[vc_row][vc_column][vc_column_text]Endometriosis is a disease that affects the female reproductive system, and it is characterized by the development of endomentrium, the tissue that normally lines inside the uterus, outside the organ. The tissue is usually known as endometrial patches, implants, nodules, or lesions, and it usually occur in the pelvic cavity, including on or under the ovaries, on the fallopian tubes, behind the uterus, on the tissues that hold the uterus in place, on the bowels or bladder, and in rare cases, on the lungs or in other parts of the body.
Despite the fact that there is currently no cure for endometriosis, there are treatments available that address the symptoms of the disease. To treat endometriosis, physicians may choose from pain medications, hormone therapy, surgical treatment or a combination of treatments, while infertility is usually addressed with surgery or in vitro fertilization (IVF). In order to define a treatment plan for patients with endometriosis takes into consideration patients’ age, severity of the symptoms, severity of the disease and whether women still want to have children or not.
Hysterectomy Procedure to Treat Endometriosis
A hysterectomy is a surgical procedure that consists of the removal of a woman’s uterus. It may be used to treat not only endometriosis, but also uterine fibroids that cause pain, bleeding, or other problems, uterine prolapse, cancer of the uterus, cervix, or ovaries, abnormal vaginal bleeding, chronic pelvic pain, adenomyosis, or a thickening of the uterus. Hysterectomy is a major abdominal procedure during which the surgeon may also remove other organs, like the ovaries and fallopian tubes, if the patches also affect them.
Surgeons may adopt different approaches to perform a hysterectomy, taking into consideration the surgeon’s experience, the reason for the hysterectomy, and the patient’s overall health. In the case of endometriosis patients, it is usually performed as an abdominal hysterectomy, which is an open surgery. During the procedure, the surgeon makes a five to seven inch incision, either up-and-down or side-to-side, across the belly, in order to remove the uterus through the opening. Women need to stay on average three days in the hospital after the surgery, which has both pros and cons.
Efficacy and Safety of Hysterectomy for Endometriosis
Hysterectomy is an aggressive and extreme decision, known to be effective in easing the pain associated with endometriosis. Despite the good results after the surgery, it does not cure the disease and there is the risk of endometrial tissue to grow again. In addition, the removal of the uterus disables women from even getting pregnant and the removal of the ovaries provoke earlier menopause. These reasons explain why hysterectomy is usually the last option for patients with severe endometriosis and who have tried to be treated other therapies.
“A high recurrence rate of 62% is reported in advanced stages of endometriosis in which the ovaries were conserved. Ovarian conservation carries a 6 fold risk of recurrent pain and 8 folds risk of reoperation. The decision has to be weighed taking into consideration the patient’s age and the impact of early menopause on her life style. The recurrence of endometriosis symptoms and pelvic pain are directly correlated to the surgical precision and removal of peritoneal and deeply infiltrated disease. Surgical effort should always aim to eradicate the endometriotic lesions completely to keep the risk of recurrence as low as possible,” concluded the authors of the study “Recurrence of endometriosis after hysterectomy” about the results of the surgery.
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