Abhishek Mahajan (narrator / author)

While surgery certainly, on average, helps with endometriosis-associated pain, it isn't curative.

The numbers obviously depend on a lot of different factors, but 5-year postoperative recurrence rates are between 20-45% and the 8-year rate is squarely in the 40% range.

Which maybe doesn't sound terrible, but consider that endometriosis surgeries aren't risk-free at all, with roughly 1% of patients developing a major post-operative complication, for example bladder injury, bowel injury, vaginal dehiscence, etc.

Mildly good news is that it doesn't seem like the development of these complications go up based on whether you've had the surgery in the past.

There are options outside of hormonal therapy and surgical operations rising, but they are largely still in their infancy.

There's dicleroacetate, which, interestingly, is also a promising drug for cancer for the same reason it works for endometriosis.

Both cancer and endometrial tissue seem to display the same unique form of cell metabolism, the Warburg effect, which dicleroacetate disrupts.

There's also cabergoline, a drug meant for Parkinson's disease that also coincidentally hinders angiogenesis, and has been shown in at least one randomized trial to reduce pelvic pain caused by the disease.

There are other burgeoning non-hormonal chemical treatments being developed, but again, none of them seem to be in active use.

This all said, having no curative procedures at all, and only management ones, isn't the worst thing in the world.

After all, that's the status quo for HIV.

And that disease went from a death sentence to something that just requires a simple pill per day to keep it at bay, no other functional impacts.

It can't be cured, but that doesn't matter.

The patient's life is basically the same either way.

Is that the case for endometriosis?

If you follow the currently recommended set of hormone therapies and surgeries, if needed, can a patient return back to their pre-disease state?

In one of the most comprehensive review papers I found, they examined that exact question, combing through 139 past studies to come up with an issue.

And, generally speaking, the answer is no.

The heavily simplified results are here.

There's an image here.