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Basic guidelines for endometriosis

short guidelines

 

No laparoscopy

If a laparoscopy is planned, then check

  • A cystic ovarian endometriosis of more than 6 cm needs surgery in 2 steps otherwise the ovary risks to be destroyed.
  • If a large deep endometriosis is suspected, hydronefrosis  (e.g. with  ultrasound) and bowel stenosis (with a contrast enema) need to be excluded
  • An ureter stent is indicated only in cases of hydronefrosis
  • Check the expertise of the surgeon and his percentage of bowel resections. Bowel resection are rarely needed  (<5%) and should be decided during surgery. .

Surgery was not performed during laparoscopy

  • The diagnosis is probably correct
  • Check the photo’s or video to ascertain what  has been checked (e.g.  appendix, the sigmoid and diaphragm)
  • This is correct: if lesions were unexpectedly severe it is better not to do surgery without the required expertise.

If surgery was performed,  you should know

  • the type of intervention and  endometriosis
  • complete or incomplete excision  ?
  • complications  ?
  • duration of surgery ?
  • video or at least photo-documentation ?

Medical treatment without a laparoscopy

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