Having a laparoscopy for diagnosis of endometriosis and poss fulguration or excisions
Can someone who had this lap for the first time tell me what all they would search in the pelvic cavity and would they look for anything else other than endo? like pelvic congestive syndrome and adenomyosis? I just need to know that they would look for anything to help diagnose this pain
Hi
, these are great questions. Typically during laparoscopy your surgeons will look all around the abdominal and pelvic areas, even up to the liver and gall bladder. They could usually see things like endo, scar tissue (adhesions), cysts and fibroids, plus checking the intestines. Adenomyosis can be harder to see because it is actually within the muscle wall of the uterus. Sometimes the uterus may look a little enlarged, but often something like an MRI would be needed to diagnose that. Same for pelvic congestion syndrome, there may be visible signs but it may need an MRI. Sometimes even endometriosis is not visible, but can be found by doing a biopsy of the pelvic lining, and they could do that at the laparoscopy. Does that answer your questions? When is your surgery scheduled? Keep us posted--we'll be thinking about you! -Audrey (endometriosis.net team) 
These are all great questions, and hopefully your doctor can go over all the answers for you. But I can share my experience from last year. I saw an endometriosis and excision specialist about a year ago. I had about a 2-hour long consult the day before the surgery where I asked him what he'd look for. He told me he has a general protocol for people with endometriosis and pelvic pain. That includes searching the diaphragm, abdominal wall, pelvis, ligaments under the uterus, ovaries, fallopian tubes, bladder — and probably some things I'm forgetting — for endo, adhesions, and other abnormal tissue. He did tell me that he can't see adenomyosis in the surgery because the lesions are within the uterine wall. He also checked my bladder on the inside and found interstitial cystitis – or inflammation of the bladder lining. (IC is a big source of my pelvic pain and something I saw a urogynecologist and pelvic floor therapist about after my surgery.)
With that said, I had 2 laparoscopies 10 and 15 years before this surgery. And neither checked for endo or other issues outside of the pelvis. But I'm hoping anyone who does excision is more thorough these days. Don't be afraid to ask you surgeon all of your questions. And keep us updated! - Keri (endometriosis.net team member)
