Has anyone had Ablation laparoscopic for severe endometriosis?
Can I still try for kids? I am 30 and now getting worried as I have read mixed reviews about ablation surgery. I have two cyst in my left ovary and one behind my uterus, and stage 4 endometioma in my bowel. The surgeon did say he can only tell me after the laparoscopic whether I will need to have IVF treatment. So does this mean that not all ablation effects your chances of trying for any children?
My understanding was that ablation carries the risk of leaving endo cells behind as it just bur s the top layers.
If you have a stage 4 bowel endometrioma I'd have thought you should be treated by a BSGE centre not a general or fertility gynae who do not have the same specialist knowledge in and advanced percision excision training for Endo as accredited BSGE centres do.
That's what the NICE pathway states. Section 1.4.2 p 8 of the NICE pdf download here pathways.nice.org.uk/pathwa...
There is much more detail on the definition of deep/severe endo in the NHS England treatment (Google severe endometriosis specification if below does not work) google.com/url?sa=t&source=...
List of accredited BSGE Centres
This is the standard for an accredited BSGE centre
bsge.org.uk/requirements-to...
It's your decision at the end of the day as individual outcomes vary greatly. You may feel you trust your fertility gynae and want to prioritise conceiving and just crack on or you may feel your bowel endo is the priority, you are uncomfortable with ablation and you want accredited Endo specialist treatment . The main thing it is your own informed decision.
Tbh, if it were me and there is bowel involvement then I would at very least want a second opinion by a BSGE Endo accredited surgeon before proceeding. It may be that you have more surgical options than currently offered in general surgery.
Hi
I am with a BSGE centre. They said my bowel needs correcting as it been pushed to the right due to the endometrioma in my bowel which my gynae specialist did not notice. But I am with BSGE centre at Homerton hospital in East London. Do you reckon I should go ahead with the ablation? Although it's too late to cancel as I need to give them 10 days notice of cancellation or else they will discharge me.
I cant advise you of that sweetpea x
Could you see if you can contact the Surgeon to express your concerns and see if they can speak to you and set your mind at rest and explain things in more detail for you as to why they have opted for one over the other? Sometimes hospitals have PALS like systems that can help with liason?
They have to obtain your consent for the surgery and that consent needs to be informed. Including risks as well as benefits. They should not be threatening you with discharge or to stop treating you as then your consent is not truly given it is under duress.
Hello
Theres 2 types of ablation. Uterine ablation and ablation removal of endo.
They are very different. Do you know which one it is?
If it's for the removal of endo you need to ask for excision, this removes more of the endo compared to ablation. Think of ablation as cutting a weed at surface level. Where as excision is like digging to remove the roots of the weed too.
Uterine ablation is different this is to removing things inside of your uterus.
I saw you said you're at a bsge centre. Is your consultant on the bsge list (a hospital can have a bsge centre but only have one or two gynecologist on the list and the others are normal gynecologists). The reason I question it is a bsge gynecologist should not be saying they'll do ablation to remove endo (some places may need it to avoid other issues) but the predominant removal method should be excision. However if it is uterine ablation that's different as as far as I'm aware that is the only method.
As to of it effects fertility that's down to where it is, how deep it is, what they can and can't do etc.
Christina
Thank you for your reply.
I know its not for the uterine. It is for endo removal. I have endo in my left ovary 2 cyst and one behind my uterus. which hasnt given me any pain since april.
I'm not sure there was a difference. I have 3 surgeons who will do the surgery. I found them under the BSGE centre list and went for them as they also had a pelvis pain clinic and fertility treatment clinic for after surgery when I need the support in conceiving.
Can I still ask the surgeon to do a excision although they have given me a surgery date next week? This is probably the next time I will see him.
I am also needing to go in for a bowel surgery as I have endometrioma in my bowel and they told me the risk is I might need a temporary stoma bag whilst the bowel heals.
but this will be done in a separate surgery.
If you want to have kids, LISTEN TO WHAT I HAVE TO SAY.
I have seen at least four women with stage 4 endo all over their bowel and urethers conceive naturally (without IVF) after a well-performed EXCISION surgery. ABLATION is NOT the gold standard for endometriosis, which is not removed effectively through ablation.
If you want to be able to conceive naturally (or at least try and optimize your chances), get EXCISION surgery with a renowned endo specialist (there are only around 5 in the UK so contact me privately if you need their names).
You need someone who will perform conservative surgery and remove all endometriosic lesions completely.
PLEASE DO NOT PUT YOUR FERTILITY IN THE HANDS OF NON-EXPERTS, I AM BEGGING YOU TO WANT THE BEST FOR YOURSELF AND SEEK THE BEST TREATMENT POSSIBLE.
Getting surgery done right the first time is pivotal to optimize your chances of conception.
Please contact me via PM for more information on doctors and facilities.
Best of luck!
I have just called through to the surgical centre after so many telephone numbers. So they said they will email the consultant now and tell them to change my surgery procedure to Excision.
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