Ask Dr. Cook Archives
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Recurrent Endometriosis After Hysterectomy and Removal of Ovaries Question: I had a hysterectomy and removal of my ovaries five years ago. I have been having a lot of bleeding, and was told yesterday that I may have endometriosis. My doctor did three biopsies to make sure; I was told that it might be endometriosis in the vaginal cuff. What can I expect from this? Is it possible that it may be cancer? Answer: It is highly unlikely that this represents cancer. The biopsies that you had are entirely appropriate, and will determine definitively if this is a benign process. Before removing the uterus, if the endometriosis is not removed from the vaginal cuff and the area behind the vagina, the patient is at a high risk of having persistent growth of the endometriosis, as well as symptoms such as bleeding and pain with intercourse. If you do have endometriosis, it is probably in the space between the vagina and the rectum. It may also be in other areas of the pelvis. A thorough laparoscopic examination will determine if this is the case. All of the endometriosis needs to be removed at surgery, preferably by a gynecologic surgeon who has had a lot of experience in treating endometriosis patients after hysterectomy. Many patients are told that the endo will melt away if the ovaries are removed. This is not necessarily true as endometriosis can produce its own estrogen, even after both ovaries are removed. Also, the very top of the vagina may need to be removed to excise all of the endometriosis. From a sexual functioning standpoint, this should not be a problem. |
