Table of ContentsView AllTable of ContentsSurgery TypesWhy It RecursSigns of RecurrenceRisk FactorsPreventionSeeking Medical Care
Table of ContentsView All
View All
Table of Contents
Surgery Types
Why It Recurs
Signs of Recurrence
Risk Factors
Prevention
Seeking Medical Care
Surgerycan be used to treatendometriosis, but for some people, the relief is not permanent.Endometriosiscan return after surgery.
This article will discuss surgical options for endometriosis, what endometriosis recurrence means, why endometriosis can return after surgery,signsand risk factors of endometriosis recurrence, and how to prevent the recurrence of endometriosis after surgery.
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Types of Surgery for Endometriosis
There are several surgical options for treating endometriosis, including:
Laparoscopy
With a laparoscopy for endometriosis, small incisions are made in the abdomen through which a thin tube with a light, camera, and other small tools are inserted. Endometriosis tissue can be removed (excision) or destroyed using intense heat (ablation).
Laparoscopy can also be used to confirm adiagnosis of endometriosis. Sometimes, both a diagnosis and excision or ablation occur during the same laparoscopic procedure.
Laparotomy
Excisionand ablation can also be performed using a laparotomy. During a laparotomy, a larger abdominal incision is made. This surgery is less common than laparoscopy for treating endometriosis.
Hysterectomy/Oophorectomy
Ahysterectomyis the surgical removal of the uterus. Sometimes other organs are removed as well, including one or both ovaries, the cervix, and/or the fallopian tubes.
Typically, hysterectomy and/or oophorectomy are only used if other treatments have been ineffective.
What Does Endometriosis Recurrence Mean?There isn’t a set definition for the recurrence of endometriosis, but it’s generally accepted to refer to one or more of the following:Relapse of painLack of improvement ininfertilityEndometriosis lesions seen via ultrasound or surgery
What Does Endometriosis Recurrence Mean?
There isn’t a set definition for the recurrence of endometriosis, but it’s generally accepted to refer to one or more of the following:Relapse of painLack of improvement ininfertilityEndometriosis lesions seen via ultrasound or surgery
There isn’t a set definition for the recurrence of endometriosis, but it’s generally accepted to refer to one or more of the following:
Sex and Intimacy After Endometrial Ablation
Why Does Endometriosis Return After Surgery?
Endometriosismay persist after surgery if some endometriosis tissue is left behind, or it can recur, stemming from de novo (new) cells.
After surgery, new endometriosis lesions can develop similarly to the initial endometriosis. The exact cause of endometriosis isn’t known conclusively, but one widely accepted theory formenstruatingis retrograde menstruation. When this occurs, menstrual blood and tissue flow backward through the fallopian tube and implant on the surface of the ovary or other structures in the pelvis.
A hysterectomy/oophorectomy stops menstruation, but endometriosis recurrence can still occur due to factors such as:
Signs of Endometriosis Returning
Recurrence of endometriosis may not cause noticeable symptoms. In those who do experience symptoms, new or increasing pain with menstruation and/or pelvic pain is commonly noted in studies on endometriosis recurrence after surgery.
Symptoms of endometriosismay include:
How Quickly Can Endometriosis Grow Back After Surgery?
The time frame for recurrence of endometriosisafter surgeryis not well-established. Some studies give an overall recurrence rate, while others look at a specific time, but most information on recurrence isn’t kept past five years after surgery.
A 2020 study found that the median time to first recurrence of endometriosis after surgery was 31 months, but all participants in this study had recurrentendometriosis lesionsconfirmed through a second surgery. This data may not apply to those whose recurrence is not significant enough to need further surgery.
Risk Factors for Endometriosis Recurring
There is conflicting evidence for what factors increase the risk of endometriosis recurring after surgery. Studies have found potentialrisk factorsmay include:
Not all studies agree on these risk factors. It’s important to talk to your healthcare provider about the benefits and risks of surgery for endometriosis and your risk of recurrence.
How to Prevent Endometriosis Recurrence
The measures taken to prevent recurrence of endometriosis depend on several factors, including intentions of becoming pregnant.
