Re: Adhesions/Endo/treatment questions to Megan
From: anonymous (anonymous@obgyn.net)
Fri Dec 1 07:54:32 2006
Hysterectomy is not a cure for endo - it can still come back, as you
noted, so it is not a cure. Lupron only works in some women, up to 50%
get no relief at all on it, and for over 50% of those who do, the pain
just comes back when they stop treatment.
If your doctor does a complete hysterectomy AND removes all your endo,
you have the best chance of it not coming back - however many docs who
do hysters for endo don't bother to remove the endo, because they think
it will "starve" without the estrogen from the ovaries. Not true at all
- endo can make it's own estrogen, and there are other places estrogen
comes from, like body fat. And of course if they take your ovaries,
you'll be in surgically induced menopause, which is very rough on your
body, especially without HRT.
What a hysterectomy is good for is adenomyosis, but you can't diagnose
adeno without a hysterectomy. They have to remove the uterus to biopsy
it.
Thorough excision by a specialist is the best treatment currently
available for endo - up to 80% of women who have excision are pain-free
5 years later.
At Tue, 28 Nov 2006, Megan wrote:
>
>After doing research on endometriosis, and talking with my ob-gyn, the
>only cure for endometriosis is a complete hysterectomy. Without the
>hormones that are generated by the ovaries, and the endometrial tissue
>from the uterus, there is nothing to sustain endometriosis, and from
>what I understand it goes away. The same concept holds true for why
>they try all of those hormone therapies, like lupron, that suppress
>hormones and periods, this, in theory, is to reduce and/or get rid of
>endometriosis, at least for the time the patient is on it. From what I
>understand, sometimes these work and sometimes they don't.
>
>My doc has mentioned in the past that a hysterectomy is the only "cure",
>however, in very rare cases, endometriosis has been known to show up in
>women who have had a hysterectomy. So, as with anything in medicine,
>nothing is 100%.
>
>At Mon, 27 Nov 2006, kathym wrote:
>>
>>Hi,
>>
>>My Dr is Keith Isaacson, he is the head of Minimally invasive GYN
>>surgery at a hospital in the greater Boston area. He is a well know and
>>respected laser surgeon. From what I read on Dr Cook or Redwine's site
>>I believe excision is performed using a co2 laser, which is what my Dr
>>used.
>>
>>My first surgery was not performed by him, basically the dr opened me up
>>and said I needed an expert to remove the adhesions, and I was referred
>>to my current DR. On my second surgery the adhesions and endo were
>>removed as best he could. The third surgery was an emergency for the
>>tubal...they could barely find my tube and was only concentrating on
>>that, since it was potentially life threatening!! the fourth surgery was
>>for removal of 2 huge endometrioma's, which were able to be done
>>laprascopically, 2 yers ago and the suspected source of my pain at the
>>time, unfortunately the pain has been bad lately, perhaps more adhesions
>>have been formed...vicious cycle
>>
>>I wasn't sure if you worked for this web site since your signature was
>>from medispace.
>>
>>I'd be interested in hearing your story. Also how much Advil were you
>>taking to develop a ulcer? How could you tell it was an ulcer not endo
>>pain???
>>
>>At Mon, 27 Nov 2006, anonymous wrote:
>>>
>>>Who is your doctor? 4 surgeries is a lot, and I'm somewhat surprised
>>>that they didn't remove endo at the last three? Or did they? Did he burn
>>>your endo out?
>>>
>>>I'm just surprised because most all the specialists use excision, not
>>>laser. What does he say about your headaches? Did he suggest the
>>>Lupron?
>>>
>>>A complete hysterectomy probably won't help unless he removes all the
>>>endo, and the adhsions at the same time, and if that's the case, why not
>>>just remove all the endo?
>>>
>>>Sorry, I don't know your doctor, but your options don't sound quite
>>>right to me.
>>>
>>>At Sun, 26 Nov 2006, kathym wrote:
>>>>
>>>>thanks for your replies, I have had 4 laproscpic surgeries..one for
>>>>adhesion/endo removal, the second for a tubal pregnancy 2 years later
>>>>(the adhesions were back and so dense they could bearly find my ruptured
>>>>tube) and the last for removal of a large choc cyst (along with my
>>>>ovary).
>>>>
>>>>My Dr is an endo specialist and an expert laser surgeon. At my last
>>>>appt, I told him I still have pain and he said , I could either go on
>>>>b/c pills, have another laproscopic surgery for adhesion removal or have
>>>>a complete hysterectomy (I'm already missing one tube on one side and
>>>>the ovary on the other).
>>>>
>>>>I'm reluctant to go through the misery of a complete hysterectomy with
>>>>the possibility of not having it resove the pain and cause more
>>>>adhesions....and other possible effects.
>>>>
>>>>I'm approaching menopause and thought that I could hang in
>>>>there...however, it has been very difficult this past year due to ever
>>>>fluctuating hormones...I think my Dr thought the B/c pills might help
>>>>with the perimenopause also.
>>>>
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