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  • Q&A with Australian Health Practitioners

    What are treatment options for inoperable endometriosis on the rectum?

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    Endometriosis Pelvic Pain Women's Health
    Hi I have endometriosis on the rectum, diagnosed via laparoscopy. Because the lesion is very low, I have been advised it is inoperable (i.e. I would need a bowel resection but the low position carries too great a risk of leakage etc). The pain is excruciating and is getting worse every month. Medication (progesterone) has proved ineffective as it increased my bleeding. I am 48.
    Suggestions (and sympathy) welcome, thanks
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    Thanks

    Dr David Rosen

    Gynaecologist, Laparoscopic Surgeon

    Dr David Rosen is a Specialist Endoscopic (Keyhole) and Robotic Surgeon with expertise in; Prolapse and Incontinence surgery, Endometriosis, menstrual disorders including complicated Hysterectomies by … View Profile

    Hello. At 48 it is very strange that you are still getting active endometriosis causing problems. As you noted the endometriosis being low on the rectum does carry risks but there is no such thing as inoperable endometriosis - it is a question of the risks you and your surgical team are prepared to take. It may be that in order to safely remove all the disease a temporary colostomy is required to allow the bowel to heal before reanastamosing the two , now enometrosis free, ends. We peform many of these procedures every year in conjunction with our colorectal colleagues.

    At 48 however , has your gynaecologist discussed the option of injectable medication called Zoladex that shuts down your ovarian activity and induces a menopause like state that should stop menstraul activity and therefore alleviate some of your symptoms. In a woman who is approaching menopause this may obviate th need for any potentially risky surgery until the menopause itself occurs.

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