Video
Voiceover:
Rebecca is suffering with a gynaecological problem which makes it extremely painful when having sex.
Rebecca:
I just get a burning, stinging sensation, which is really uncomfortable for about an hour, sometimes up to an hour afterwards.
Voiceover:
Dr Pixie swabbed her in order to eliminate any sexually transmitted infections. Our microbiologist Val has the results.
Professor Val:
Well, the good news here is everything’s come back as negative for Rebecca. There’s only normal bacteria in her swabs. So there must be something else causing her problems.
Voiceover:
As she is all clear, Dr Pixie sends Rebecca to see gynaecologist Tyrone Carpenter to get to the bottom of her pain.
Mr Carpenter:
What I’d like to do…I think we need to examine you.
Rebecca:
Yeah.
Mr Carpenter:
And really what I’m trying to tease out is where the pain, I guess, is coming from. So we’re going to start on the outside, and I’m going to use a cotton bud and I’m going to touch various areas, and I’d like you to give me a pain score. So, zero’s no pain, and ten’s the worst pain you could possibly imagine. And then we need to examine you internally, and we’ll use a similar scoring system, um, on the inside.
Mr Carpenter:
Could you give me a number for that?
Rebecca:
About five.
Mr Carpenter:
About five, okay. And I’m just going to stretch the ligaments at the back of the womb now. Could you give me a number for that?
Rebecca:
About seven.
Mr Carpenter:
About seven. And one more thing, I’m just going to put the womb on a stretch one way…sorry, let me do that again, could you give me a number for that?
Rebecca:
About five.
Mr Carpenter:
About five. Okay, that’s fantastic, pop your things back on, come through and we’ll have a chat. Okay?
Rebecca:
Thank you.
Mr Carpenter:
Well, having examined you, I’m beginning to wonder if perhaps, the pain is started from somewhere else, beginning on the inside, and you’ve developed a learnt response to the pain—whereby you anticipate pain, and that causes a superficial pain.
Rebecca:
Okay.
Mr Carpenter:
Now the most common cause for pain deep on the inside with intercourse is endometriosis.
Rebecca:
Okay.
Voiceover:
Endometriosis is thought to affect around two million women in the UK. It’s a condition where cells like the ones lining the womb are found elsewhere in the body. During the monthly cycle, hormones stimulate the endometriosis, causing it to grow, then break down and bleed. This internal bleeding, unlike a period, has no way of leaving the body, and leads to inflammation and pain.
Voiceover:
A week later, and it’s the day of Rebecca’s operation to look for the cause of her pain, and she’s hoping that Mr Carpenter will be able to provide her with some answers. She is undergoing a procedure which is carried out using keyhole, or laparoscopic, surgery. Mr Carpenter begins by inflating Rebecca’s abdomen with carbon dioxide…
Mr Carpenter:
Gas on, please.
Voiceover:
...so he can see her organs more clearly and has space in which to move his instruments. Next, he inserts a camera into the area, and then manipulates his instruments in and around the ovaries and uterus to inspect the tissue.
Mr Carpenter:
What we do is gently lift the ovary and look underneath to see if there’s any disease under there. And that’s all normal. Um, same on the other side, here’s her left ovary here. Ah, and we’re just trying to move it up, and it doesn’t want to move very easily, and we can see there’s some disease there.
Voiceover:
Mr Carpenter has found endometriosis, which is where cells from the womb are found elsewhere. Finally, after five years, Rebecca has an answer for her pain. As well as under her left ovary, Mr Carpenter finds endometriosis in front of and behind Rebecca’s womb.
Mr Carpenter:
Here’s a classic bit of endometriosis here, you can see it’s, it’s pulled in, it’s puckered. And the interesting to note about this, it isn’t just on the surface, you can see it looks like it’s dug in underneath, it’s sort of under the surface. And that’s the thing about endometriosis, it’s an invasive disease, it starts on the surface and it burrows its way in. And that’s why when we treat it, modern treatment involves excising it and chopping all of it out, including the base of it, rather than just cauterising the top, which is traditional old-style treatment. This bulging structure you can see here is her rectum, and we’re just going to the right of the rectum, but we need to be wary, because we’re going to be needing to use heat to remove this. And we don’t want to cause an inadvertent burn to the rectum itself.
