BMI and "radical" endometriosis surgery

[Charbonz_flower]

Hi, just looking for some opinions, suggestions on how to approach this issue. I was recently seen my a gynaecologist from a generic gynaecology department (outside of my local hospital but still nhs). I was discharged earlier this year after also having recieved a diagnosis of PCOS. I was advised I would need a referral to my local endometriosis unit within the hospital here, for "radical endometriosis surgery" given my pain. However, the specialist advised my GP they should not refer me until I have a lower BMI of less than 35 (currently 42).

I am trying so hard to lose weight, I'm prescribed orlistat to help with this but it is a huge struggle especially with PCOS. I am steadily making progress but it's going to be a journey, and in the mean time I'm in agony with my endo.

I was wondering if anyone knows what I can do about this, if it is an absolute no go for surgery if your BMI is this high, and if anyone thinks it might be worth rediscussing with my GP, can they 'overide' this boundary by the specialist if they think it would be worth it? I've estimated that at my current weight loss it'll be about 8-12 months until I am at the right BMI, then there will be waiting times etc when i am referred!

I'm also stressing about what is meant by "radical surgery" would this refer to something like a hysterectomy as I'm only 25, with no children and desperately want a family if it's possible.

[MrsPaddingtonBear]

Hello

I too had this issue regarding surgery and BMI. Mine was 45, I too had orlistat. It took me two years and treatment with zoladex and hrt, then prostat and hrt to get BMI of 38. I am disabled with mobility issues so that didn’t help. I began daily exercise online with a lady called Jules her site is called Improved health. She does all levels from complete starter to intermediate and chair exercises. I managed to build up to 20/30 mins cardio 6 days a week. I lost 3 1/2 stone. I had a hysterectomy 12 weeks ago. Sadly it became a medical emergency and I had life saving bowel surgery and a colostomy bag fitted. I will have that reversed next year. My bowel and womb were stuck together with endometriosis. Hopefully you will get a clear answer from the clinic regarding what their suggested treatment is and can made an informed decision about what to do. Best of luck.

[Cailleach]

Hi,

Do you know the extent of your endometriosis ie has it been shown on any scans? If it is extensive you should be treated in a specialist centre ( BSGE). Or is that the unit being referred to?

I can’t see any reason why your GP can’t refer you for investigation/ treatment of your endo. You are only going to go on a waiting list to sit in an office and discuss your symptoms and perhaps be referred for scans (MRI can be helpful in showing the extent of endo).

There are other hormone treatments they could offer that are not surgery, as well as advice on pain relief, if you are not currently suitable for surgery. I would also expect that they would discuss your plans for a family with you and do their best to offer options that preserve your fertility.

If you are offered surgery in the future on these conditions of weight loss , think it’s worth asking why specifically the surgery can only be done if you lose weight. What is the actual problem caused by your excess weight? Not all areas have this policy so that’s why I say ask.

I hope you are able to move forward with this soon xx