Endometriosis affects one in 10 women of reproductive age. It causes tissue similar to that lining your womb (endometrium) to grow in other parts of your body and attach to other organs, such as your fallopian tubes.
Endometriosis can cause pelvic cramps and severe period pain, which can disrupt everyday life. It can also result in issues with fertility as the build-up of tissue can cause problems with egg production and block your fallopian tubes.
While mild to moderate symptoms can be managed with medication, surgery may be needed to help manage more severe endometriosis. Surgery involves the removal of excess endometrial tissue and is most commonly a keyhole surgery ie performed using small incisions (laparoscopy).
The surgery is carried out under general anaesthetic and involves making one or two small cuts in your abdomen. Depending on the severity of your endometritis, the surgery could take 30 minutes to six hours.
If you have severe endometriosis that can’t be treated with keyhole surgery, you may need to undergo open surgery. This is more invasive and requires a larger cut to be made so that your surgeon can see into your abdomen to remove the excess endometrial tissue.
If you undergo keyhole surgery for endometriosis, you may be able to go home on the same day. However, if your surgery takes a long time or if your endometriosis is extensive, you may need to spend the night in hospital.
If you undergo open surgery, you will need to stay in hospital for at least one night, although it could be longer depending on your recovery and pain levels.
You will likely feel tired and groggy after surgery. You may also feel sick, and if you do, let a nurse or your surgeon know as they may be able to provide anti-sickness medication.
You will be given pain medications to take after your surgery and will need to rest for several days. You should also avoid straining your abdomen as this can cause pain and discomfort. If you sleep on your side, it may help to use a pillow to support your abdomen and avoid pulling on your wound(s).
After your surgery, you’ll experience some pain around your wound(s). You should keep your wounds clean and dry, which may require you to change the dressings after a few days.
Your abdomen may also feel sore and tender, making it difficult to sit up. This should improve in a few days but you should take it easy for at least the first week after surgery.
Some of the gas that was used to inflate your abdomen can remain in your body after surgery. This can cause bloating, cramps and shoulder pain, which can last for up to a week until your body absorbs the remaining gas. Gentle activity, such as slow walks, can help speed up this process but you should only try this if your pain is minimal.
You may also feel emotional or tearful for a few days after your surgery, which is a common symptom after having a general anaesthetic.
It’s important to remember that everyone’s recovery is different. Some people can feel better a week after undergoing keyhole surgery while others may still have some pain and tiredness after two weeks.
If you have open surgery, plan for a minimum of two weeks’ recovery time, although you may still experience some discomfort after this. Recovery from open surgery takes longer because the cut made by the surgeon is larger and therefore takes longer to heal.
It’s better to plan for a longer recovery period to give yourself as much time as possible to heal. Even if you don’t have much pain after a few days, you will likely still get tired easily. So make sure you give your body enough time to fully recover before attempting to begin your usual activities. It’s a good idea to take at least two weeks off work and either go back part-time or work from home if possible for a further week or two.
After your endometriosis surgery, you should take it easy and avoid strenuous activity. Even though you may be discharged from hospital the same day, you should not drive for up to two weeks after your surgery, which means someone will need to collect you from the hospital.
Avoid lifting, pulling or pushing heavy objects for the first couple of weeks after your surgery so you don’t accidentally strain your abdomen — this will reduce your chances of developing a hernia. Your surgeon may also advise you to avoid exercise for a few weeks after your surgery; this includes swimming, as swimming in public pools increases the risk of infection of your wound.
Many people experience a heavier-than-normal period after their surgery, which can cause more pain than usual. You should prepare for this before your surgery by stocking up on sanitary products and making sure you have painkillers.
You may also experience difficulty when trying to urinate, although this tends to be a short-term problem. If this lasts longer than a week, see your GP.
You should also see your GP or doctor as soon as possible if you are unable to pass urine at all or if there is a burning or stinging sensation when you pass urine.
While keeping your wound sites clean and dry will help avoid infection, you should still look out for signs of infection. These can include:
If you experience signs of infection, contact your GP immediately as you may need antibiotics.
If you're concerned about symptoms you're experiencing or require further information on the subject, talk to a GP or see an expert consultant at your local Spire hospital.
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Lux has a BSc(Hons) in Neuroscience from UCL, a PhD in Cellular and Molecular Biology from the UCL Institute of Ophthalmology and experience as a postdoctoral researcher in developmental biology. She has a clear and extensive understanding of the biological and medical sciences. Having worked in scientific publishing for BioMed Central and as a writer for the UK’s Medical Research Council and the National University of Singapore, she is able to clearly communicate complex concepts.
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