Voiceover:
He then carefully cuts away the diseased tissue and removes it from the area. It’s a technique that requires a great deal of skill, but is the best way of resolving the problem.
Mr Carpenter:
For many years endometriosis was simply being treated by people burning the top of the disease in the hope that they would get rid of it. However, by virtue of the fact that the disease invades within the tissues, burning the top is simply like just melting the tip of an iceberg. So nowadays, with advanced laparoscopic surgery and with a high-definition kit, we’re able to go as deep as we need to, and that way we ensure that all the disease’s out. Obviously having had the operation, Rebecca’s going to be rather sore this afternoon, however with radical analgesia, she should be fine to go home later today. Now it’ll take some time to see how well, uh, this operation’s worked, as obviously the areas that we’ve treated on the inside need time to heal out, and these will be more painful initially, rather than less. And she certainly should be back to full normal activity in a couple of weeks’ time. However at two weeks, it’s far too early to assess whether this has been of any benefit with regard to intercourse, we really need around six months for that.
Voiceover:
Six weeks after her op, and Rebecca is back to update Dr Pixie.
Rebecca:
I had it in three places: on my bowel, behind my womb and around one of my ovaries. Um, so he actually managed to cut all that away, while I was under anaesthetic, and managed to remove it all for me.
Dr Pixie:
So, one would hope that because he’s gone in, and done some surgery, that in time…I guess you’re, I guess the whole thing has to sort of settle down first.
Rebecca:
Yeah.
Dr Pixie:
But I think it’s worth giving it a bit of time to see, to see what happens.
Rebecca:
Yeah, I’ve been told, um, that three to six months is kind of a recovery time, when I should start to see a reduction in my symptoms, so I’m just waiting for things to settle down, really.
Dr Pixie:
Are you pleased now that you know what’s going on?
Rebecca:
Yeah, at least now I’ve got something that I can research.
Dr Pixie:
It’s really a case of watchful waiting now, and see what happens.
Rebecca:
Yeah, exactly.
Dr Pixie:
Super, well, thank you very much, and really nice to see you again.
Rebecca:
Thank you. Yeah, thank you.
Dr Pixie:
And yeah, keep us posted.
Voiceover:
Since seeing Dr Pixie, Rebecca has been able to enjoy an active sex life.
Rebecca comes to talk to Dr Pixie about the severe pain she gets whenever she tries to insert a tampon or have sex. Dr Pixie performs an examination to check the cervix and ovaries but finds everything to be in order so sends Rebecca to see a gynaecologist. Dr Tyrone Carpenter soon finds Endometriosis around Rebecca’s womb, ovaries and bowel. Subsequently Rebecca undergoes surgery to literally cut the Endometriosis out. 6 weeks later Rebecca returns to Dr Pixie and, although the healing process is a long one, notes a marked improvement in her sex life.
Patient Name: Rebecca Gibbs
Condition: Endometriosis
Specialist: Mr Tyrone Carpenter, Consultant Gynaecologist
Hospital: BMI The Harbour Hospital, Poole
Length of operation: Approx 20 minutes
Yes
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I would advice everybody to ask their GP to be refer to a gynecologist straight away and not loose time. The earlier you are diagnosed, the more chance you have. I tried everything, but Painkillers like IBUPROFEN seem to reduce the contractions and pain (see : prostaglandines effects) but you need to take it 3 days before your periods or ovulation time + 2/3 days after, to get the benefit. It was a revelation to me ! Exercice (30mn minimum per day) and diet can be very VERY important, I found. The more endorphines you get, the less the ENDO can crush you. Reduce all type of caffeine, sodas and sugar intake and eat more yogurt and fresh vegetables will make a difference on the long term. I am 37 and suffer with endometriosis since now 7 years. I have only been diagnosed, last summer, and been found with cysts on each ovary. I am waiting for surgery, in 4 months. I tried the pill, the 30 days pill, all kind of painkillers : but things work only for a short time. Join your local group of ENDO, even if you don't know what you have yet and listen to the women there : it will be very helpful and you will be able to talk about your pain if you want. Also, Get an information pack on : http://www.endometriosis-uk.org/information/symptoms.html
After having suffered endo for the last 15 years, I am now having hormone injections monthly for 6 months to put me on an early menopause. I have had a mirena fitted for the last 8 years which was great, but the last 2 years the endo has come back with a vengeance. I have had 2 laporoscpys, and my next step if the injections don't work, which they don't seem to have done, as I only have 1 to go and the pain and the bleeding is still there, it to have a hysterectomy. I am 45 and now just want the operation done so I can carry on with my life.
