Has anyone had a laparoscopy with excisions for endometriosis?

[Armyofprawns]

After decades of gynae and digestive issues, I was finally told I have deep endometriosis and adenomyosis. This was following a pelvic MRI in 2023. I was 50!

I had to wait a while to see an endo gynae and was put on a waiting list last May. I was told it would be at least a 12 month wait, maybe longer.

But I'm really getting myself in a stew about it all. Although I have had many gynae procedures (5 hysteroscopies, polyps removal in day surgery and a uterine ablation) I have always opted to be awake for these as I am petrified of general anaesthetic. I had a GA 25 years ago for a D&C and felt like crap for a month after (dizzy, constant nausea and just strange). I know many people love GA's and will say it's the best sleep they've ever had etc but I am truly terrified of them.

All made worse by the gynae saying if he finds any deposits on my bowel he will instantly stop the operation and I will need to return at a later date with a colorectal surgeon on hand. Just the thought of gearing myself up for an op only to have to go through it again leaves me so anxious.

I will probably also need a hysterectomy at a later date because my uterine ablation failed and I now have adenomyosis as a result.

I'll be honest, I have not enjoyed being female!

I’m sorry you’re suffering with so much anxiety, on top of the physical symptoms. Have you approached your GP about this - a calm discussion may help to reassure you.

If it doesn’t I wonder if a few therapy sessions would help? Because I would urge you to proceed with the laparoscopy if you possibly can.

you'll be pleased to know that anaesthetics have progressed quite a bit in the last 25 years. The prolonged drowsiness and nausea that people used to get after even short procedures is much less common. GA can be combined with spinal anaesthetic too to help with post op pain if they think they're likely to be doing a lot on the inside (isn't always needed, but is there as an option - anaesthetist'll be able to make a sensible plan with you on the day). The surgeon probably wouldn't even start the operation if they thought they were likely to need a colorectal surgeon available so hopefully it's a good sign that it's something they've thought about and decided they don't need (they won't want you to need to have two procedures instead of one, but it also makes absolutely no economic sense to do an operation they don't think'll work). (DOI: anaesthetist that does pretty regular gynae)

I do have a GP appointment next week, I think I'll mention it then. Thanks.

Thank you so much, that's very reassuring.

I had terrible problems with endo, years of issues, pain and bleeding. Nothing worked for me until I insisted they sort me out, so I went on zoladex for 6 months which basically brings on the menopause but is reversible if that doesnt fix the problem. It did, so I then had my ovaries removed and am now pain free. Maybe ask if zoladex could be an option for you.

Hey there. Sorry to hear what you've been going through. Popped on to reassure you about the GA. I've had 3 of them. 1st for Endo excision surgery to remove an endometrioma on ovary and multiple bowel adhesions. 2nd for a hyteroscopy (fibroids). 3rd another laparoscopy for removal of a fallopian tube. In addition I've had 6 rounds of IVF to have our little boy where although it's not GA it's very heavy sedation where you are intubated (fentanyl). Never felt sick or any issues. They explained how they use anti sickness and a cocktail of things. They seem to have it down to a T these days. Regarding your concerns with the colorectal bowel surgery. What he said is standard unfortunately as they only have that type of surgeon on hand if bowel Endo is already confirmed and expected. Mine didn't show up on ultrasound or MRI. I was just fortunately in that my consultant at Wythanshaw (Andy Pickersgill) is an endo specialist who is skilled on doing bowel excision also so he did it on finding it all in one go. He's probably a rare find but it's maybe worthwhile asking if there's anyone like this in your area to avoid two surgeries and recoveries. They potentially like hens teeth I think I just dropped on xx

I was offered Zoladex but the gynae put me off tbh, he listed off all these awful side effects and they sounded brutal. I am 52 in March so hopefully not far off natural menopause but the thought of suddenly being plunged into full meno overnight wasn't a pleasant thought.
Did you experience any awful side effects?

Oh that reminds me regarding Zoladex. There's Zoladex and Prostap. Both do same thing. When I volunteered for the Endo uk helpline you often found one out of the two would agree with women and it was pot luck which. I tried Zoladex first. Didn't agree with me. Was fine with prostap. They do 1 or 3 month injections. I had a 3 month if I was to do it again I'd start with a 1 month so if it doesn't agree with you, you're not stuck with it in your system for 3 months. As I really struggled with insomnia and other symptoms xx

I've had two of these.

I get very bad reactions to GA. If you say to the anaesthetist they can add more anti nausea drugs into the mix. My more recent ops have been much better for this reason.

@Armyofprawns no side effects at all. It pretty much put me in the menopause straight away so hot flushes started but for me it was like an instant relief. They only offered it to me when I got really bolshy with them. The consultant was asking what did I want to sort out, the pain or the bleeding to which I said both. So for me it was brilliant, and I think they were reluctant to even offer it because of the cost. But yeah, it worked for me and you can only be on it for six months max anyway.

Thank you. Sounds like you've been through the wars yourself. Endo isn't much fun is it?
We have a fantastic endo gynae at our hospital which is an endometriosis centre but he has such a long waiting list it's impossible to get to see him on the NHS. I did see him privately but he wanted £7500 for a lap, sadly I just don't have the funds for that.
I just hope and pray my gynae is as good 🤞x

I've had two laparoscopies. I was very anxious for the first one as I'd never been in hospital let alone had a GA and an operation. The surgeon could see my anxiety was quite high, so he offered to shuffle the order round so that I wasn't waiting as long and he gave me some medicine to take to calm me down. Whatever it was it worked. I was much less anxious the second time I had the operation.

Please try to speak with your dr and see if there are anti anxiety medications you could take on the day. I was fully recovered within a week. Best of luck.

I'm waiting for mine, having excision, chocolate cysts removed, a mirena fitted and adhesions remove from my bowel
Colorectal surgeon in theatre with the endo surgeon

I see them on Friday next week for consent if there's anything you want to know I can always ask? I have a list already!

Oh and no issues with GA
My dad was petrified but didn't say anything until he blurted out to me "do they still hold that gas mask on your face?"
He came out raving about modern anaesthesia! I always ask for as much anti nausea as they can give

I will definitely ask for extra, thanks.

Thanks, I'll ask my GP next week.

Thank you fivebyfivebuffy - I will have a quick think. I hope it goes really well for you, do you have a date for your surgery?

No but hopefully March/april, I'll have to see what they say at my appointment
I've been moved up as on morphine for pain relief and struggling

Good luck, I hope the op really helps you. There is nothing worse than being in pain 24/7