Some studies have found thatpregnancy after surgerymay help prevent recurrence of endometriosis. If you wish to become pregnant after surgery, talk to your healthcare provider about your options, how to prepare, and other considerations.
Somemedicationsthat may be used to help reduce the risk of recurrence include:
These medications may need to be used long term and can have risks and side-effects. Your healthcare provider can help you determine the bestcourse of treatmentfor you and your needs.
When to See a Healthcare Provider
It’s important to follow all of your healthcare provider’s post-operative guidance and to schedule regular follow-up appointments to look forsigns of endometriosis recurrence.
You should also see your healthcare provider if younotice symptoms of endometriosis, such as pain or infertility, persist or return after surgery.
Summary
Surgery such as laparoscopy, laparotomy, or hysterectomy/oophorectomy can be an effective treatment for endometriosis. In some cases, endometriosis can recur after surgery.
Endometriosis recurrence generally refers to a return ofpain, persistence of fertility problems, and/or observable endometriosis lesions after surgery.
Endometriosis recurrence may result from endometriosis tissue left behind after surgery, the development of new endometriosis tissue through retrograde menstruation, hormonal factors, or ovarian remnants.
There is conflicting evidence on risk factors for endometriosis recurrence after surgery, but some risk factors may include pain with menstruation and/or severity of disease before surgery, younger age at surgery, previous surgery, lack of completeness of tissue removal, and larger cyst(s) at surgery.
Pregnancy after surgery and using medications such as hormonal contraceptives may help reduce the risk of endometriosis recurrence after surgery.
Talk to your healthcare provider aboutpost-operative careand treatment.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.The Royal Women’s Hospital.Laparoscopy and endometriosis.Johns Hopkins Medicine.Endometriosis.Wollongong Obstetrics and Gynaecology.Hysterectomy for the removal of endometriosis: What works best.Bozdag G.Recurrence of endometriosis: risk factors, mechanisms and biomarkers. Womens Health (Lond Engl). 2015;11(5):693-699. doi:10.2217/whe.15.56Yu L, Sun Y, Fang Q.Efficacy of laparoscopic surgery combined with leuprorelin in the treatment of endometriosis associated with infertility and analysis of influencing factors for recurrence. Front Surg. 2022;9:873698. doi:10.3389/fsurg.2022.873698Zakhari A, Delpero E, McKeown S, Tomlinson G, Bougie O, Murji A.Endometriosis recurrence following post-operative hormonal suppression: a systematic review and meta-analysis. Human Reproduction Update. 2021;27(1):96-107. doi:10.1093/humupd/dmaa033Office on Women’s Health.Endometriosis.MedlinePlus.Endometriosis.Nirgianakis K, Ma L, McKinnon B, Mueller MD.Recurrence patterns after surgery in patients with different endometriosis subtypes: a long-term hospital-based cohort study. JCM. 2020;9(2):496. doi:10.3390/jcm9020496Yang F, Liu B, Xu L, Liu H.Age at surgery and recurrence of ovarian endometrioma after conservative surgery: a meta-analysis including 3125 patients. Arch Gynecol Obstet. 2020;302(1):23-30. doi:10.1007/s00404-020-05586-3Seckin Endometriosis Center.Why can endometriosis return after surgery?Endometriosis.net.Recurrence of endometriosis.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.The Royal Women’s Hospital.Laparoscopy and endometriosis.Johns Hopkins Medicine.Endometriosis.Wollongong Obstetrics and Gynaecology.Hysterectomy for the removal of endometriosis: What works best.Bozdag G.Recurrence of endometriosis: risk factors, mechanisms and biomarkers. Womens Health (Lond Engl). 