Basic guidelines for endometriosis
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
Shiny trinkets are shiny.