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Does endometriosis require surgery?

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In brief: Surgery

The aim of surgery is to remove as much of the endometriosis as possible while keeping the womans ability to have children.
Surgery is recommended:
• if the pieces of endometriosis are larger than 4 - 5cm (1.5 - 2 inches)
• if there are many adhesions or they are interfering with the normal workings of internal organs such as the bowel
• if the endometriosis is blocking the Fallopian tubes and causing infertility
• if there is severe pain which cannot be controlled with analgesics or hormones. The endometriosis may be cut away, or destroyed with heat produced by an electrical device or by using a laser. This can often be done through small cuts in the belly, using a laparoscope (keyhole surgery), but may require an open operation.


Endometriosis returns in about 1 in 5 women five years after having surgery. Hormonal medicines are sometimes given after surgery to try to delay this return. However, the only sure way to prevent endometriosis returning is to remove the ovaries. This is only considered for women with severe symptoms as a last option, or in women who are not planning to have a baby.

Endometriosis may reduce the chances of a woman being able to get pregnant. In severe cases this may be due to blockage of the Fallopian tubes, but even mild endometriosis can reduce fertility. Medicines used to treat endometriosis do not improve fertility, but surgery can if the endometriosis is interfering with the normal workings of the womb and ovaries. Some women with endometriosis who want to have a baby may need fertility treatment.

In brief: Surgery

The aim of surgery is to remove as much of the endometriosis as possible while keeping the womans ability to have children.
Surgery is recommended:
• if the pieces of endometriosis are larger than 4 - 5cm (1.5 - 2 inches)
• if there are many adhesions or they are interfering with the normal workings of internal organs such as the bowel
• if the endometriosis is blocking the Fallopian tubes and causing infertility
• if there is severe pain which cannot be controlled with analgesics or hormones. The endometriosis may be cut away, or destroyed with heat produced by an electrical device or by using a laser. This can often be done through small cuts in the belly, using a laparoscope (keyhole surgery), but may require an open operation.


Endometriosis returns in about 1 in 5 women five years after having surgery. Hormonal medicines are sometimes given after surgery to try to delay this return. However, the only sure way to prevent endometriosis returning is to remove the ovaries. This is only considered for women with severe symptoms as a last option, or in women who are not planning to have a baby.

Endometriosis may reduce the chances of a woman being able to get pregnant. In severe cases this may be due to blockage of the Fallopian tubes, but even mild endometriosis can reduce fertility. Medicines used to treat endometriosis do not improve fertility, but surgery can if the endometriosis is interfering with the normal workings of the womb and ovaries. Some women with endometriosis who want to have a baby may need fertility treatment.
Quality HealthCare Team
Quality HealthCare Team
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Dr. Adam Levy
Board Certified, Obstetrics & Gynecology
34 years in practice
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