Endometriosis Centre

What causes my pelvic pain?

Pelvic pain is a debilitating condition and it can significantly impact on a women’s work, life and relationship. Long-lasting chronic pelvic pain may also impact psychological health in some women. Endometriosis is a well-known cause of pelvic pain and it can affect all women of child bearing age and currently 1.5m women in the UK are living with this condition.

A study published in 2021, found that nearly 3 out of 5 of women with endometriosis report having experienced pelvic pain for more than five years. Another recent study also found that 2 out of 5 of patients have experienced pain so severe and presented to an accident and emergency department in UK.

Apart from endometriosis, musculoskeletal strain in the pelvic floor and neuropathic (sensation of nervous system) pain can contribute to overall pain which may be challenging to differentiate. Endometriosis can be a difficult condition for a doctor or a nurse to diagnose due to the variations between symptoms. However, our specialist gynaecologist and multidisciplinary team can give patients access to a clinical diagnosis with a full range of diagnostic tests including endometriosis specialist ultrasound scan, MRI and laparoscopy.

What do you mean by extra-pelvic (outside pelvic cavity) endometriosis related symptoms?

If endometriosis is located in the upper abdominal organs such as liver, diaphragm, intestines and appendix, you may have shoulder pain and right upper abdominal pain during periods.

It can also be found close to the abdominal wall and episiotomy surgical scars, which may cause cyclical, localised tenderness; chest and thorax, which may cause cyclical chest pain and coughing up blood during periods; and close to the nerve routes of the pelvis, which may cause cyclical pain radiating to legs.

Diagnosis depends on your symptoms. A gynaecologist can carry out:

• a physical examination 
• tests such as ultrasounds and MRI scans
• procedures like a diagnostic laparoscopy - a minimally invasive surgical procedure, although it may be more appropriate to try to manage your symptoms initially without surgery).

There are many treatments for managing multiple pelvic pain symptoms. At a primary care level, there are various types of pain relief and hormonal treatments, depending on your circumstances and potential side effects. At a more severe stage, you might benefit from a referral to a gynaecologist or a BSGE-accredited specialist endometriosis centre.

Depending on symptom severity, age and whether you have had children or not, treatments may involve surgery, pelvic pain physiotherapy, being seen by a chronic pelvic pain clinic.

We are an BSGE accredited private endometriosis centre in Oxford. We receive enquiries and referrals regionally, nationally and internationally.

Why choose the BSGE accredited Nuffield Manor Endometriosis Centre?

It is one of the handful of private endometriosis centres with access to excellent technologies and procedures designed to help treat the debilitating symptoms of complex endometriosis, irrespective of the location, who require access to private healthcare.

You can expect the following from our expert team:

• Leading gynaecology consultant care – from an experienced and well recognised gynaecologist with expertise in treating cases of severe endometriosis involving bowel, bladder, ureters, nerves and other pelvic and non-pelvic organs
• Experienced multidisciplinary team (MDT) from Oxford – including gynaecologists, colorectal surgeons, urologists, pain physicians, pelvic pain specialist physiotherapists, specialist nurses and consultants with radiology and fertility expertise
• Excellent diagnostic imaging – onsite endometriosis pelvic ultrasound and MRI, reported by specialist radiologists
• Experienced staff to look after patients after advanced surgeries
• Convenient central Oxford location – easily accessible by car, coach or train (about an hour to one and half hours away from west London)
• Tertiary referrals can choose to have either a virtual or face to face consultation.

How much does treatment for endometriosis cost?

Private healthcare comes with a fee to the patient and it is important to understand the complete costs prior to agreeing to any treatments.

Following your initial consultation and diagnostics, possible cause/causes for your symptoms will be established. If the main cause of your pelvic pain is due to endometriosis, different management options and their risks and benefits which include, conservative, medical and surgical treatments will be discussed with you

If your main cause of the pelvic pain is related to musculoskeletal and neuropathic causes, it’s advisable to initiate your treatment pathways addressing those causes.

If you require surgery to manage your endometriosis, it will be extensively discussed by the specialist endometriosis surgeon Mr Kirana Arambage, answering all your queries based on the published evidence and his experience. If you choose to have surgery then the booking team of the Manor hospital would be able to provide fixed price packages based on the complexity of each case.

If you are fully insured, your expenses will be covered by your insurer based on your policy etc.

If you are not insured self-paying treatment packages start from £3,600 and can go up to £9,900 if you require uterine preservation surgery. If the planned procedure is a joint operation with a member of the multidisciplinary team, the final costs will be determined by the booking office of the Manor hospital for the most complex cases. Our fees include all inpatient care with our multi-disciplinary team of specialists and one post operation follow up but exclude outpatient care both pre and post-operatively. Any unforeseen costs are included.

Enquiries

Medical secretary - Fiona Goulthorp
Email: gynae.secretary.ka@gmail.com
Tel: 07863573987
Fax: 01865 590576

Follow up care

Conservative and medical treatment - Will arrange based on the treatment and diagnostics.

Surgical treatment

Endometriosis surgeon will see the patients when they are an inpatient. They can contact Fiona on weekdays via mobile if you need any urgent advice from the medical team.

The patients will be given pre-operative and post operative BSGE questionnaires by the clinical nurse specialist in Endometriosis based at the Manor Hospital, and the patients reported outcome of treatment will be reviewed at 6, 12 and 24 months’ post-surgery. This is a requirement of the accredited endometriosis centre in the UK apart from providing annual exemplar surgical video provided by the specialists.

Meet the endometriosis multidisciplinary team members

Sara Carlton, Pelvic Pain Physiotherapist
Niall Moore, Consultant Radiologist specialised in Endometriosis/Gynaecology
Fertility specialists
Endometriosis practitioner

Useful links
Patient information leaflets