Should I cancel first lap with general surgeon and wait to see endo specialist?

[halfpint17]

I am due to have a pre op with a general fertility surgeon tomorrow in anticipation of lap in two weeks to confirm endo. I had an ultrasound that showed enlarged ovary stuck to uterus and the nurse who carried out advised she thought was endo. The gyno I've been seeing regularly over last year has been reluctant up until recent ultrasound to carry out investigations as put all symptoms down to health anxieties etc, but referred me for lap appt recently with general fertility surgeon following ultrasound, despite there being endo specialist within same hospital. I'm convinced I have endo as all the dots seem to add up...painful sex, blood in urine, feeling of constant uti's, but no infection, painful bowel movements with blood, pain in pelvis, shoulder pain, hip pain and sciatica, amongst others. I'm in my mid 30s and explains symptoms I've had since I wad 15. Should I go through with op or should I ask to be seen by endo specialist, even though will inevitably have to wait longer to have op? Advice would be very much appreciated.

[charlotte88]

I've waited almost a year for a specialist and pleased I waited, It got canx 6 times!! I don't know if this is just pure unlucky, but 100% happy I waited for him. If your going under, it might Aswel be with the best possible x

[halfpint17 in reply to charlotte88]

Thanks loads for your quick response and advice. Was that also your diagnosis lap you waited for to be done at same time too? x

[Impatient]

As this is the 1st lap- I would advise you to go ahead with it and wait to see what the results are. You might only have one or two spots of endo- which a regular gynae should be able to handle- and they can ceratinly handle adhesions sticking ovaries in the wrong place, but if it turns out your endo is more tricky then it will be much easier to get referred to a proper endo expert surgeon.

Remember that people with less pain usually have more complex endo- the more pain you have the fewer patches of endo (it is a strange fact but true.)

I would definitely grab the opportunity for a diagnostic lap 1st..that way at least you will have a much better idea of what is going on in there and so too will the surgical team who can then refer you on to more experienced experts if needs be. You might not need any other surgery- one lap op might be enough to unstick the ovary, cut back the adhesions and remove any surface endo seen, and leave you sorted out for a long time to come.

The vast majority of endo cases are only a few small endo patches, having raging complex endo everywhere is pretty rare even for endo cases, so I would advise to have the diagnostic lap op to see what the state of affairs is first and foremost.

Having the op tomorrow gives enough time to be well on the road to recovery by x-mas.

[Livvyg2bt]

Defo have this lap, you will find you will always be at the bottom of the endo specialist list without being diagnosed then once you have this lap if you get diagnosed with endo it will be passed on and you won't have to have unessecery surgery as the pics will already be there x

[ozgarden]

As other endo sufferers have suggested you should.have the operation. It will save you all the worry. I had cancelled my appointment with a specialist because I was dreading having the operation. But then I had to wait for three months. This had increased my anxiety. But soon I will have my operation. In the meantime carry out some relaxation yoga exercises. It will reduce your stress levels and your pain. You can also have green smoothies to reduce your pain. But do change the ingredients you use every day to take.away toxins.

[Beau83]

I would go ahead with this lap, but be prepared for the possibility that it may come back clear. Less experienced gynaes are less likely to be able to spot endo lesions if they are small, clear or in a tricky place. So if it comes back clear, but you are still suffering ask to be referred to the specialist for a second opinion.

[halfpint17]

Thank you all so very much for your advice, really has been been very kind of you and put me more at ease going through with it. Only pre op this morning, with op week before Xmas...eek, but was all so ready to cancel. My concern it's advanced now is the women areas and bowel have only become a problem since I was 33 (sporadic at first), but have become progressively worse, particularly in last two months. Up until then, problems with back easily explained by scoliosis and breaking back twice. But of course I'm just speculating. Thanks loads to all once again for getting back to me. Wishing you all a good day x

[halfpint17]

Hi all. So I went for the pre op and was seen by nurse, gutted as wanted to ask questions to surgeon that she couldn't answer. Was unnerving at first that nurse was too busy to talk to me as was filling in labels and forms for bloods of, who I can only assume, the previous patient. She then didn't know what op I was going to have. The only info I know is he will remove what he can, if he can, with hot wire. I'm of understanding excision is most effective. Is hot wire the same principle of laser in that it only burns off top later? Any advice, as always, greatly appreciated.

[Impatient]

Hot wire- diathermy is pretty similar to laser. it is good for surface endo- not enough for deep endo. But at this stage not knowing what kind of endo you have it is fair to state that this diagnostic lap op is when they will tackle the surface endo that they find.

Deeper endo is best seen to by specialist surgeons in the organ(s) that the deep endo is growing in to.

Colorectal surgeon if it is the bowel, Urologist for the bladder and so on.

The shallow endo is the most painful sort - so if you consider yourself to be in a huge amount of pain - the odds are that the shallow endo is what is causing that, and is by far the most common- accounting for some 80% of endo patients. Laser or diathermy should be enough for most of those lesions.

The remaining 20% of endo surgery cases need more complex surgery by specialists.

Don't be disheartened- it could be just what is required and you might not need anything more invasive. Even with some deeper endo lesions you will probably have, by that stage of things, also got a fair few shallow lesions to be removed too. Let this surgeon do what they can- every thing done to endo surgically does some good in the battle against it.

Even if they can't do it all- they can certainly tackle some of it. Making it worth while having the diagnostic op.

Some surgeons do nothing- just look, spot the endo and close you up again and tell you that you do have endo- but don't do a thing to actually tackle it in a diagnostic lap op.

now that really is a waste of resources.

[halfpint17 in reply to Impatient]

Hi. As always, thank you very much, your knowledge and advice are incredibly helpful. I was disheartened today when I was told I would have to continue seeing general surgeon rather than being transferred to endo specialist should extensive endo be found...they work in same hospital, but different departments. Does this really have to be the case? I thought there would be patient choice, but maybe it's a protocol I'm unaware of?