Can endo spots be lasered away from the sac of douglas? My gyno doc said it was too dangerous.

[aabb]

When I went to get more laser treatment 3 weeks ago the gyno doc said he couldn't laser it away because of where it was. Has anyone else had it in the sac of douglas and managed to get it lasered?

[missteal]

I'm thinking it might just be you it's difficult on, maybe you have nerves near it or something? Or even scar tissue? I have known ladies to have it lasered off of the pouch of douglas so it sounds to me either it's difficult on you or the surgeon you saw isn't able to do it himself?? xx

[aabb in reply to missteal]

Thank you for your thoughts. I am going back to see him in a couple of weeks because he said he would rather speak to me at his clinic about it all rather than when I had just come round from anaesthetic. All he told me was that my left side is really stuck, my right side has adhesions, that I only have 1 spot of endo in sac of douglas. He said something about my kidneys and bladder, not sure if this has anything to do with it being in sac of douglas. Am sure I will find out whats what when I go. Just hope that what ever the treatment or medication is will work for wee while anyway.

[Sunflower846]

Nope I'm the same as they can damage ur bowel or womb during the op. I have alot of endo there too xx

[Sunflower846]

Sorry didnt mean to write nope, lol. was on the bus and wasnt thinking straight! Yes they can operate but it is a big surgery because of the complications it could cause, x

[aabb in reply to Sunflower846]

Thank you for getting back to me. It just seems a bit frustrating to have endo that can't be removed in what ever way. Do you suffer more pain and discomfort because you still have it there?

[Sunflower846 in reply to aabb]

Yeah i had my lap done 29th nov and have no relief from it. Still same pain and when i have bowel movements the pain in my stomach is excruciating and this is why i have been put on a temp menopause to shrink it, but suffering really badly from side effects that i wont get my 2nd injection, cant cope with it, its a daily struggle so not sure what my next option is until i see my gynae again. xx

[aabb in reply to Sunflower846]

Oh I hope you get some relief soon. take care.

[stevieflp]

Hi, I had it rife in my Pouch of Douglas. It had stuck everything to everything down there. I successfully had it all excised out rather than by laser but you would need to see a skilled endo surgeon rather than one who uses laser.

[aabb in reply to stevieflp]

Thank you for your input. What exactly is involved in the treatment you got? I have never heard of that before. Has it worked for you?

[cupcakegirl]

It usually can be removed from the pouch of Douglas - this is the area between your womb and rectum. I've seen a video of one of my laps where my old specialist removed lots of endo from there using diathermy rather than laser - I'm not sure why it would be a problem unless there's issues with scar tissue and so on. I would ask more questions and ask to be referred to a specialist - if your gynae can't do it, they should be referring you to someone who can.

x

[aabb in reply to cupcakegirl]

Thank you for getting back to me. I am going back to the gyno in a couple of weeks. You have given me some other questions that I can ask. Hope to get some sort of treatment to get back to normal, well for a wee while anyway! lol.

[blueboo]

Hi, I had a huge 'nodule' (surgeon's word) removed from my Pouch of Douglas last summer but it was cut out rather than lasered. It was all done by keyhole surgery. I did get cut open at the same time but that was to repair my ureter which had also been affected and couldn't be operated on laparoscopically. My bowel was all pulled up and they shaved some endo off there as well so if you get a good team (I had three surgeons present at the op and it took 6 hours) then it is definitely possible to remove it.

[aabb in reply to blueboo]

Thank you for your comments. Hope your surgery has worked for you. I am going back to see him in a couple of weeks because he said he would rather speak to me at his clinic about it all rather than when I had just come round from anaesthetic. All he told me was that my left side is really stuck, my right side has adhesions, that I only have 1 spot of endo in sac of douglas. He said something about my kidneys and bladder, not sure if this has anything to do with it being in sac of douglas.

[cupcakegirl in reply to aabb]

I would definitely wait until you've spoken to him again as being drowsy can affect what you remember and you may not have the full picture.

If indeed they did only find one spot of endo in the pouch of Douglas, removing it probably wouldn't make much, if any, difference to your symptoms. Mild endo can cause lots of pain, but one or two spots in itself is unlikely to cause really major problems. However, the adhesions could be contributing to your pain - I had one lap where they only found a couple of spots of endo but masses of adhesions (I was on depo provera at the time so I wasn't having periods and the endo subsided, then returned when I stopped) and it sounds as though you may have had similar findings - saying they only found one spot of endo in the PoD suggests that's the only endo they found, unless he had some reason to tell you what they found just specifically in that area.

Kidney and bladder issues won't be related to the mild endo the pouch of Douglas (aka rectouterine pouch) as the womb sits in between - this image might help you visualise:

academic.amc.edu/martino/gr...

If you have endo or adhesions affecting your bladder and or kidneys, this would probably require a specialist surgeon. Problems here and your other adhesions would suggest that, if they only found one spot of endo, your endo was more widespread in the past (unless they could be caused by previous surgeries?). Are you currently on a hormonal treatment or have you been recently?

