What it is
Endometriosis is tissue like the lining of the uterus growing outside it. It bleeds every month with no way out, and that causes pain and scarring.
A camera in the belly is how it is confirmed. What is found is removed in the same operation.
Cutting the tissue out is called excision. Burning the surface is called ablation. Excision goes deeper, and it is what Dr. Mueller does when the disease allows.
Why it is done
- Period pain that keeps you home from work
- Pain during or after sex, felt deep
- Pain with bowel movements, worse around your period
- Pelvic pain on days that are not your period
- An ovarian cyst that looks like endometriosis on ultrasound
- Trouble getting pregnant with no other cause found
- Pain that has not settled on hormonal medication
What happens, step by step
- 1
Before surgery
Dr. Mueller takes a pain history, examines you, and orders an ultrasound.
- 2
Getting in
A camera goes through the belly button, and two or three small cuts go lower.
- 3
Looking everywhere
The ovaries, tubes, bladder, bowel surface and the space behind the uterus are all inspected.
- 4
Removing disease
Visible lesions are cut out, and scar tissue holding organs together is released.
- 5
Samples to pathology
What comes out goes to the lab. That is what confirms it.
- 6
After surgery
You go home the same day and are seen in two weeks with the report.
Questions people ask
- Can an ultrasound show endometriosis?
- Usually not. It can show a cyst that suggests it, but the tissue is only confirmed under a microscope.
- Will the pain come back?
- It can. Surgery treats what is there now, and hormonal medication afterward is often used to slow new growth.
- Does surgery help me get pregnant?
- It can, especially when scarring is holding the tubes or ovaries down. At the follow-up visit Dr. Mueller tells you exactly what she found and what it means for conceiving.
- How big are the scars?
- Three or four cuts, each under half an inch. One of them is hidden in the belly button.
- Will I need a hysterectomy?
- Usually not. Taking out the uterus does not remove endometriosis growing outside it, so it is not the first operation.