When all else fails, then you can proceed with a hysterectomy. Hysterectomy is where we remove the uterus. The uterus is the source of endometriosis because that's where the endometrium resides in its normal habitat. So if you persistently are having pain, despite all other measures, then our last resort is to remove the uterus. We oftentimes, if you are still in the fertile and or premenopausal age, we oftentimes will try to keep your ovaries in place. However, you may still have pain from the endometriosis, from the ovarian structures being there, because there may be some implants that are not visible at the time of surgical intervention. If this occurs, you may require at some point to even have your ovaries removed as well.
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