Endometriosis surgery, typically excision of endo implants and related fibrosis, using minimally invasive laparoscopy or robotic surgery, significantly impacts women’s health and recovery journey. Here’s an enhanced guide to life post-surgery, incorporating tips to improve physical and mental healing towards lasting thrivorship.
Understanding Endometriosis and Its Surgical Treatment
Endometriosis involves the growth of tissue similar to the uterine lining outside the uterus, creating pain and sub-fertility. Thankfully, minimally invasive surgery requires only small incisions through which a camera and instruments can be placed. This is the gold standard for diagnosing and treating endometriosis and has revolutionized the healing process and length of time to full recovery. (Ferrero et al., 2018).
The Recovery Period
Recovery from laparoscopic or robotic minimally invasive surgery varies based on the extent of endometriosis and overall health. Typically, full recovery involves several weeks to a few months. Patients might experience tiredness initially and are advised to consume soft foods, stay hydrated, and take fiber supplements to avoid constipation, especially when using narcotic pain relief. It’s crucial to initially avoid strenuous activities but engage in light walks to promote healing. This reduces the risk of venous clots in the legs but avoids complications like hernias through the incisions.
How long you should take off work depends on the extent of the surgery, physical job demands, and any known medical co-existing conditions that might slow the healing process, such as diabetes. Discuss this with your surgeon before the procedure to set realistic expectations.
Enhanced Recovery Tips:
- Balanced Nutrition: Within limits of allergies and food intolerance which may be specific to you, the following is a generic prudent healing plan:
- Protein: Lean meats, fish, eggs, tofu, and legumes help repair tissues.
- Fruits and Vegetables: Rich in vitamins, minerals, and antioxidants to reduce inflammation.
- Whole Grains: Brown rice, quinoa, and whole wheat bread for energy and fiber.
- Healthy Fats: Avocados, nuts, seeds, and olive oil for inflammation control.
- Hydration: Plenty of water, green and herbal teas.
- Bromelain Supplements: Bromelain, an enzyme found in pineapples, can reduce inflammation and promote healing by minimizing post-surgical scarring (Walker et al., 2018).
- Arnica: Homeopathic arnica can help reduce bruising and swelling, and may reduce pain as well.
- Vitamin C and Zinc: Essential for tissue repair and immune function.
- Probiotics: Support gut health, which can be disrupted by surgery, antibiotics used around the time of surgery, and pain medications.
- Red Light Therapy: Otherwise known as photobiomodulation, this modality can exert and anti-inflammatory effect, reducing prolonged inflammation and thereby can promote healing. Keep in mind, acute inflammation is part of normal healthy healing, so it may be prudent to avoid this for at least a month postop. (Hamblin MR)
Physical Health Post-Surgery
Post-surgery, physical health generally improves, with reduced bodily pain and better physical functioning. However, side effects like hot flashes can occur, particularly if the ovaries are removed or compromised and/or hormonal treatments are part of the post-surgery plan. Regular follow-ups are essential to monitor recovery and address any complications promptly. This is a highly individualized situation, so work with an expert before and after surgery.
Pain Management:
- Heat Therapy: Use heating pads to alleviate abdominal pain. Be careful not to burn skin by not using something like a towel between the heat source and the skin.
- TENS Units: Transcutaneous Electrical Nerve Stimulation can help manage pain by sending small electrical pulses to the affected areas.
- Acupuncture: Can relieve pain and promote healing.
Mental Health Post-Surgery
Mental health is a crucial aspect of recovery. Enduring a chronic condition like endometriosis can lead to anxiety and depression. Therefore, incorporating mental health support into post-surgery care can be vital. Many women report improved emotional well-being post-surgery, but not all. So ongoing support may be necessary to manage any lingering psychological effects (Stratton et al., 2020).
Mental Health Tips:
- Therapy and Counseling: Cognitive-behavioral therapy (CBT) can be effective.
- Mindfulness and Meditation: Practices like yoga and meditation can help manage stress and improve mental clarity.
- Support Groups: Joining endometriosis support groups can provide emotional support and practical advice.
Fertility and Family Planning
Fertility and family planning are significant concerns for many women with endometriosis. Studies show that surgery could double the spontaneous pregnancy rate in people with mild endometriosis. Those with moderate to severe endometriosis also have improved spontaneous birth rates after the laparoscopic removal of endometrial-like lesions.
However, even after successful surgery, some women may struggle with fertility issues. It is essential to have a candid discussion about fertility and family planning with your healthcare provider before surgery.
Financial Considerations
Endometriosis surgery can be financially burdensome. Many specialists are out-of-network, leading to high out-of-pocket costs in many, but not all, cases. It’s best to discuss potential expenses with your insurance provider and surgeon’s office beforehand. Additionally, explore options like payment plans or grants for financial support.
Managing Recurrence
Despite effective surgery, endometriosis can recur. Studies indicate a 51% recurrence rate within ten years. However, it can be in the 5-10% range if complete excision of visible implants is possible. This may require additional interventions that are often hormonally based but can also be integrative and holistic to some degree. Risk factors for recurrence include age, ovarian endometriosis, incomplete removal of lesions, and the initial surgeon’s expertise. Regular monitoring and follow-up surgeries may be required to manage recurrences effectively. It is very prudent to find the most experienced and highly trained surgeon possible. Here is a review of what you should be looking for in selecting a surgeon.
Prevention Strategies:
- Hormonal Treatments: Birth control pills, gonadotropin-releasing hormone (GnRH) agonists, and other hormonal therapies can help prevent recurrence but may also carry significant and prolonged side effects. In general, the least potentially harmful option should be considered first and this should be highly individualized with your endo expert and/or reproductive endocrinologist.
- Lifestyle Modifications: Maintaining a healthy diet, avoiding toxins and regular exercise can support overall health and reduce the risk of recurrence by modulating and more efficiently eliminate excess estrogen in your system.
- Anti-inflammatory Diet: Incorporate foods rich in omega-3 fatty acids and antioxidants to reduce inflammation. It is best to craft a personalized plan with a nutrition expert.
Holistic Approaches:
- Herbal Supplements: Consider supplements like turmeric, which has anti-inflammatory properties.
- Aromatherapy: Essential oils like lavender and peppermint can aid in relaxation and pain relief.
Conclusion
Quality of life after endometriosis surgery involves a multifaceted approach to physical and mental health, fertility, and financial planning. By understanding the recovery process and incorporating comprehensive care strategies, women can optimally navigate their post-surgery journey. Work with an endometriosis expert.
References
- Ferrero S, Evangelisti G, Barra F. Current and Emerging Treatment Options for Endometriosis. Expert Opin Pharmacother. 2018;19(11):1109-1125. doi:10.1080/14656566.2018.1507067. https://pubmed.ncbi.nlm.nih.gov/30096049/
- Vercellini P, Buggio L, Frattaruolo MP, Borghi A, Dridi D, Somigliana E. Medical treatment of endometriosis-related pain. Best Pract Res Clin Obstet Gynaecol. 2018;51:68-91. doi:10.1016/j.bpobgyn.2018.06.001. https://pubmed.ncbi.nlm.nih.gov/30126775/
- Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020;382(13):1244-1256. doi:10.1056/NEJMra1810764. https://pubmed.ncbi.nlm.nih.gov/32212520/
Updated Post: July 09, 2024
