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  • Q&A with Australian Health Practitioners

    Can endometriosis return after having a laparoscopy?

    I am 28 years old and was diagnosed with stage IV endometriosis in September 2011 when I had a laparoscopy. They did not remove all the cysts as they were worried they would damage my bowel so I had another laparoscopy in April 2012. My periods have gradually become more painful, my last one being as bad as it was before the laparoscopies. Is it common for endometriosis to return after a laparoscopy?
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    Dr Joseph Jabbour

    Gynaecologist, Gynaecologist - Infertility (IVF) Specialist, Obstetrician

    Dr Joseph Jabbour is a specialist Obstetrician & Gynaecologist and Fertility Specialist with Monash IVF situated in Sunnybank (Brisbane Southside). Dr Jabbour has had the … View Profile

    There is definitely a recurrence of endometriosis after the initial treatment of the disease. This also depends on the degree of severity of the disease. Stage IV endometriosis has a higher recurrence rate. Some studies show a recurrence rate of 14% of the disease at laparoscopy 2 years after the initial surgical excision. 
    20% of women with severe endometriosis will require repeat laparoscopy 2 years after the first surgery. The risk of recurrence at 10 years can be as high as 40%. 

    To reduce the risk of recurrence, it is important to combine your surgical treatment with medical management such as the Combined Oral Contraceptive Pill, or the Mirena IUD. 
    Once you have completed your family (Pregnancy helps with the symptoms of endometriosis), you may benefit from a Laparoscopic Hysterectomy with excision of endometriosis. 

    This definitely warrants a discussion with your gynaecologist. 

  • Dr Arun offers specialised service in the following areas: Holistic approach in the management of Urinary Incontinence including Urodynamics for women Botox injections to bladder … View Profile

    I agree with this.

    with regards to medical management, I tend to use Dienogest (Visanne) or Qlaira as OCP if contraception . I rarely recommend Zoladex  due to th menopausal side effects.

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