[aabb in reply to cupcakegirl]

Thank you for your comments. I 1st got the 6mth hormone injection and used the HRT but only for 6 weeks as the side affects from the HRT were worse than the injection. The 2nd time I got it lasered and it worked. The 3rd time the doc put me on a mini pill but that was waste of time, then I got 3mth hormone injection without HRT! Then I was getting more laser treatment 3 weeks ago and he couldn't do it. So right now I am talking or on no medication. I just wander what he will suggest now.

[Allieline]

I have it there as well and my Gynae has said that it is very risky to operate as the bowel may be permanenty damaged. My bladder, kidney and everything else are affected as well. He is willing to go ahead with a team of specialist surgeons when I feel ready. At the moment I am well so I'm not rushing. Have you tried all other options? The Mirena coil has been fantastic for me although I do realise its not for everyone. Hope you find something that works for you.

[aabb in reply to Allieline]

Thank you for getting back to me. I 1st got the 6mth hormone injection and used the HRT but only for 6 weeks as the side affects from the HRT were worse than the injection. The 2nd time I got it lasered and it worked. The 3rd time the doc put me on a mini pill but that was waste of time, then I got 3mth hormone injection without HRT! Then I was getting more laser treatment 3 weeks ago and he couldn't do it. So right now I am talking or on no medication. I think the only thing I havent tried is the Mirena coil. I have been lucky over the years in a sense that I haven't had lots of spots of endo and the spots I had managed to get lasered ok 3yrs ago. I think my problem from the way it sounded was because my left side is completely stuck n now my right side has adhesions.

[Amb43]

Hi ladies, do any of you that have been diagnosed with Endo in the Pouch of Douglas suffer with lower back period like pain? Dull, nagging, dragging, ache? And do you have any problems with your bowels and bowel movements because of it? Thank you all xxx

[aabb in reply to Amb43]

Over the past year I have had spells of having diarrhoea n stomach cramps. I have noticed that when I do have this problem I also get a dull ache in my lower back. I was sent for tests at the hospital to check my stomach and bowels were ok but gastro doc said it was my IBS because evrything came back clear. I am not convinced! Even my gyno doc said it was my endo.

[Amb43 in reply to aabb]

Read this earlier, aabb: Sudden bouts of diarrhoea may be caused by bacterial infection. In woman with endometriosis, deficiency of vitamin A and B are common, causing low level of enzymes that allow food to pass through the intestine undigested.

Until recently I nearly always had diarrhoea at the same time as my period, and was interested to read this because I was diagnosed with the old scape goat IBS, but was never convinced.

xx

[cupcakegirl in reply to Amb43]

That's interesting about the vitamin deficiency - I know that in my case it was caused by adhesions on my bowel as it stopped immediately when I had surgery to remove them and hardly any endo was found. However, I'm sure there are various reasons that cause the same result and it may be worth trying a supplement to see if it helps.

I too was diagnosed with IBS at around the age of 14 or 15, after I'd already been complaining of pain and heavy periods to my GP. I wish they knew enough about endo to at least consider it when a patient has many of the symptoms.

[cupcakegirl in reply to Amb43]

Yes - lower back pain, and feeling like you're being stabbed up the bum! Lower back pain can also be caused by endo on the ligaments supporting the womb I think.

My endo symptoms started when I was 12 or 13 and around the age of 14 I started with IBS symptoms - every time I ate, I'd have awful stomach cramps and then diarrhoea. Even after I was diagnosed at 22 and I was taking tramadol then morphine, this still happened - until I had my first lap with my specialist and he removed loads of adhesions from my bowel. I didn't go to the loo for two weeks after that op and had some serious issues. Ever since then, I suffer from severe constipation due to my painkillers so it's gone completely the other way.

Bowel issues can be endo near the bowel, or on the bowel, or adhesions. It's definitely worth getting checked out though, as it's not always related to the endo and could be something else.

x

[weealex]

Hello I just wanted to add that I'm another who has had endometriosis excised from the pouch of Douglas, so cut out rather than lasered. So it's definitely possible. I would agree with an earlier post in that not all surgeons are capable and it's worth finding one who is. There's a list on this website bsge.org.uk/ec-BSGE-accredi... of accredited teams. It's a great site and I found it really reassuring, especially the section that notes the standards they must reach before becoming accredited.

I remember waking up afterwards and hearing about what they found after the first operation. So hazy! It's a double edged sword I think...I'd hate to have been kept in the dark, but it was also the absolute worst time to be told anything like that!

Wishing you the best of luck with everything x

[Noodle1984]

I had stage 4 recto vaginal Endo lasered off in February. My rectum was fused to my vagina, the surgery took almost 3 hours because the damage was extensive. I had an Endo specialist and colon surgeon work together to remove it. I was very lucky I didn’t end up with an ostomy bag, they even fitted me prior to surgery just in case. Because they worried my ovaries would fuse to the area excised I had to have them pinned to my abdomen for a week which was less than comfortable 🥴.