Statement — Surgery and Endometriosis: Clarity, Consent and Care

Recent national reporting has raised serious questions about endometriosis surgery in Australia — including concerns about whether some procedures may have been unnecessary or not appropriately indicated. We recognise how unsettling this may feel, particularly for those who have already undergone surgery, are considering surgery, or have spent years advocating to be heard about their pain.

Endometriosis is a complex, chronic inflammatory condition. It presents differently in every individual — from superficial lesions to deeply infiltrating disease affecting organs such as the bowel, bladder or ovaries. Symptoms range from manageable to debilitating. There is no single pathway that suits everyone.

What current Australian guidelines say

Australia’s Living Evidence Guideline for Endometriosis (developed through RANZCOG) makes clear that surgery is not recommended as a first-line diagnostic step in most cases. Initial management typically involves hormonal therapy and symptom-based treatment.

Surgery may be considered when:

• symptoms persist despite appropriate medical management

• imaging suggests significant disease (such as endometrioma or deep endometriosis)

• fertility is a priority

• diagnosis remains uncertain

• medical management is contraindicated or not tolerated

Importantly, these guidelines emphasise shared decision-making. Surgery is not a guaranteed cure, and outcomes vary. For some, it can significantly improve pain, quality of life, or fertility. For others, it may not. Appropriate patient selection, transparent discussion of risks and alternatives, and informed consent are critical.

Pain is real — and often complex

Persistent pelvic pain can coexist with endometriosis or occur independently of visible lesions. Modern care increasingly recognises the importance of multidisciplinary management, including pelvic health physiotherapy, pain medicine, psychological support and medical therapies alongside — or instead of — surgery.

Whole-person care matters.

If recent coverage has left you questioning your own care

If the media coverage has created anxiety or doubt about past treatment decisions, you are not alone. Endometriosis already carries a long history of delayed diagnosis and dismissal. Public scrutiny can reopen those wounds.

Before drawing conclusions about your individual situation, we encourage you to review your medical history and reports — including surgical and pathology information — with a trusted healthcare provider or clinician who can interpret them in context.

If concerns remain, seeking a second opinion is entirely reasonable and appropriate.

No one should feel pressured into surgery — and no one should feel shamed for having chosen it based on the information and guidance available at the time.

Elgin House’s commitment

At Elgin House, we are committed to evidence-based, trauma-informed, women+ centred care. We support:

• Guideline-aligned medical management as first-line where appropriate

• Multidisciplinary pelvic pain care

• Genuine informed consent and shared decision-making

• Surgical referral only when clinically indicated and aligned with a patient’s values and goals

Endometriosis care in Australia is evolving. Debate within medicine is part of that evolution — but it must never invalidate lived experience.

Your pain is real.
Your questions are valid.
And you deserve care that is thoughtful, transparent and centred around you.

— Elgin House