the disease process leading to worsening symptoms over time and more fibrotic lesions. Approx 70% of teens with pelvic pain fit in this category. They are later diagnosed with endometriosis. Medical management with hormonal suppression diminishes symptoms. It is not effective to prevent the disease or with improving fertility.

Surgery

Surgical management with laparoscopy may be key to disease management in many cases. In order to minimize the chance of recurrence, all endometrial lesions have to be removed. It’s important to realize that this requires highly advanced surgical techniques. The skill of the operating surgeon is the most important factor influencing the outcome.

Other factors to consider are the following:

• Disease severity
• Type of surgery: there is evidence that excision surgeries are more effective than ablation at completely removing lesions
• Location of the lesions and possible complications associated with removal of surrounding tissue.
• Physical therapy post-surgery to improve healing and tissue mobility.

At Body Harmony Physical Therapy, we have extensive experience treating patients with endometriosis including pre and post surgery. Every woman experiences endometriosis uniquely. It is best managed with an individualized plan of care for her specific needs. We offer private one on one consultation and treatment. This allows each woman to tell her own story and begin her road to recovery. Call us to schedule an appointment at 212-233-9494.

Written by: Irene Hernandez, PT

Edited by: Keely Faridi, PT

References:

(1) https://www.ncbi.nlm.nih.gov/pubmed/21420081
(2) https://www.ncbi.nlm.nih.gov/pubmed/25155119
(3) https://www.ncbi.nlm.nih.gov/pubmed/29632080
(4) https://www.ncbi.nlm.nih.gov/pubmed/28456617