Recurrence of Endometriosis after Hysterectomy

What is Endometriosis?

Endometriosis is a disease in which the tissue on the lining of the uterus grows outside the uterus. It causes pain in the pelvis and other complications. It can begin in menarche and can last until menopause.

The growth of the tissue outside of the uterus causes inflammation and scar tissue formation in the pelvis and elsewhere. Endometriosis creates symptoms like the following:

• Severe pain in the pelvis
• Menstrual discomfort
• Difficulty in using the bathroom
• Trouble getting pregnant
• Fatigue
• Depression and anxiety

Hysterectomy and Endometriosis:

One treatment for endometriosis is a hysterectomy. A hysterectomy is a procedure in which the uterus is surgically removed. When used for treating endometriosis, this surgery removes the endometrial tissue and the uterus with or without the ovaries.

Most patients with endometriosis do not require a hysterectomy. According to research in the United States only 12% of women who suffer from endometriosis get a hysterectomy. 

Like any medical treatment, endometriosis has its advantages and disadvantages.

Advantages:

• The relief of symptoms
• No menstrual periods or associated pain
• No worries about pregnancy

Disadvantages:

• If the ovaries are removed, early menopause, which can cause:
• Vaginal dryness
• Lowered libido
• Pain during sex
• Organ prolapses, a condition in which one or more organs slip from their position
• An inability to get pregnant
• The possibility that endometriosis will recur

How and why Endometriosis Recurs:

There is no consensus on what causes endometriosis recurrence post a hysterectomy.

One possible reason is an incomplete excision of endometriosis. This is the most predominant reason found in the literature. Another cause is the performance of endometriosis without removing the ovaries. A high recurrence rate is reported in hysterectomies in which the ovaries were conserved. 

Because there is a possibility of endometriosis recurring even after a hysterectomy, the patient must think carefully before making her decision to have a hysterectomy done on herself. She and her healthcare providers must consider her age and the impact of early menopause on her life style among other factors.

It is important that the surgery is flawless. The recurrence of endometriosis symptoms and pelvic pain are directly correlated to the surgical precision and removal of the tissue growth. Surgical effort should always aim to eradicate the endometriotic lesions completely to keep the risk of recurrence as low as possible.

Should you have a Hysterectomy?

If you have endometriosis there are other treatments other than a hysterectomy. Please think carefully before choosing to undergo one. 

If you do, we at Dr. Manu’s Chennai Gynecologist Clinic will perform a highly precise, safe and effective hysterectomy. We will make sure that your endometriosis does not recur.