What can one expect after lap surgery for endometriosis?
August 31, 2011 7:55 AM   Subscribe

Lap surgery for endometriosis. What can I expect after?

Hello,

This was very helpful regarding women's experiences and treatments before a lap.

It has been confirmed I have an ovary wrapperd around the back and attached to my uterus so they are suspecting adhesions. I have one son so it did not affect my fertility (then again I did use ART).

It's always been an issue for me but birth control pills since 25 (I'm now 40) have been a lifesaver in controlling my cycle and pain. But after having my son 3 years ago (naturally) it feels like it spread or did something to the endo. Even on birth control pills I've been in constant "inflammatory-like" pain and the left/adhesion side is to the point it hurts to move, sit, carry my son, etc. I'm just sick of it and am highly considering surgery.

I'm talking with 3 specialists--My fertility specialist because for peace of mind, I really just want to know my ovarian reserve. My OB who I adore. And an endo specialist.

I do not want to go on Lupron but I would go back on birth control pills.

What can I expect after surgery?

-how long of recovery
-how much pain afterwards
-how is a person's cycle
-treatment afterwords to keep it at bay--birth control?
-you just don't wake up to "oh it was so bad we did a hysterectomy" do you? Because this is a huge fear
-did you regret the surgery/feel like it made it worse?
posted by stormpooper to Health & Fitness (18 answers total)
 
--I was doing vigorous activity about 4 days later but I do not recommend that! Prohibitions on lifting heavy objects, sex, and a few other things are in the weeks. This is something to ask the surgeon.

--I was in less pain afterwards, even without pain meds, than I was in before the surgery. My anesthesia wore off and I forgot to take the codeine. There was pain, but compared to the endometriosis it was not a big deal. I was taking RX meds at night for my pain, though.

--My cycle went from irregular with 7 days of bleeding, severe pain, and diarrhea to 3 days and easily tolerable. If you're on HBC and go off of it your period will probably be a change but it's hard to say how it will change.

--Treatment afterwards is controversial/there isn't much. Some docs say HBC, some say that's pointless.

--It was was worse than they thought, they went an hour over the time they gave to the case and had to have a bowel surgeon involved. No hysterectomy! Most modern docs who are well-informed about endo are VERY reluctant to do hysterectomy because unlike previously believed, it doesn't necessarily help/cure endo and it's a huge deal. You can always tell them that if it's that bad, they must close you up and get separate consent for the hysterectomy.

--I do not regret the surgery. I love the surgery so much that if it were a person I would home bake it cookies.
posted by the young rope-rider at 8:55 AM on August 31, 2011


Just popping in here to clear up that I believe the OP is talking about Laparoscopic Surgery for Endometriosis. (first google responses to "lap surgery" brought up the LAP band for me)

Tons of websites pop up with a google search.

Hopefully this will help get you some answers.

I've had laparoscopic surgery to remove my gallbladder. Obviously that's not endometriosis, but I was out of it for about a week but other then some tenderness and a crazy drive to sleep my on stomach (which was impossible during my recovery), it wasn't so bad.
posted by royalsong at 8:58 AM on August 31, 2011 [1 favorite]


1. My recovery was about 10 days. I spent the first two days in bed and dealing with pain in my shoulders that comes from the gas used to inflate your abdomen. I was in my 30's, excellent health and in good shape.

2. The pain from the incisions is only bad on the first day or two. Recovering from the anesthesia was the worst part for me but YMMV.

3. I spotted the first few days but then my period came back on schedule after that.

4. I use birth control to keep the endo at bay. It really works for me. No back pain, easy periods and plus really clear skin! That doesn't mean the the endo is a bay of course, it just means that I'm not dealing with any of the other annoying period stuff. I get an every 6 month ultrasound to check in on the size of a endometrioma on my ovary.

5. So, I went in thinking they were removing a dermoid cyst and them ended up having to remove one ovary. The surgery was MUCH longer than anticipated so it freaked my family out a bit but after kind of being sad that I was now missing one of my parts, I snapped back to reality and told myself that I trusted my surgeon and that he did what was best for my health.

6. No regrets. I feel 100% better and hopefully you will too.

Good luck!
posted by yfatah at 9:10 AM on August 31, 2011


@yfatah, was the removal of an ovary a possibility they discussed or complete surprise? My HSG test showed clear tubes but this very clear showing of the ovary wrapped around behind my uterus and stuck there like gum on a sidewalk does concern me with waking up with suprising news.

