Endometriosis Treatment – Q&A with Dr Stephanie Jackson

Do you have a question about endometriosis and what treatment options are available?

Peninsula Health Obstetrics and Gynecology Consultant Dr Stephanie Jackson answers some common queries about ways to alleviate pain caused by endometriosis, including medical and multidisciplinary therapies, and surgical intervention.

Q: What is a laparoscopy?

A: A laparoscopy is a procedure where a small camera is passed through your belly button to look in your abdomen and pelvis. This may be indicated to treat conditions of the pelvic organs, such as ovarian cysts, and to assess for causes of pelvic pain, such as endometriosis.

Q: Does the procedure both diagnose and treat endometriosis?

A: Yes. The main goal of laparoscopy is to both diagnose and treat any endometriosis that may be found. Ideally any suspected endometriosis will be removed (excised) so that the diagnosis can be confirmed with assessment under the microscope. It may also be cauterised (ablated) to deactivate the endometriosis tissue.

Endometriosis can be diagnosed in many stages, with differences in surgical risks. It is important you have a good quality ultrasound prior to your planned laparoscopy, so we can make sure you have the right surgery for you.

Q: Do I have to have surgery to treat my pelvic pain?

A: No. Surgery is not always the answer for treating pain in your pelvis and generally is not recommended as a first line management of pelvic pain.

There are many effective medical options to treat pain and endometriosis that should be tried first, even if you have not had a formal diagnosis with surgery. It is also very important to address other common causes of pain, such as digestive issues, sore pelvic floor muscles and impacts of stress and anxiety.

If an appropriate trial of medical treatment and multidisciplinary therapy, including input from a physiotherapist and dietician, have not improved your pain, surgery can be considered in discussion with your specialist.

If you are experiencing infertility, your specialist may recommend having a laparoscopy as a first line management option to help optimise your chance of successful pregnancy.

Q: How many incision sites does an endometriosis laparoscopy require?

A: Laparoscopy involves small incisions (usually 2-4) through which instruments are inserted. The exact number and location depend on the complexity of the procedure. The incisions are usually about 5-10mm.

Q: Do I have to stay overnight after the procedure?

A: The majority of people will go home on the same day as the procedure, but some people stay longer if the surgery is complex, or if they have a lot of pain.

Q: What is the recovery time – will I feel better in a week or so?

A: Pain levels vary between people, but most will experience mild to moderate discomfort for at least one week.