I had excision surgery on April 29, 2025, and I am still experiencing excruciating pelvic pain like I experienced before surgery. My doctor said that I’m still healing internally and that’s the cause. When should I expect to be pelvic pain free?
Endometriosis
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It’s understandable to feel concerned when you’re still experiencing significant pelvic pain after excision surgery. While some discomfort is expected during the healing process, ongoing excruciating pain could indicate something more than typical post-operative healing. Everyone heals differently, but by 8–12 weeks post-op, most patients notice significant improvements. If your pain continues to mirror pre-surgery symptoms, it’s important to advocate for yourself consider seeking a second opinion from an excision specialist or a pelvic floor physical therapist who can assess for muscular or nerve-related contributors to your pain. Your healing deserves both patience and thorough support.
Even though we clear patients for all restrictions at their final postoperative visit (typically 3 to 8 weeks postop) we know that there is a low level of healing that continues after that. For example, your incisions will continue to flatten, soften, and fade over the next year, and there is probably a low level of healing that continues on the inside as well. It is common for patients to not really know how much pain relief they are going to get from surgery for 3 to 6 months, even up to a whole year. In fact, some patient’s pain will get actually get worse before it gets better, so the first few periods after surgery can actually be even worse than before surgery. Also, it is important to note that surgery alone may not get you to “pain free.” Often patients have multiple causes of pain. For example, spasm of the pelvic floor muscles is very common, so pelvic floor physical therapy to learn to relax the pelvic floor muscles can be helpful. And finally, if you had surgery with a lower volume, less skilled surgeon, it is possible that not all of the endometriosis was fully treated or atypical appearing endometriosis was not recognized. When patients have persistent pain after surgery, when to reoperate is a tricky question, so I would make sure you are seeking care from a high-volume subspecialized endometriosis surgeon who works in coordination with a multidisciplinary team.