Mega Doctor News
May Clinic News Network
DEAR MAYO CLINIC: I was recently diagnosed with advanced-stage endometriosis and I am told I need to have surgery. I still want children someday — should I be worried about my future fertility? What else should I know about recovering from surgery?
ANSWER: As you are learning, endometriosis is a condition in which tissue that is similar to the inner lining of the uterus grows outside the uterus. It can cause serious pain.
With advanced-stage endometriosis and things such as uterine fibroids and large ovarian cysts, we do our best to minimize the negative effects on fertility and instead actually optimize for pregnancy. A myomectomy for uterine preservation, for example, allows women to maintain their uterus, even with large fibroids. Similarly, removing endometriosis but leaving the uterus, fallopian tubes and ovaries intact ensures there is still the possibility of future pregnancy and can even promote a successful pregnancy. Even when large, endometriosis-filled cysts are present (endometriomas), we are able to remove the abnormal tissue but leave the normal, healthy ovarian tissue in place for future fertility and hormonal needs.
The biggest question I get from patients after surgery is, “When can I get back to life?” Patients have families, jobs or responsibilities outside of their own health. We know that women especially can struggle with that balance of taking care of themselves while also taking care of everyone around them. Understanding what those constraints are from a personal perspective and getting women back to their lives as quickly as possible are among the key things that we focus on.
The best recommendation I have for anyone going into surgery is to be the healthiest you that you can be. The less stress you have, the better your diet is and the more rest and exercise that you’ve been getting is all going to support your body through the stress of surgery, which in turn is going to help speed along the recovery. The other thing I always make sure my patients are aware of is that, after surgery, be prepared to need some assistance doing daily things until the pain and fatigue lifts. It’s normal to need a bit of help, so be prepared for that.
The advances that we’ve had in technology when it comes to surgical procedures have pushed the envelope and allowed us to do the majority of gynecologic procedures through a minimally invasive approach. This means most patients are back at work a couple of weeks after surgery, depending on the procedure, but have a speedy recovery because we’re not negatively affecting their bodies any more than necessary.
The other thing to keep in mind from a recovery perspective is not every surgery is the same. There are some surgical procedures where the total downtime is only the day of surgery. In contrast, if we’re doing something such as a hysterectomy to remove the uterus— even if it’s done through small incisions — we want to ensure that healing happens well. So we don’t want any heavy lifting or strenuous exercise for typically six weeks after surgery. However, we do want normal physical activity to start even the day of surgery because that really helps maintain strength and normal body function, which helps speed along the recovery.
My team and I like to develop a close relationship with our patients to make sure that we know what their fertility goals are for the future and any barriers that might potentially stand in that way. Talk to your healthcare team about any other concerns, and best wishes to you during this time. — Megan Wasson, D.O., Gynecology, Mayo Clinic, Phoenix
