“Will endometriosis relapse after surgery? “

Patients often worry about this aspect. Sometimes uncertainty robs them of the joy of rediscovering wellness. This is due to a misconception, which unfortunately is still the cornerstone of the (global) medical system. What is classified as a relapse, represents, in most cases, the same endometriosis lesions that are not excised during the surgery. That doesn’t mean that the disease doesn’t really recur.

It is important to distinguish between deep endometriosis, which can be anywhere in the pelvis, in the form of nodules or adhesions, and ovarian endometriosis. In the case of deep endometriosis, especially when we talk about intestinal damage, with the practice of intestinal resection, the rate of relapse is very low. Once the node has been completely excised and the portion of the affected intestine removed, the chances of the disease recurring (partially or with the same aggressiveness) are very low. However, the chances of relapsing increase when the patient undergoes hormone treatment for ovarian stimulation in the case of assisted reproduction techniques. Regarding ovarian endometriosis, things are different, this can relapse despite the removal of the cyst.

The excision surgery requires the removal of endometriosis lesions “from the root”. While this technique is highly efficient but complex, many untrained surgeons use ablation, or fulguration or coagulation which doesnt remove the disease and is linked with much higher rates of  recurrence, so patients are under the impression that this is a chronic disease which keeps coming back. Recurrence rates with ablation surgery vary from 50 – 80 % where as recurrence rates after excision of endometriosis are between 0.5 % to 3 % for deep endometriosis and 10-15% for ovarian endometriosis.

One needs to understand the difference between true recurrence and disease left behind or persistent disease. If all the lesions are not identified or are not excised completely then they will continue to grow and probably become symptomatic again.

There is no clear, scientifically established link between diet, lifestyle and endometriosis. Thus, post-op, patients have no reason to burden themselves with food or other restrictions, for fear of relapse. The only fair reason for an approach to a restrictive lifestyle is proven intolerance to certain substances.

Thus, we advise that after endometriosis surgery you focus on recovering and returning to normalcy, whatever that means for you, without being under the threat of a relapse hypothetical.