Endometriosis is the abnormal growth of the uterine lining (the endometrium) at sites other than lining of the uterus, and a hysterectomy (surgical removal of the uterus) is often one of the recommended solutions. However it is important to know about endometriosis after hysterectomy – and whether this possibility of this occurring negates the value of undergoing a hysterectomy.
The fact about endometriosis after hysterectomy is that the procedure that removes a woman’s uterus is not a complete endometriosis solution, and nor is there any guarantee that a woman will start to enjoy a symptom free life after her hysterectomy.
The chance of endometriosis after hysterectomy occurring does depend upon the kind of hysterectomy that is performed, reducing chances of recurrence to a lesser or greater extent. However no type of hysterectomy offers absolute protection against the recurrence of endometriosis symptoms.
The types of surgery possible for treating endometriosis are-
It is the type where the reproductive organs are retained and the surgery is performed in respect of the endometrium, adhesions, so that the normal pelvic anatomy is restored so far as possible. Procedures such as cysectomy, ablative surgery and laparoscopy could be used for this kind of surgery.
Types of hysterectomy
A partial hysterectomy removes the uterus only; a total hysterectomy removes the uterus as well as the cervix, and a radical hysterectomy also involves an oophorectomy so this kind of procedure removes the uterus, cervix and the ovaries as well.
These surgeries may be performed either by making an incision into the abdominal wall or they could be done by accessing the reproductive organs through the vagina and may be laparoscopically assisted. None of the kinds of surgery are a complete guarantee against recurrence of endometriosis, and there is a slight chance of the recurrence of endometriosis after hysterectomy even of the radical kind.
Also the impacts of a hysterectomy can be very difficult to deal with, which is why it is also referred to as surgical menopause. Women have hot flashes, vaginal dryness, weight gain, mood problems, insomnia and the other menopausal symptoms; only the symptoms in the case of surgical menopause are more severe and sudden.
Since the recurrence of endometriosis after hysterectomy of any kind remains a worry, it has to be considered whether it is a good option at all. Surgery offers benefits such as pain control and when it is done laparoscopically there is lesser risk of post operative adhesions. With surgery, the possible intolerance to medicine can be avoided. Also many medications are not able to be used over a longer period of time, so there are plus points to surgical interventions for endometriosis.
However the possibility of the symptoms of endometriosis after hysterectomy recurring is the same as medical interventions so there is some merit in considering medical interventions since they are known to be as effective for pain control and are also more cost effective. Also medical interventions can be modified according to requirement or response to treatment.