2015;11(5):693-699. doi:10.2217/whe.15.56Yu L, Sun Y, Fang Q.Efficacy of laparoscopic surgery combined with leuprorelin in the treatment of endometriosis associated with infertility and analysis of influencing factors for recurrence. Front Surg. 2022;9:873698. doi:10.3389/fsurg.2022.873698Zakhari A, Delpero E, McKeown S, Tomlinson G, Bougie O, Murji A.Endometriosis recurrence following post-operative hormonal suppression: a systematic review and meta-analysis. Human Reproduction Update. 2021;27(1):96-107. doi:10.1093/humupd/dmaa033Office on Women’s Health.Endometriosis.MedlinePlus.Endometriosis.Nirgianakis K, Ma L, McKinnon B, Mueller MD.Recurrence patterns after surgery in patients with different endometriosis subtypes: a long-term hospital-based cohort study. JCM. 2020;9(2):496. doi:10.3390/jcm9020496Yang F, Liu B, Xu L, Liu H.Age at surgery and recurrence of ovarian endometrioma after conservative surgery: a meta-analysis including 3125 patients. Arch Gynecol Obstet. 2020;302(1):23-30. doi:10.1007/s00404-020-05586-3Seckin Endometriosis Center.Why can endometriosis return after surgery?Endometriosis.net.Recurrence of endometriosis.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
The Royal Women’s Hospital.Laparoscopy and endometriosis.Johns Hopkins Medicine.Endometriosis.Wollongong Obstetrics and Gynaecology.Hysterectomy for the removal of endometriosis: What works best.Bozdag G.Recurrence of endometriosis: risk factors, mechanisms and biomarkers. Womens Health (Lond Engl). 2015;11(5):693-699. doi:10.2217/whe.15.56Yu L, Sun Y, Fang Q.Efficacy of laparoscopic surgery combined with leuprorelin in the treatment of endometriosis associated with infertility and analysis of influencing factors for recurrence. Front Surg. 2022;9:873698. doi:10.3389/fsurg.2022.873698Zakhari A, Delpero E, McKeown S, Tomlinson G, Bougie O, Murji A.Endometriosis recurrence following post-operative hormonal suppression: a systematic review and meta-analysis. Human Reproduction Update. 2021;27(1):96-107. doi:10.1093/humupd/dmaa033Office on Women’s Health.Endometriosis.MedlinePlus.Endometriosis.Nirgianakis K, Ma L, McKinnon B, Mueller MD.Recurrence patterns after surgery in patients with different endometriosis subtypes: a long-term hospital-based cohort study. JCM. 2020;9(2):496. doi:10.3390/jcm9020496Yang F, Liu B, Xu L, Liu H.Age at surgery and recurrence of ovarian endometrioma after conservative surgery: a meta-analysis including 3125 patients. Arch Gynecol Obstet. 2020;302(1):23-30. doi:10.1007/s00404-020-05586-3Seckin Endometriosis Center.Why can endometriosis return after surgery?Endometriosis.net.Recurrence of endometriosis.
The Royal Women’s Hospital.Laparoscopy and endometriosis.
Johns Hopkins Medicine.Endometriosis.
Wollongong Obstetrics and Gynaecology.Hysterectomy for the removal of endometriosis: What works best.
Bozdag G.Recurrence of endometriosis: risk factors, mechanisms and biomarkers. Womens Health (Lond Engl). 2015;11(5):693-699. doi:10.2217/whe.15.56
Yu L, Sun Y, Fang Q.Efficacy of laparoscopic surgery combined with leuprorelin in the treatment of endometriosis associated with infertility and analysis of influencing factors for recurrence. Front Surg. 2022;9:873698. doi:10.3389/fsurg.2022.873698
Zakhari A, Delpero E, McKeown S, Tomlinson G, Bougie O, Murji A.Endometriosis recurrence following post-operative hormonal suppression: a systematic review and meta-analysis. Human Reproduction Update. 2021;27(1):96-107. doi:10.1093/humupd/dmaa033
Office on Women’s Health.Endometriosis.
MedlinePlus.Endometriosis.
Nirgianakis K, Ma L, McKinnon B, Mueller MD.Recurrence patterns after surgery in patients with different endometriosis subtypes: a long-term hospital-based cohort study. JCM. 2020;9(2):496. doi:10.3390/jcm9020496
Yang F, Liu B, Xu L, Liu H.Age at surgery and recurrence of ovarian endometrioma after conservative surgery: a meta-analysis including 3125 patients. Arch Gynecol Obstet. 2020;302(1):23-30. doi:10.1007/s00404-020-05586-3
Seckin Endometriosis Center.Why can endometriosis return after surgery?
Endometriosis.net.Recurrence of endometriosis.
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