Living with endometriosis can mean spending years trying to understand why you hurt, why your symptoms keep coming back, or why one treatment works for a while and then stops helping. If you have reached the point of considering surgery, you may already know that there are different ways to treat endometriosis during a procedure. Two of the terms you may hear are endometriosis excision and endometriosis ablation.
So, what is the difference, and how do you know which approach may be right for you?
While both approaches are effective endometriosis treatments, the best choice depends on factors like where your endometriosis is located, how deeply it has grown, your symptoms, previous treatments, and whether you hope to become pregnant.
Read on to understand how these procedures differ, how to prepare for either procedure, and where to find the best endometriosis specialist in Los Angeles to guide you through recovery.
What Is Endometriosis Excision?
Excision involves surgically removing endometriosis lesions from the tissue where they are found. This can be performed laparoscopically or with robotic assistance. This type of treatment is usually considered when endometriosis is associated with:
- Chronic pelvic pain
- Severe menstrual pain
- Pain during intercourse
- Pain with bowel movements or urination
- Pelvic adhesions
- Fertility concerns
- Symptoms that have not improved with medical treatment
How Does Endometriosis Ablation Work?
Ablation uses energy to destroy visible endometriosis lesions. Depending on the surgical technique and equipment, the surgeon may use heat, electrical energy, laser energy, or another energy source to treat the affected surface tissue. Ablation has been used for many years to treat endometriosis, particularly when the endometriosis is not embedded deep into other tissues
It is also important to clarify the terminology. Endometriosis ablation is different from endometrial ablation. Endometrial ablation treats the lining of the uterus to reduce menstrual bleeding. Endometriosis ablation treats endometriosis lesions outside the uterine cavity.
What Is the Difference Between Endometriosis Excision and Endometriosis Ablation?
The main difference between these two endometriosis treatments is how the surgeon treats the endometriosis tissue:
Which Endometriosis Treatment Provides the Best Pain Relief?
Both excision and ablation can effectively treat endometriosis when used in the right circumstances and performed with careful attention to the location and extent of disease. The most appropriate approach depends on factors like where the lesions are located, how deeply they have grown, your symptoms, your previous treatments, and your reproductive goals.
Finding the best endometriosis surgeon in Los Angeles to evaluate your situation ensures your treatment plan is tailored to your needs.
Does Endometriosis Excision Mean Endometriosis Cannot Come Back?
No surgical procedure guarantees that endometriosis will never return. Endometriosis is a chronic condition, and symptoms can recur after surgery. Some severe cases of endometriosis may be difficult to see or safely remove during an operation. Hormonal factors and other causes of pelvic pain can affect symptoms after surgery as well. With this in mind, remember that surgery can relieve pain and improve fertility for some women. Long-term care should include symptom monitoring, medication, fertility planning, or additional treatment when appropriate.
How Should Endometriosis Be Treated to Protect Future Fertility?
Endometriosis can affect fertility in several ways: Pelvic inflammation and adhesions may interfere with normal pelvic anatomy, while endometriosis involving the ovaries or other reproductive structures may create additional concerns. Because of this complex relationship between endometriosis and fertility, fertility goals should be part of the conversation before treatment. Before surgery, the best laparoscopic endometriosis surgeon in Los Angeles will consider:
- Whether you are trying to become pregnant now
- Whether you plan to pursue pregnancy in the future
- The location and extent of endometriosis
- Previous pelvic or fertility treatments
- Ovarian involvement
- Other factors affecting fertility
Choosing the Best Endometriosis Specialist in Los Angeles
Before choosing an endometriosis surgeon, you should consider the surgeon's endometriosis experience, approach to tissue preservation, ability to evaluate complex pelvic anatomy, and willingness to tailor treatment to your goals.
Dr. Sukrant Mehta is a board-certified, fellowship-trained minimally invasive gynecologic surgeon with more than 15 years of medical experience. His training includes Cedars-Sinai Medical Center and Montefiore Medical Center, followed by nearly a decade in UCLA's Department of OB/GYN, where he served as an Associate Professor and Associate Program Director for the Fellowship in Minimally Invasive Gynecologic Surgery. He uses laparoscopic and robotic techniques that provide enhanced visualization and instrument control when removing endometriosis.
Ready to discuss your treatment options with the best endometriosis specialist in Los Angeles?
