Can Endometriosis Come Back After Surgery?

UPDATED ON 26TH APR. 2025

Endometriosis is a common condition that can cause pain and infertility. It occurs when tissue that normally lines the inside of the uterus grows outside. Endometriosis may go away after surgery, but it can also come back. If you have endometriosis, talk to your doctor about what to expect after surgery.

Keep reading to know more about the chances of endometriosis recurrence after surgery.

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Recurrence Rate of Endometriosis

The first rule of surgery for endometriosis is that it has to be done by a team that specializes in the management of the disease.

Once a patient gets operated on by a super specialist, the risk of disease recurrence goes down drastically. In fact, in our series, we normally give the patient in return that the rate of recurrence for their disease is going to be less than 2%. Once a radical expression of the endometriosis has been achieved after doing a thorough pre-surgical evaluation based on ultrasound for every patient.

Unfortunately, in a country like India, the vast majority of the patients who are having and suffering from endometriosis usually get treated by doctors who are not experts in the management of the disease, and as a result of this, more than 60% of the patients encounter an almost immediate recurrence, usually within the first year of the surgical procedure.

This causes a tremendous amount of emotional, mental, and financial trauma to the patients, and as a result, most of them give up on the management of the disease and continue to suffer a life full of pain.

Simultaneously, the majority of these young girls are also put on an unindicated medical management with a false hope that it will take care of the disease completely.

Endometriosis’s return (recurrence) after surgery depends on several factors, including the type of operation used.

Factors that increase the risk of recurrence include:

• Presence of ovarian cysts at the surgery.
• The large size of endometriotic lesions.
• Involvement of other organs.

Recurrence is also more likely if endometriosis was not completely removed during the original surgery.

How can you tell whether endometriosis has returned after treatment?

The symptoms of endometriosis can vary from woman to woman and may also change over time. However, if you have had surgery to remove endometrial tissue and are experiencing any of the following symptoms, there are chances that endometriosis may have returned:

1. Painful or heavy periods
2. Pain during or after sex
3. Difficulty conceiving
4. Excessive bleeding
5. Infertility
6. Abdominal pain
7. Bloating or nausea
8. Constipation or diarrhea
9. Fatigue
10. Increased ovarian cysts

If you notice any of these symptoms, consult a doctor for proper diagnosis and treatment. Dr. Jay Mehta, a leading endometriosis specialist in Mumbai, India, can help detect if the disease has returned and guide you on the next steps

How to stop endometriosis from recurring?

There is no definitive answer to this question. Some women find that their endometriosis returns after surgery, while others do not. However, there are several things you can do to help reduce the chances of your endometriosis coming back, including:

• Follow your doctor’s post-operative instructions closely. It includes taking any medication prescribed and attending all follow-up appointments. Now, this part is extremely important for the patient to follow. The majority of the patients are kept on a once-a-year basis.

Follow up for the next eight years following the surgery. Some of these young girls, for whom planning for a family is still a distant vision, are kept on temporary separation predominantly in the form of first-line medical management, which includes oral contraceptive pills or progestins.

• Maintaining a healthy lifestyle, with plenty of exercise and a balanced diet.

• Avoid known triggers for endometriosis flare-ups, such as stress and caffeine.

Though multiple studies have been published, which actually do not pinpoint the actual cause for having an enhancement of endometriosis, people often find a lot of solace in trying to stick to a diet that may reduce the recurrence of endometriosis; however, due to a huge variety of polymorphic factors. It is very difficult to predict which woman will benefit from an endometriosis diet.

•  See your doctor if you experience any symptoms that suggest the return of endometriosis. Early diagnosis and treatment are key for preventing any further damage.

Conclusion

Endometriosis is a common issue that can recur even after a successful surgery. Unfortunately, there is no way to prevent its recurrence, but there are some tips that you can follow to stay aware and healthy. And to make sure that as a patient, you have the best possible outcome of this disease, make sure that you consult a team of endometriosis super specialists rather than relying on the knowledge of your nearby local doctor.

This is also a place where we must stress the need for having a strong referral for endometriosis across the country of India, which is currently nonexistent, as a result of which the vast majority of the patients do get treated by people who do not specialize in the disease, leading to a heavy rate of recurrence.

As Shree IVF and Endometriosis Hospital, a referral unit for endometriosis across India, we officially note that the majority of the surgeries that we perform are usually on patients who have been operated on at least 1 to 2 times before. This makes it extremely difficult for the patient to then go ahead and choose the right form of management because they’ve already burned their fingers once before. 

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