And back in my early 20s, I did have a cyst on my right ovary burst (hellooooo excrutiating pain) but seeing I couldn't get pregnant without IUI, Clomid, and trigger shot, they never could find a good reason why I couldn't have kids naturally. I'm guessing I didn't release the egg so perhaps my endo/parts aren't THAT damaged but still, this pain is getting ridiculous. I should be able to sit down (I have a desk job) without feeling ripping/tearing squishing of my organs.
posted by stormpooper at 9:19 AM on August 31, 2011


My recovery time seems to have been abnormally long - I was popping codeine for at least two weeks afterward and didn't feel 'myself' again until about a month after surgery. I had plans to do all sorts of work (mostly marking student essays!), but ended up spending much of the time in bed or too high on pain meds to trust myself to work. So, my advice would definitely be to give yourself time to heal and take at least two weeks off if you can.

Part of the reason for my discomfort was the litre of anti-adhesion fluid that they put it me - I really was sloshing about. It might be worth checking with your specialists to see if they have similar plans for you.

Having said all of that, I share the young rope-rider's affection for my laparoscopy. It lessened my pain considerably. It fixed the adhesions (significantly less tugging on my left side), and the scars have healed really nicely.

My endo was a bit worse than they thought with the bonus of some adhesions, but they left my bits intact and even ran dye through my ovaries to make sure everything was fine and clear.

I really trusted my surgeon and it was a very positive experience for me (possibly tinted slightly by the fact that I was pregnant by my 3 month follow up appointment!). Absolutely no regrets.

Oh! and one last thing, if they haven't talked to you about it already, you might want to bring up the possibility on physio therapy for after you recover- I also had pain on my left side and managed it by sitting in odd positions that seems to have made all my muscles a little lopsided. A few exercises every night have really helped my posture and seem to help the little bit of remaining pain.

Best of luck!
posted by brambory at 9:24 AM on August 31, 2011


It was a cakewalk and definitely reduced all pain and suffering.

Do it.
posted by jbenben at 9:38 AM on August 31, 2011


I had the same issue at yfatah, about the absolute, horrible pain in my shoulders and neck from the gas. OMG.

And I didn't appreciate the fact that, even though I read all over the place about it, and even my doc told me, that "hey, it's a speedy recovery - in and out!" I was a bloody, cramping, mess! I was thinking I'd be sitting at my laptop, ready for work that evening or the next morning - very wrong (guess i should have asked for more specific about the definition of 'speedy recovery'....). Thankfully my boyfriend was there and totally took care of me, including (before having to get dressed) wiping off dried blood before that was all over me that the slack-ass nurse didn't bother with. And, of course, the prescrips helped, although i can't remember exactly what I had.

Doc ended up taking some adhesion and also shot some dye through the tubes to check for any blockages. Other than that, I recovered in about three days, I think, about that.

All in all, I'd say the pain in the neck/shoulders area actually stand out the most.
posted by foxhat10 at 9:47 AM on August 31, 2011


1. My recovery was about 10 days. I spent the first two days in bed and dealing with pain in my shoulders that comes from the gas used to inflate your abdomen. I was in my 30's, excellent health and in good shape.

2. The pain from the incisions is only bad on the first day or two. Recovering from the anesthesia was the worst part for me but YMMV.

3. I spotted the first few days but then my period came back on schedule after that.

4. I use birth control to keep the endo at bay. It really works for me. No back pain, easy periods and plus really clear skin! That doesn't mean the the endo is a bay of course, it just means that I'm not dealing with any of the other annoying period stuff. I get an every 6 month ultrasound to check in on the size of a endometrioma on my ovary.

5. NA for us...

6. No regrets. I feel 100% better and hopefully you will too.


+1

My wife had it done twice - both times pretty much spot on wiith the above. We were having fertility issues and in both cases we conceived in early attempts following both. And now we have a son and a daughter. Yay us!
posted by thatguyjeff at 10:00 AM on August 31, 2011 [1 favorite]


I had this surgery when I was 26, about 3 1/2 years ago. I was otherwise healthy and in pretty good shape.

I found the recovery pretty rough. I was off work for a week, and pretty uncomfortable for most of that. I agree with the others that the worst pain was in my shoulders. I also needed help getting up off the couch or out of bed for a few days, so I was lucky that my partner was home with me at first.

