At NYU Langone, doctors sometimes recommend surgery to reduce or eliminate pelvic pain in women who have certain conditions, including adenomyosis, endometriosis, fibroids, ovarian cysts, and pelvic organ prolapse.
This minimally invasive surgery may be used to remove ovarian cysts, fibroids, or endometrial implants—the uterine lining that grows outside the uterus in endometriosis—or to return prolapsed organs to their original positions.
During a laparoscopy, a surgeon inserts a thin scope with a light at the tip into a small incision in the abdomen to look for and remove endometrial implants, fibroids, or scar tissue caused by endometriosis or pelvic inflammatory disease. The scope also enables the doctor to locate and operate on prolapsed organs.
The surgical tools are inserted through other incisions in the abdomen. This surgery takes place in the hospital with general anesthesia.
Some women may go home the same day of the procedure to rest and can expect to return to normal activities in 10 to 14 days. More complex procedures may require a hospital stay of one or more nights.
As with traditional laparoscopy, robotic laparoscopy enables surgeons to remove endometrial growths, fibroids, and scar tissue, and return prolapsed pelvic organs to their natural positions through small incisions in the abdomen. Robotic surgery gives doctors a high-resolution, three-dimensional view of the pelvis and smoother, more precise hand movements than routine laparoscopy. It is performed with general anesthesia.
You can leave the hospital the same day or the next morning after surgery and return to your normal activities within 10 to 14 days. As with laparoscopy, more complex procedures may require a hospital stay of one or more nights.
Myomectomy involves removing fibroids, thereby relieving the pain they cause. There are three different types of procedures: hysteroscopy, laparoscopy, and laparotomy.
In hysteroscopy, a thin, lighted scope is inserted through the vagina to remove fibroids from the inside of the uterus. In laparoscopy, surgeons insert surgical instruments through small incisions in the abdomen to remove fibroids that grow on the outside of the uterus. In laparotomy, doctors make an incision several inches long in the abdomen to remove large fibroids that have grown in the wall of the uterus.
Because myomectomy preserves the uterus, it is an acceptable treatment for women who wish to become pregnant. This procedure is performed with general anesthesia in the hospital, and recovery can take up to two weeks. Your doctor may recommend rest at home.
Doctors may recommend vaginal surgery for certain women with pelvic organ prolapse, such as those who have had abdominal surgery, are older, or have other medical conditions that make abdominal surgery risky.
In this procedure, a surgeon is able to put the prolapsed, or dropped, organ back in its original location by operating through the vagina. Vaginal surgery is performed with general or spinal anesthesia, and most women go home within 24 hours. You may need to limit some activities—such as lifting, exercise, and sexual activity—for up to six weeks after this surgery.
Hysterectomy is the surgical removal of the uterus. Sometimes it includes the removal of the ovaries, which is called oophorectomy. It’s considered a last-resort treatment for pelvic pain, and is often performed when a woman has severe adenomyosis, endometriosis, or fibroids and doesn’t want to become pregnant. NYU Langone specialists can perform hysterectomy with laparoscopy, robotic laparoscopy, or “open” surgery, which involves a large abdominal incision.
Depending on the type of surgery performed, you may go home the same day or stay in the hospital one or two nights. Recovery at home typically includes several weeks of limited activity and a delay in returning to sexual activity.
The operation with oophorectomy causes the body to enter menopause, which can relieve the symptoms of adenomyosis, endometriosis, and fibroids. Your doctor can help you to address any symptoms of menopause that arise, such as hot flashes.
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