after watching this programme i think this is what i have, i have been to the doctors loads of times but they are telling me its thrush however it is not going away. It is sore to have sex or insert tampons and it seems very inflammed and swolen inside. could it be endometriosis?
i have had the same symptoms and suffered for a year or more and getting admitted to hospital with stomach pain and been told theres nothing wrong 18 months ago i was admitted they decided to do the laporocopy and found endometriosis they lazered it off..now 18 months lata ive got the same symptoms and going in again on the 10th of march to see if it has come back ..can it come back ?? no pain relief seems to work at all please is there no miracle cure other than hysterectomy ..im only 32 n not ready to have that yet .. i seem to get everything i also have coeliac disease, ibs, osteopenia..
i was diagnosed with endometriosis about 6 years ago,i was also referred to a gyneocologist who carried out a laparoscopy and the old treatment of using laser surgery,i have since had my 3rd child,and suffer daily. i am in agony 24/7,i have been back to my doctor,and i have been put on the pill and all types of painkillers,my dr seems really reluctant to refer back to the hospital 4 more surgery,i am 28 and it is really starting to affect my life daily! does anyone know what i can do next?
Its quite ironic because the same day this was shown i had my own laparoscopy, they found endometriosis and i had the small endometrial implants lasered. Im in constant pain everyday (particularly during menstruation) and i also suffer from another auto-immune disease which causes severe pelvic pain: interstitial cystitis.
i have endometriosis had it for two three years had a lump in my scar from a op which was painful to touch or move had that remove but still in loads of pain 6 months later my consalutan said that you dont get pain unless you are bleeding on your monthly period but i read that you do i also had a oversure to stop my bleeding which helped my bleedind but i get most of all the time it so bad am thinging of giving up work .i have also be back to my doctors because i have another lump which is really painful i go to bupa but dont feel that my doc no much about it can you help me because iwonder if i sould see someone else .
I have had severe pains for the last 9 years about 3 years ago they diagnosed me with endometriosis so i had a laparoscopy which got rid of it.I was still getting the pain even after the procedure.Around october last year i had another laparoscopy and it show that the endometriosis was no longer there. I am still having severe pain that makes me unable to move 24/7 and me and my partner are no longer having a sex life as it puts me in incredible pain and i cannot move.I have been seeing the same gp for 2 years and at first she was really helpfull but now i dont seem to be getting any explanations i keep having to keep a chart.Can you HELP please.
I also suffer from endometriosis ans a cyst on my ovary, it seems that doctors allmost ignore the pain that we as sufferers have to go through. I got put on course of hormone theapy that put me through an early menopause, it releived the syptoms for a couple of months but soon returned after the course ended, and as a result my hormones are now all over the place and ive gained about three stone. I really wish doctors were more sympathetic towards the condition, and not allow us to suffer in silence and be fobbed off. Does the NHS provide the service of actually removing diseased tissue or do they only still laser the surface ?
I was diagnosed at 24. Im now 38 and have a daughter aged 10. I suffered years of pain thru endo, having had it lasered 3 or 4 times. It even reappeared whilst pregnant! I am now fitted with a mirena and my periods have ceased. Having had the laser treatment and a brilliant gynae my life is back on track. Although in my 20s the pain was severe there is light at the end of the tunnel.