Endometriosis surgery: when to do it, risks and recovery

Surgery for endometriosis is indicated for infertile women or women who do not wish to have children, since in the most severe cases it may be necessary to remove the ovaries or uterus, directly affecting the woman’s fertility. Thus, surgery is always advised in cases of deep endometriosis in which hormone treatment does not have any kind of result and is life-threatening.

Surgery for endometriosis is done in most cases with videolaparoscopy, which consists of making small holes in the abdomen to insert instruments that allow the removal or burning of endometrial tissue that is damaging other organs such as the ovaries, outer region of the uterus, bladder or intestines. .

In cases of mild endometriosis, although rare, surgery can also be used along with other types of treatment to increase fertility by destroying the small foci of endometrial tissue that are growing outside the uterus and making pregnancy difficult.

when is indicated

Surgery for endometriosis is indicated when the woman has severe symptoms that can directly interfere with the woman’s quality of life, when drug treatment is not sufficient or when other changes are observed in the endometrium or reproductive system of the woman as a whole.

Types of endometriosis surgery

According to the age and severity of endometriosis, the doctor may choose to perform conservative or definitive surgery:

• Conservative surgery: aims to preserve women’s fertility, being performed but often in women of reproductive age and who wish to have children. In this type of surgery, only foci of endometriosis and adhesions are removed;
• definitive surgery: it is indicated when treatment with drugs or conservative surgery is not enough, and it is often necessary to remove the uterus and/or ovaries.

Conservative surgery is usually performed by means of videolaparoscopy, which is a simple procedure that must be performed under general anesthesia, in which small holes or cuts are made near the navel that allow the entry of a small tube with a microcamera and the instruments doctors that allow the removal of endometriosis foci.

In the case of definitive surgery, the procedure is known as hysterectomy and is done with the aim of removing the uterus and associated structures according to the extent of endometriosis. The type of hysterectomy a doctor performs varies depending on the severity of endometriosis. Learn about other ways to treat endometriosis.

Possible risks of surgery

The risks of surgery for endometriosis are mainly related to general anesthesia, so when the woman is not allergic to any type of medication, the risks are usually greatly reduced. Also, as with any surgery, there is a risk of developing infection.

Therefore, it is recommended to go to the emergency room when a fever above 38º C appears, very strong pain appears at the surgery site, swelling occurs at the site of the stitches or there is an increase in redness at the surgical site.

Recovery after surgery

Surgery for endometriosis is performed under general anesthesia in a hospital and therefore it is necessary to stay in the hospital for at least 24 hours to assess whether there is any bleeding and to fully recover from the effect of the anesthesia, however you may need to stay longer. time hospitalized if a hysterectomy was performed.

Although the length of stay is not long, the time for complete recovery after surgery for endometriosis can vary from 14 days to 1 month and during this period it is recommended:

• stay at nursing homenot being necessary to stay in bed constantly;
• Avoid overexertion how to work, clean the house or lift objects heavier than a kilo;
• not doing physical exercise during the first month after surgery;
• avoid sexual intercourse during the first 2 weeks.

In addition, it is important to eat a light and balanced diet, as well as drink about 1.5 liters of water a day to speed up recovery. During the recovery period it may be necessary to make some regular visits to the gynecologist to check the progress of the surgery and evaluate the results of the surgery.

Watch the video with Dr. Helizabet Ribeiro, a gynecologist specializing in endometriosis who clarifies all doubts about this disease: