In 2024, Shamita Shetty underwent surgery to treat endometriosis. This has brought attention to a health issue that affects millions of women but is still not well understood. The actor has posted a message on Instagram about her experience, symptoms, treatment, and when surgery is necessary.
Doctors state that, while endometriosis has a significant impact on the quality of life, surgery is not always necessary. Treatment usually involves medication, hormone therapy, and surgery, which is usually necessary in the event of complications.
What is endometriosis, and why does it cause symptoms
Endometriosis is a chronic health disorder in which tissue that is similar to the tissue lining the uterus grows outside the uterus. These abnormal tissues usually grow on the ovaries, fallopian tubes, and pelvic lining. Dr Priyanka Dass, Consultant – Gynec Laparoscopic Surgeon at Motherhood Hospitals, explains that the misplaced tissue can trigger inflammation, adhesions and cyst formation.
“Endometriosis can cause persistent pelvic pain, infertility and other symptoms that affect a woman’s daily life and overall wellbeing,” she says. Many women are able to manage the condition with medication, hormonal therapy and lifestyle changes. However, surgery may be recommended when symptoms become difficult to control.
When surgery becomes necessary for endometriosis
Doctors emphasise that surgical treatment for endometriosis is always decided after careful evaluation. Several factors affect this decision, including the patient’s age and fertility wishes, as well as the response to medical therapy.
Surgical indications:
Pain that is severe and cannot be controlled with medication. If the pain does not improve with hormone therapy, surgery may be necessary to remove endometriosis growths.
Large endometriosis growths on the ovaries
Endometriosis can cause cysts on the ovaries, also known as “chocolate cysts.” If the cysts become larger, surgery may be necessary.
Infertility due to endometriosis
Scar tissue can form, causing the uterus, fallopian tubes, and ovaries to stick together. Surgery may help restore normal anatomy, which can improve fertility.
Deep endometriosis
If the endometriosis is severe, involving organs such as the bowel or bladder, surgery may be necessary.
Uncertain or complex disease
If the disease appears complex on imaging studies, such as complex cysts or severe adhesions, surgery may be recommended.
Why is laparoscopy considered the gold standard
Today, the most common surgical approach for endometriosis is laparoscopy, often referred to as “keyhole surgery”. Dr Dass explains that laparoscopy allows surgeons to both diagnose and treat the disease during the same procedure. Using small incisions, specialised instruments and a high-definition camera, surgeons can directly visualise the pelvis and remove endometrial lesions with precision while preserving healthy reproductive organs.
Compared with traditional open surgery, laparoscopy offers several advantages:
- smaller incisions
- faster recovery
- less post-operative pain
- minimal scarring
It also allows doctors to map the disease accurately and restore normal pelvic anatomy.
Can surgery improve fertility?
Dr Kunzang Dolma, Fertility Specialist at Nova IVF Fertility, explains that treatment decisions depend on disease severity and reproductive plans. “If the endometrioma is small and causes mild symptoms, it may be managed with medications,” she says. “However, larger cysts or severe disease may require surgical removal, particularly if fertility treatment is being planned.”
That said, doctors carefully weigh the benefits and risks of surgery because removing cysts can sometimes affect ovarian reserve.
Surgery is not always a permanent cure
Experts also caution that surgery does not eliminate endometriosis permanently. The condition can recur, particularly in younger patients. Dr Chetana V, Senior Consultant – Obstetrics and Gynaecology at Aster CMI Hospital, says that long-term management often includes hormonal therapy after surgery to reduce the risk of recurrence. “The decision for surgery must always be individualised after detailed counselling about benefits, risks and long-term management,” she explains.
Doctors say awareness is key. Many women live with symptoms such as painful periods, pelvic pain or difficulty conceiving for years before receiving a diagnosis.
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