Confused/angry

[Natashaoscar1]

Okay so the gynecologist suspects I have endometriosis.. I'm in agony everyday.. She's scheduled me for a laparoscopy in June and said if they find it they'll zap it away there and then so I was relieved....

Then she sends me a letter today (which she's forwarded to my doctor) and it states if they find endometriosis... They will bring me back in the near future and see what's going on... So protebtially if they find it I'm left in pain for a whole after with no help or support what do I do? Xxxx

[hayls]

Hi

This is pretty normal I'm afraid and comes down to theatre timetables mainly. A first lap is a diagnostic lap and it is just that - its a diagnostic procedure not an operation. It is used to have a look around and if endo is found the surgeon maps out the endo. If endo found is only very slight or minor they may then try to do something at the same time but the theatre time allocated to a diagnostic lap is very very short, typically 15-30mins and they do 8-10 a day - they simply do not have time allocated to then go on and do anything major to fix things (operative laps for endo are typically allocated several hours and often involve a mix of surgeons, not just gynae).

If you are diagnosed with endo that needs surgical treatment you then have a separate operative lap to treat it, this is often a good thing as often the gynaes doing the diagnostic laps aren't experienced enough at treating endo (they can diagnose it but dont have the skills to operate on it) so depending on what is found during the disgnostic lap you are often referred on to an endo specialist (preferrably at a bsge accredited endo centre) to then discuss surgical treatment options or other treatment/management as its outside the capabilities of the general gynae. At this point you may also need involvement of endo specialist colorectal or urology surgeons if your bladder or bowel are also found to be involved during your diagnostic lap.

I know it sounds frustrating but its the way it works on the nhs - they can't plan for surgical treatment if they dont know what they are facing until they get in there. It also gives them an opportunity to discuss with you once they have a diagnosis before going ahead etc and means that if you are unlucky and they find severe endo you can make sure that you have the surgery with an actual endo surgeon.

Also, just for your info "zapping" it will not work, a general gynae during a diagnostic lap may laser/zap a few patches if they can but this is not effective treatment so you would still most likely need further surgery as this does not destroy the endo, instead it takes the top layer and then it starts to regrow. Instead the endo would need to be excised (cut out) and really really needs to be done by an endo specialist for good results, so if you are diagnosed and it is moderate to severe your next steps would be to push for a referral to an endo specialist at an accredited BSGE endo centre.

I'm sorry if its confusing etc, there is some logic to it (my diagnostic lap found severe grade 4 endo, if the surgeon had gone on to treat me then and there I would have woken up to discover I'd had a hysterectomy whereas I've now had extensive excision and all organs are still intact!) - but I completely agree that it does potentially mean no immediate solutions. What painkillers are you taking? The most important thing you can do at the mo whilst you are waiting is push for proper pain relief x