Help pls !!

[Endo-battle]

Help pls ladies I dnt understand the terminology in the letter could u help figure it out for me pls it says the pouch of Douglas is obliterated by a plaque which extends from the torus uterinus with mild thickening of bilateral uterosacral ligaments I have appt with endometriosis surgeon ( specialist) do u think they will do hysterectomy and put me out of this pain , thanks for your help

[Moon_maiden]

HiI had a lap last November with Helica treatment to the pouch of Douglas, it’s the cul-de-sac between the uterus and rectal/large bowel area. hysterectomy last November, where endo gynae found a lot more adhesions and on uterosacral ligaments which were down as rectovaginal endo. He said the bowel wasn’t effected. There was supposed to have been an MDT meeting but it never happened and they failed to pass it on.

Do make sure they explain properly and if it will or has been discussed with any other consultants. The NICE guidelines state that with a hysterectomy all endo that can be seen needs to be removed.

Ask exactly what will be done and expectations for afterwards.

The pelvic pain is certainly easier, abdomen not so.

Let us know how you get on.

[Endo-battle in reply to Moon_maiden]

Oh no I’m sorry that they failed to pass it on in MDT have you got another appointment I have telephone appt with consultant on 12th so hopefully get sorted pls try to get in touch with your consultant and get sorted

[Lindle]

An obliterated POD is stage 4 endo and must only be treated in a specialist centre. A hysterectomy is not a treatment for this but you could need the uterus removed as well as excision if it is diseased or if it would be too difficult to dissect around it. A hysterectomy alone in this scenario with uterosacral ligament endo can make matters worse as deep endo is often left in the vault that goes on to progress. The main factor is that you must be treated in tertiary care in a centre if not already.

[Endo-battle in reply to Lindle]

Thank you I have already had ovary and tube removed from right side and we have lunch syndrome in family so tbh I want hysterectomy now

[Lindle in reply to Endo-battle]

I'm not sure what lunch syndrome is but just wanted you to be aware that excision is the treatment for stage 4 and not a hysterectomy. But if you are in a tertiary centre they should know the best treatment.

[Endo-battle in reply to Lindle]

Sorry it’s lynch syndrome typing error it’s default in genes