I noticed a really big difference after. I am on HBC and had been since two months before the surgery, so that helps a bit, but I really think the surgery made a big difference. I've been on HBC since, except for the first six months of this year when I went off it just to see what would happen...the pain definitely started getting worse, and I don't know if that means that the endo was growing back faster, or that as the hormones left my body my periods got worse. Regardless, I went back on because I'd rather not have to have surgery more often than necessary.

It was a really good choice for me. My surgery was diagnostic because they hadn't been able to see anything in my scans before, and so I really wasn't sure about going through with it. But I'm really glad that I did, and I definitely have better quality of life now (don't have to miss work every 3.5 weeks, etc.). I wish I didn't have to be on HBC (don't need it otherwise) but that's not the end of the world.

Good luck!
posted by sabotagerabbit at 10:21 AM on August 31, 2011


My girlfriend just had a laparoscopy a week ago today. She didn't have any pain in her shoulders or legs - what she mainly talked about was the pain at the incision sites. As long as she kept from moving much, she felt alright. She started work Monday, and has been getting along fine - she's driving herself to the Doc's to get the stiches out today.
posted by daboo at 10:31 AM on August 31, 2011


Ooh, I had a cyst on my right ovary burst too! It was a chocolate cyst, nice and fat, had wound 'round my ovary and twisted the fallopian tube, whee. (Where "whee" = "oh %$#*.")

I had laparoscopic surgery to fix up everything, and as others have said, it was recovery from anesthesia that was the hardest. Be prepared for the possibility of horking up your stomach contents not long after waking. And the gas pains, and helpful nurses saying "yes dear I know it hurts and you can barely stand but we need to get you to the toilet so you can pass some of the gas"... and they stay in the bathroom with you to catch you if (when, for me) you reel over because you're still barely conscious, and are exhausted. Then you feel like puking again.

But then you can push a button for codeine! WHEEE! (Where "whee!" = "whee!") I was released 24 hours after waking, which honestly, I thought was a bit soon, but I also lived a block from the hospital. Took about a week to get feeling normal-ish again, two weeks to feel peppy. The post-op pain was, as others have mentioned, easier than endo pain. Y'know how endo pain has that "oh god just knock me out please right now please it's ripping me apart" sensation? Post-op pain is "clean", you can tell things will be OK.

I did have a surprise in that doctors feared my right ovary might have been twisted so long that it had "died", but they said it looked like it might still be all right, and since I was 21 at the time (no kids) they decided to be safe and keep it. If it had looked worse they'd have taken it out, they said. So they were careful and informed me about the possibility – they couldn't have done so earlier because it was too hard to see what was going on.

I've never really heard of anyone having a surprise hystorectomy, I wouldn't worry about that! I think that in the very rare case that would be needed, they'd rather keep you intact (taking off whatever else was needed), let you wake up and inform you of your options and the prognosis.

Birth control pills have kept me cyst- and adhesion-free ever since, been eleven years now. It's nice to have 1.5 weeks for every month of my life back. I do have occasional cyst pain scares, but they're few and far between and have never been an issue beyond checking them out to be sure. But even with those, the horrific gut-wrenching pain is gone. Yay!
posted by fraula at 10:52 AM on August 31, 2011


Oh, fraula's answer reminded me:
Coming out from under anaesthetic was the worst. I think it's very, very personal how you respond, but I was really sick. I kept throwing up (nothing), then getting hiccups, so needing to drink water, which would make me throw up. I was also in a day surgery unit, so they wouldn't let me sleep because they wanted me to recover enough to leave soon, and that was pretty awful. Be sure to have someone there with you, both to look after you and help you to the bathroom, etc., but also to listen to instructions for your aftercare. My surgeon came and gave me all the instructions literally while I was throwing up (I know!); if my partner hadn't been there, I would not have gotten any of that information.

Also, if they do tell you it will be day surgery, be prepared to stay over if need be. I had to pee before I was allowed to leave, and I couldn't, so they ended up admitting me and catheterizing me, which was a bit traumatic because I had no idea it was a possibility. As it turned out, it was probably good to stay over that night, but I would have liked to be more prepared.

But, all of that said, I'm so so glad I had the surgery; it was absolutely worth it. I just think it's good to know what it can be like!
posted by sabotagerabbit at 10:58 AM on August 31, 2011


Yeah, I had trouble keeping food down too. I think the stomach just protests angrily the invasion of your abdomen with sharp poking things. They wouldn't let me go home until I managed to eat something and keep it down.

