Hysterectomy from Endometriosis

It has been three years now that I have had my hysterectomy. And three years that I have been going thur menopause. And I must say that it has been a rough three years. I was dignosed with severe endo and they tried everything possible from birth control pills, to depo lupron and the little sugeries that they perform to look in the belly. Well nothing helped so the only thing left for them to do was the hysterectomy. I was 21 at the time and I already had my son which was the biggest miricale ever. And well lets just say that my menopuase experience isn’t going to well. My question to you is can endo come back even after hysterctomy. Because here in the past week and half I have been feeling really terrible. I have had adomal pian on off over three years but never really thought about it much because i did have the surgery. And I have been weak and losing weight. I’m just concered that there might be something wrong again. But like i said is it possible that you can get endo even after hysterectomy, I look forward to hereing back from you. Thanks Evelyn

Dear Evelyn-
This is a very sad case….Endometriosis is not a curable condition, even with hysterectomy. Many patients are given that surgery with limited success. Endometriosis is responsive to estrogen….if your doctors left your ovaries in, the endo will continue to respond to monthly changes you were experiencing. If your ovaries were removed…once you start any hormone replacement therapy the endo implants in and around the pelvis will respond and start to grow again.
This disease needs to be aggressively treated with repeat laser surgeries. I do not advocate hysterectomy for endo, as the symptoms usually persist and patients may experience other untoward complications and side effects. You need to go back to your gyn and get an opinion on your current symptoms. Good Luck

I am 45 and my doctor is recommending a total hysterectomy with removal of my ovaries for fibroids in my uterus. There are 5 fibroids with the largest being 2cm in size. At age 28 I was diagnosed with endometriosis. Since then I have had 2 full term pregnancies and the endometriosis seemed to subside. Symptoms indicate its return. My doctor tells me that if the endometriosis is present when they do the hysterectomy that I will have to go without HRT for 4-6 months. Do I have any alternatives?

Dear Stressed-
Your alternative is FAS!!!!
I would not recommend removing your uterus. This will not change the condition of the present endometriosis in your abdomen. Even if the uterus is removed, the current endo will respond to hormone changes every month. The pain will continue and the disease will spread. Even after menopause, when on hormone replacement….the same scenary exists. The endo needs to be eradicated with laser treatment. The entire pelvis must be treated, and sometimes more than once to ensure effective outcomes. There is however no reason to remove your uterus. Please read our website section on post hysterectomy complications…these are real outcomes. Many women call our office post hysterectomy wishing they had never removed their uterus.
Please research your condition thoroughly before agreeing to remove your organs.
Good Luck

I’m 28 years old 4 years have past I am still having a major problem I am bleeding everyday and they my doctors have told me that I have emdometriosis they told me. we have tried everything with you. you have to a hysterectomy
I go in feb 5 I got 7 different oponions they say the same thing

Dear Dawn-
You probably have adenomyosis-which is a form of uterine endometriosis. Most traditional gynecologists will only offer you a hysterectomy for this condition. We offer you FAS. We can laser remove the disease but allow you to keep your organ for hormone regulation and normal sexual functioning. Please do your research on hysterectomies….there are many post operative complications that follow this procedure…and it is irreversible. You are far too young to have that surgery…I know we an help you.

I had a hysterectomy with both ovaries removed 4 years ago at the age of 31 to stop my severe pelvic pain. It didnt work and I have now been told that I have severe endometriosis as well as a functioning ovarian remnant. I have bowel and bladder problems, cyclic pain and fatigue. Had I been told I had endometriosis before the hysterectomy I would never had agreed to it but it was not diagnosed.

What options are open to me now for an end to the pain and symptoms?

Dear Stella-
We just operated on a patient with painful endometrial implants post hysterectomy.
I would recommend a diagnostic laparoscopy that will probably turn into a therapeutic laparoscopy where they can treat endometrial implants in your pelvis.
As long as you have a functionning ovarian remnant, and continue to have hormone shifts, these implants will respond and present with pain. I would recommend leaving the remnant to assist your body in hormone regulation, but the implants need to be discovered and aggressively treated in order to reduce spread and minimize your pain.
Find a good laparoscopist that has had success in treating endometriosis.
Good Luck

Dear Dr Del Junco,
I am really confused about something and wonder if you could help me please!

I have been told I have endometriosis by two leading specialists in the UK. This is after my hysterectomy for pelvic pain and supposedly chronic PID.
Both of these specialists say my endo is deep, infiltrating stage 4 endo that has been there for a long time. But would the histology report on my removed uterus and ovaries not have shown endo was present? Would it have been looked for? Or could the endo just not have been picked up because it wasnt on the organs removed but was elsewhere, like the recto-vaginal septum?
Any light you could shed on this would be really appreciated.
Thanks!

Dear Penny-
Endometriosis is the implantation of uterine endometrial cells on other organs in the pelvis. These cells escape, usually from retrograde bleeding during menstrual cycles, and implant on the surface of other abdominal organs ie; bladder, bowel, pelvic floor, abdominal walls etc.
During monthly cycles, these cells respond to hormone changes and bleed, as if in the uterine lining. This creates pain in the pelvis.
There would be no sign of “endometriosis” on the uterus or ovaries, unless the cells implanted on the outside of these organs. It would not be diagnosed from internal uterine or ovarian tissue samples.
I have seen pain from endo continue in patients even after both uterus and ovaries are removed…sometimes ovarian remnants are left over or patients are on hormone replacement therapy which causes the endo cells to respond. Unless the disease is removed from the abdominal organs, pain may continue. We recommend a laparoscopy with possible laser treatment of the discovered implants.
Hope this answers your question.