Questions re rectovaginal endo op

[MajawithaJ]

Hi,

I have severe endometriosis, some of it removed via laparoscopy back in August and surgeon saw endometriosis on the bowel but didn’t operate on it and I’m in the process of being referred to a specialist at the endo centre to discuss the possible operation.

I’ve also had an MRI in the meantime, which showed that sigmoid is “closely applied to the lower uterine segment/cervix”.

I’m reading up on the stuff before I see the consultant.

My gyno recommendation is to take Zoladex prior to the op.

My question is, is that always necessary? Do you always have to take it before the op? It scares me after reading the horror stories about it & I’d rather not take it. Thanks in advance.

[luthien]

I've not had to have it before the op so can't help from that view. I had the same sort of thing; first lap excised endo from all over uterus and bladder, and second lap with additional colorectal specialist to excise endo off the bowel by a rectovaginal shave - I think that means removing endo without cutting into the bowel.

A quick google suggests it thins the lining of the uterus so perhaps it shrinks the endo before the lap?? not sure, sorry. Perhaps ask your specialist what they expect to happen if you do take it?

Sorry I can't be more help xx

[Christin_a]

Hello

I'm short no you don't have to do anything. You can say no, they can only suggest but you have to read up and agree for yourself if it's something you want to do. Alot of people say no to zodalex due to the long list of side effects, others say yes because they want to try. Either way the choice is yours, but zodalex is only recommended for a maximum of 6 months for endometriosis.

[Hidden]

Zoladex helps reduce size of endo and also slows production of that dreaded hormone I’ve never had it before a lap but things with endo medical information changes all the time maybe it would be worth speaking to your consultant to ask what the benefits of taking zoladex before the op are I’m sure they can point you in the right direction

[MajawithaJ]

Thanks all, that’s helpful, & yes, I think it’s to do with slowing the production.

I think I’ve read somewhere that the medical route is explored before the surgical one and just wondered whether that’s the absolute norm & whether they’d operate without the course of Zoladex.

I’m scared of the operation-not sure if it’ll be a resection or a shave but I think I’d be more scared of the Zoladex side-effects, so I’d rather avoid it if I can. Thanks again!

[Smuggle in reply to MajawithaJ]

No medical treatment shrinks endo in so far as regressing its progress - it might reduce inflammation and in doing reduce the size of nodules (deep infiltrating endo). The guidelines for treatment of severe endo only mention taking these injections for 3 months prior to surgery to shrink endometriomas (which are mostly made up of old blood) so if you have these it would be the usual suggestion. But otherwise it tends to be based on surgeon choice and there is no evidence that it makes any difference to the surgical outcome (ESHRE 2.5). Some surgeons like women to have it prior to surgery so that the pelvis is 'cleaner' while others prefer the endo in all its glory. So this is not a choice for your gynae to make - it is the choice of you and the operating surgeon together.

eshre.eu/Guidelines-and-Leg...

[MajawithaJ in reply to Smuggle]

Thank you, that’s good to know. I feel like I need to know as much as possible before I see the specialist & know about my options. There was also a talk of hysterectomy at the same time so maybe Zoladex was to induce the chemical menopause & to see what happens. I’m not rushing into anything as I’ve had my thyroid removed this year so I’m reluctant to go on HRT post hysterectomy. Plus I wouldn’t have hysterectomy until I knew all the surrounding endometriosis has been removed.

Thanks for the link as well!