Dr. Magtibay explains why the ovaries are the most common locations for endometriosis and shares the optional surgical procedure used to remove endometriosis. Dr. Paul Magtibay is a surgical oncologist at Mayo Clinic in Arizona.
The ovaries are the most common location for endometriosis simply because of their proximity to the fallopian tubes. With that retrograde menstruation the lining of the uterus passes back through the fallopian tubes and the fallopian tubes, the ends of fallopian tubes, are right next to the ovaries.
Just as, for example, when a woman ovulates, the egg actually comes out of the ovary and goes into the fallopian tube itself so they have to be close together in order for that process to work. So it makes logical sense that the ovaries would be the highest risk area for the development of endometriosis.
A hysterectomy is an option for the management of endometriosis and the reason why is because the uterus, we think, is the source for the endometriosis. So if we get rid of that source, then we get rid of where the endometriosis is coming from.
Now if we leave the ovaries in place, if there’s any microscopic endometriosis, meaning small implants of endometriosis in place, theoretically the ovarian hormones – the estrogen, which fuels endometriosis – could cause those little microscopic implants to continue to grow.
So not infrequently, after a hysterectomy if a woman wants to keep her ovaries, we will put her on some type of suppressive hormone medication to shrink up any little bits of endometriosis that might be left behind and then let those ovaries return to normal function. And with the source gone, hopefully her pain and her symptoms are gone as well.