Endometriosis occurs when the lining of the uterus, the endometrium, grows on other organs outside the uterus. These usually include the reproductive organs as well as other organs within the pelvic system such as the bowel and bladder among others.
The symptoms of Endometriosis are very painful and one of the more permanent ways to treat it is by having a radical hysterectomy. This means that the ovaries, fallopian tubes, uterus and cervix are taken out. When the cervix is removed, a vaginal cuff is created. This is where vaginal cuff Endometriosis occurs.
The best way to describe a vaginal cuff is by using the example of a tube sock. If you can visualize how a tube sock looks sewn at the toes, then you have a good idea what the vaginal cuff looks like. It is created by the surgeon and does not dramatically shorten the vagina.
Usually, only about a quarter of an inch of the vagina is folded to form the cuff. However, neither you nor your partner will notice the difference when having sexual intercourse. The reason for this is that the vagina is flexible and will stretch with time. Most women think that once they have a hysterectomy then that is the end of the Endometriosis. However, if there were small implants that were not seen, these can grow back to cause vaginal cuff Endometriosis.
The vaginal cuff tends to be an area vulnerable to residual Endometriosis after surgery. If the Endometriosis had spread to the rectovaginal septum and was not all taken out before the hysterectomy was done, then you may get vaginal cuff Endometriosis.
This is because endometrium tissue that is not seen at that time can easily be sewn into the vaginal cuff. This is a condition that many women suffer from. Initially you may be surprised to experience the same old symptoms, especially if you had thought of the surgery as a cure. If your doctor does not remove all the Endometriosis in this area it can re-grow causing much pain and frustration.
Many women suffering vaginal cuff Endometriosis wonder how the doctor could have missed the tissue when they were performing surgery. However, by the time one comes in for a hysterectomy they have probably had previous surgeries to remove endometrial tissue in the past.
This means that they will likely have scar tissue as well as fibrosis present. The Endometriosis will be buried beneath this scar tissue out of sight. It gets wadded and buried in the tissues and the surgical scars heal over it. This means that it looks normal on the outside but there is Endometriosis growing on the inside.
This is what happens with vaginal cuff Endometriosis. As the doctor clamps, cuts and stitches tissues, some endometrial tissue may be buried in the flesh out of sight. The area then heals normally and the Endometriosis may be impossible to see unless it is again opened up.
This can cause the recurrence of Endometriosis symptoms and can be a difficult issue to deal with for most women.
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