I was in the hospital over night. Went home the next afternoon. I tell you what, I'm susceptible to motion sickness at the drop of a hat. Motion sickness rears it's ugly head with reckless abandon when you're a passenger in a car and hyped up on pain killers.
posted by royalsong at 11:36 AM on August 31, 2011


So recovery should be interesting combined with a very active, very "mamma, mamma, come here" 2.5 year old. :) And work is going to be @#$# off about the time. I may have to wait until new cycle of vacation or end of year.

Started to set up consults to see who to choose. God I'm so scared. But thank you for your stories. I'm glad all worked out well.
posted by stormpooper at 11:55 AM on August 31, 2011


I had this done. It was to drain/remove a cyst, and they found huge amounts of endo (adhesions, one tube pretty much glued shut, etc.) which I had no symptoms of previously (except for the cyst). Recovery was hard the first 24 hours. It's outpatient here, and I was very nauseous after surgery and they wouldn't let me sleep it off -- they needed to get me up and out before a certain time or they'd have to admit me. Honestly the worst part was the aftermath of catheterization, which seemed to have made my urethra stick shut or swell, so my bladder became painfully full and I had a very hard time peeing (this was at home, later). I never had any bad pains from the gas. I did have swelling and pain at the incisions. I have bad reactions to narcotic painkillers so I used tons of ibuprofen and it helped me through. I mostly slept for the first couple of days at home, and I wore loose, comfortable clothing for a couple of weeks. I think I was back to work after 5 or 6 days. After a year the scars are pretty much invisible, if that matters to you. And I am now on a low-dose of birth control, not having any periods ever, and no more cysts!

I wouldn't do it again without doing better research first, which it sounds like you have done.
posted by chowflap at 1:05 PM on August 31, 2011


A friend of mine had suspected adhesions (only) and turned out to need an ovary removed due to serious amounts of scarring. This meant that it took longer than expected, recovery was more unpleasant than expected, and she was pretty out of it on pain medication and so on. They kept her in one or two nights, which we weren't expecting, and then I was around so that she didn't need to bend over and do pet care and stuff for about a week. Stairs and in/out of the car seemed to be double plus ungood at first.

Best wishes!
posted by wintersweet at 3:02 PM on August 31, 2011


Definitely take a couple weeks off work if you can, and get someone to look after your kid because you'll want to take it easy. Getting up from a lying-down position will be very difficult for the first few days, and coughing and laughing will hurt. Keep a towel nearby to hold to your belly if you need to cough or laugh, and to get up from a lying-down position you'll want to roll on your side first and swing your legs to the floor.

Nthing the problems with anesthesia; if at all possible get a spinal instead of general, you'll avoid the nausea. I threw up after two of my surgeries (I've had six), but if you ask ahead of time they'll give you anti-nausea meds in your drip to help post-op.

Don't worry about a surprise hysterectomy; most docs are very reluctant to do a hyst, and will only do it as an absolute last resort. They certainly won't do it without getting your consent. Worse comes to worse, if your doc feels it's necessary, s/he will close up before doing anything and discuss options with you. Make sure your surgeon knows about your concerns, but really don't worry about it. My ovaries continued to function even after getting badly damaged with scar tissue and adhesions. I've since had everything removed (at my own insistence).

HBC is probably your best bet for keeping it at bay afterwards (I would avoid Lupron; the side effects are nasty and it's most useful pre-op), although there's a school of thought regarding dietary restrictions to combat endo (I forget the author of the book I'm reading, but I'll try and post a link when I get home), which you might consider. My cycle returned to normal right after surgery (when I wasn't on Lupron).

I do not regret any of the surgeries, but in my case it did not solve the problem. I continue to have chronic pain, even after everything has been removed (including my cervix). Many women have several surgeries, so you should prepare yourself for this possibility (sorry). It sounds to me like you've got quite a sticky mess inside. My advice is if you want more children, have them asap as endo will likely make you infertile. Sorry to be the bearer of grim tidings. Feel free to MeMail me if you want to talk. And good luck :)
posted by Koko at 3:15 PM on August 31, 2011


A link to the book I mentioned.

Caveat: I have not yet tried making the changes that Shepperson Mills suggests, because they are VERY restrictive, but I do plan to work them in to some extent. A friend of mine tried this diet with very positive results. The book goes into a lot of detail about how what we eat affects our hormone levels, which in turn affects endo flare-ups.
posted by Koko at 5:06 PM on August 31, 2011


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