It is important to find out why they have recommended a hysterectomy, as there is still some old school medical thought that says that a hysterectomy is the cure for endo, particularly amongst general gynae consultants, who are not always the most experienced in dealing with endo as it is just a string to their bow. Obviously some have chosen to particularly specialise in endo but these tend to go onto be endo consultant surgeons rather than remain general gynae.
I was lucky enough to see one of the top endo consultants worldwide and his view is that a hysterectomy only helps where endo is actually in the uterine muscle (known as adenomyosis). It is also helpful for other gynae problems such as heavy menstrual bleeding, fibroids etc. However, endo is commonly found elsewhere in the peritoneal cavity and this must lso be removed.
Does your consultant think you have adenomyosis, which will be helped by a hysterectomy? Not everyone who has peritoneal endo will have adeno. It is important to be clear that this is what your consultant suspects and is not just of the old school who thinks a hysterectomy cures all.
It does sound like your consultant is intending to laser any other endo found. However, it is also recognised by endo consultants that excision of endo (cutting it away) has a better long term result than laser which burns endo off the surface. He explained this to me by using the analogy of gardening. If you cut a weed down from the surface (i.e. laser) the roots can remain underneath and, although they will not come back up for a time, or in the same spot as laser creates scar tissue, it is possible over time to re-emerge elsewhere. Excision surgery takes the roots out also so it is less likely to cause any further problem. The reason ladies often end up going back for multiple surgeries, despite having endo excised is because most surgeons only do 'patch excision' and do not remove it all. These patches removed have a good outcome but problems may arise later from further endo that was not removed. The top guys advocate removing all endo and not just patches here and there.
I was originally told by a gynae consultant that I "was a total mess" and a hysterectomy was my best option. I did research and came to the conclusion this was not necessarily the case, unless I had adenomyosis. Adenomyosis cannot be confirmed100% until after a hysterectomy and a biopsy is done. It can be suspected from a bulky womb but this can also be due to fibroids, and sometimes just how you are.
I decided not to have a hysterectomy but underwent pioneering endo surgery called "total radical excision". This is where the whole lining of the peritoneal cavity is excised. I also had the Pouch of Douglas (recto/vaginal) pocket completely cleared . The op was all done keyhole and took c8 hours. This ensured that as much endo as possible was removed all in one go. It heals more cleanly too, more or less giving you a new peritoneum. I can honestly say that I have been fine since (3 years) with no signs to-date of any abdominal pain at all. Best periods I have ever had too. He did suspect I might have adenomyosis as my womb was bulky but I decided to have the radical excision done first to see how I was after that and, if still getting bad monthly pain, go for the hysterectomy. I have not needed it to-date.
Just make sure your consultant is an endo specialist and that he is recommending a hysterectomy for the right reasons. I am sorry if this will unsettle you but I think it is important to be informed and to make such a choice not in haste but with having looked at all the options and facts.
It is also thought that Estrogen Dominance may contribute to the increase in endo in modern times due to all of the chemicals we daily plaster ourselves in with toiletries, cosmetics, cleaning products and plastics used in the food packaging industry etc.
I recommend the following books:
Estrogen Dominance by Dr Michael Lam
Stop Endometriosis and Pelvic Pain by Dr Andrew S Cook.
The latter will particularly arm you with information for discussion with your consultant.
All very best wishes x x