Surgical management of endometriosis - excision rather than burning (diathermy) treatment

Most women with severe stage endometriosis are in agony and report to be at the end of their tether. The diagnosis of pelvic endometriosis is delayed up to 8 years in some cases, especially when young women starts complaining of symptoms (mainly painful periods and painful intercourse) in their teens.

The commonest sites of endometriosis are the ovaries, Fallopian tubes, peritoneum (skin that covers the pelvis), vagina, bladder, ureters, bowel and rectum. Because of the possibility of involving different organs, surgery for endometriosis may be complex and challenging even for a very experienced surgeon. Most recent evidence advocates excision (removal) of the endometriosis, especially in advanced stages, rather then diathermy (burning) of the lesions as the latter surgical approach is more likely to cause recurrence and worsening of the disease. Ultimately the treatment of severe endometriosis is pelvic clearance which entails hysterectomy and salpingo-oophorectomy (removal of the womb, tubes and ovaries) but the following factors have to be borne in mind when advising women regarding radical surgery for endometriosis: chronological age and fertility preservation (plans to conceive). Since endometriosis is often diagnosed in women between the age of 25-40 years, conservative surgical management involving the removal of the endometriotic lesions only is recommended.

Mr Nardo runs dedicated endometriosis clinics both in Manchester and London, and he works with a multidisciplinary specialist team to ensure women suffering with endometriosis and pelvic pain receive the best possible management.