Questions to Ask Your Physician About Endometriosis
Are you trained in excision techniques for endometriosis?
Excision of deeply infiltrating endometriosis often requires advanced training in Minimally Invasive Gynecologic Surgery (MIGS). A fellowship trained physician in MIGS has typically performed 2 additional years of surgical training in laparoscopic removal of deeply infiltrating endometriosis around the bowel, bladder, and ureters. If you have a known endometrioma on imaging (endometriosis cyst on the ovary), then you have >80% risk of having alternate areas of endometriosis that require excision.
How many endometriosis surgeries do you perform annually?
High volume surgeons have been shown to have better outcomes in regard to optimized patient outcomes and decreased complications. Do not be afraid to ask your surgeon about his or her surgical numbers.
What do you do if everything is stuck together from endometriosis?
Preoperative physical exam and imaging can often provide information regarding endometriosis and scar tissue; however, occasionally there is more disease than anticipated. It is important to ask your surgeon how he or she handles this situation. Does he or she end the surgery and refer you to someone else, or is he or she comfortable in completing the case?
How do you treat bladder or bowel endometriosis?
Advanced surgical training is often required for complete excision of bladder and bowel endometriosis.
How do you treat endometriosis growing around the ureters?
Advanced surgical training is often required for complete excision of ureteral endometriosis.
How will removing the uterus treat endometriosis that is growing in other areas of the pelvis?
Even if hysterectomy is performed, all remaining endometriosis lesions should be excised to provide optimal symptom relief.