Lack of endometriosis specialist increases chance of extra surgery

Via Endometriosis Awareness Campaign:

Lack of endometriosis specialist increases chance of extra surgery
by Emily Roberts

DOZENS of women suffering from endometriosis are having to undergo surgery twice because Basingstoke hospital does not have a specialist based there to treat the condition if it is severe.

It means that the majority of women who are diagnosed with the illness, which is incurable, and can cause chronic pain and fertility problems, face undergoing two lots of surgery – the first to diagnose the condition and the second to treat it.

Only those with mild endometriosis, which Basingstoke hospital has said is a minority, are given the option to have it treated during diagnosis.

The only way to properly diagnose endometriosis is via a laparoscopy, which is keyhole surgery to look inside the body.

The Endometriosis Institute, a not-for-profit organisation fostering research, education and clinical advances in endometriosis, states on its website: “An experienced laparoscopic surgeon should be able to resect or destroy endometriotic lesions with electrical current or laser at the time of diagnostic laparoscopy.”

Endometriosis UK, a charity supporting women with endometriosis, in offering information to those waiting for a laparoscopy, adds: “A laparoscopy is carried out under general anaesthetic. At the same time, various procedures can be performed in order to destroy or remove the endometriosis, endometriotic cysts and release scar tissue.”

Basingstoke hospital said that 131 women had endometriosis diagnosed via a laparoscopy between July 2013 and July 2014, of which only a “minority” were able to receive treatment during this surgery.

The hospital, in Aldermaston Road, said following diagnosis, a treatment plan is formulated and patients may be referred to the Royal Hampshire County Hospital, in Winchester, where the specialist endometriosis centre is based.

Basingstoke hospital has not been able to provide figures to show how many women are referred for further surgery following diagnosis.

Some may choose to receive hormonal treatment to control the endometriosis instead, although this does not get rid of it.

Claire Iffland, clinical director of obstetrics and gynaecology at Basing-stoke hospital, said that Hampshire Hospitals Foundation Trust has several endometriosis experts, but added: “They are unable to undertake all the diagnostic laparoscopies, the majority of which will not result in a diagnosis of endo-metriosis.”

She added: “It is not possible to know in advance which women have endometriosis, or for those who do have it to know in advance how extensive the disease is.

“One of the difficulties with endometriosis is that there is little correlation between the symptoms a women experiences and the extent of any endometriosis.

“Operating lists have to be planned to take into account the likely length of time of a procedure and the skills and training of the surgeon performing the investigation.

“Endometriosis surgery can take the form of a few minutes of simply diathermy which can be undertaken by the majority (but not all) doctors who do diagnostic laparoscopies.

“Equally the surgery required may be extensive and require time and significant expertise to achieve.

“At Basingstoke, we usually offer diagnostic laparoscopy first, followed by a discussion with the patient and a planned procedure which takes into account the likely length of time of the procedure for that particular individual and whether or not she needs complex treatment by an endometriosis expert.”