Endometriosis is a condition where tissue similar to the lining of the uterus grows elsewhere in the body, causing various symptoms. Excision surgery is one of the available treatment options.

Endometriosis is a chronic condition that occurs in approximately 1 in 10 females of reproductive age. Symptoms include pain and heavy bleeding. It can also affect fertility.

Health experts do not fully understand the cause of endometriosis, but hormonal imbalances and genetic factors may play a role. Treatment options may include pain relief medication, hormone therapy, surgery, or a combination.

This article discusses excision surgery and whether it can help treat endometriosis.

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Excision surgery is a minimally invasive surgical procedure that involves removing the endometrial tissue that has grown outside the uterus. The procedure also aims to repair damage to organs and other sites that endometriosis may have affected.

Excision surgery may be suitable for people with moderate to severe endometriosis and those experiencing pain, infertility, and heavy periods due to endometriosis.

The surgery may also be suitable for people with endometriosis that is unresponsive to pharmacological treatment or where pharmacological treatment is not appropriate.

Excision surgery involves cutting out the endometrial tissue that has grown outside the uterus.

A surgeon may perform an excision surgery laparoscopically. This type of surgical method involves making small cuts in the abdomen and inserting a laparoscope through the cuts. A laparoscope is a thin tube with a camera on the end. This allows the surgeon to see inside the pelvis and remove the endometriosis tissue using other surgical instruments.

Laparoscopic ablation is another type of laparoscopic surgery. However, in this method, the surgeon destroys the endometriosis tissue by burning, freezing, or electrifying it.

The cost of excision surgery will depend on many factors, including:

  • whether a person’s insurance provider will cover the surgery partly or fully
  • the surgeon performing the procedure
  • the severity of the endometriosis
  • whether the person has other health conditions

A 2018 multicenter prospective cohort study investigated the effectiveness of laparoscopic excision surgery in women with rectovaginal endometriosis. It found that 6 months postsurgery, there was a significant reduction in:

  • pelvic pain
  • low back pain
  • bladder pain
  • pain during sexual intercourse

The researchers also found significant reductions in bowel frequency, urgency, constipation, and passing blood. The study also notes that these reductions continued 2 years postsurgery.

A 2017 systematic review found that laparoscopic excision surgery showed significantly greater improvement in pelvic pain, painful periods, and difficulty passing stool when compared to ablation surgery.

A 2020 systematic review also notes that moderate quality evidence shows that laparoscopic surgery increases viable intrauterine pregnancy rates.

Some possible side effects of excision surgery may include:

Recovery from excision surgery for severe endometriosis may take up to 4 weeks. It may also take a person up to 6 months to experience improvements in their endometriosis symptoms. Recovery times may be lower for moderate endometriosis.

While excision surgery is one treatment option for endometriosis, it may not be the most suitable for some. Additionally, a person may require surgery and pharmacological treatment to treat their endometriosis effectively.

Pharmacological treatment

Some pharmacological treatment options include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs improve the pain symptoms associated with endometriosis.
  • Combined hormonal contraceptives: These drugs stop the growth of the endometrium, which is the layer of tissue that lines the uterus.
  • Progestins: These drugs also stop the growth of the endometrial tissue and inhibit ovulation.
  • Gonadotrophin-releasing hormone (GnRH) analogs: These hormone-targeting drugs decrease endometriosis-related symptoms.
  • Danazol: This androgen drug reduces endometriosis-related symptoms.

Other surgical treatment

Excluding excision surgery, surgical treatment options can include:

  • ablation of uterosacral nerves
  • electrocautery
  • laser treatment
  • presacral neurectomy
  • hysterectomy

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus, causing pain, heavy bleeding, and infertility.

Excision surgery is a minimally invasive procedure that involves removing the endometrial tissue that grows outside the uterus and repairing any damage caused by endometriosis. The surgery is suitable for moderate to severe cases and can help reduce pelvic pain, back pain, bladder pain, and other symptoms. Recovery may take up to 4 weeks.

Other treatment options for endometriosis may include pain relief medication, hormone therapy, other surgery, or a combination of these approaches.