I've woken from endometriosis operations to find the surgery hasn't been done

Kelly O'Shea needed complex endometriosis surgery because the disease also affected her bowel. That meant bowel and bladder specialists had to be available alongside endometriosis surgeons. She expected the planned operation to relieve her daily pain, but the required team and operating time were not reliably available.

After one operation, Kelly was woken about 45 minutes later and told the bowel surgeon had been unavailable. Her endometriosis was therefore left untouched. On another occasion, surgery was cut short because the theatre was needed for an urgent case. Repeated operations also caused more scar tissue, she said.

Kelly has lived with daily pain for about three and a half years. She was told another Welsh centre might treat her, but the wait could reach two years. Frustrated and desperate, she felt forced to pay £20,000 for treatment. Her experience highlights the consequences of limited specialist staff and theatre capacity.

Endometriosis is a disease in which tissue similar to the womb lining grows on organs such as the ovaries or fallopian tubes. The womb lining normally builds up and then breaks down each month. Endometriosis matters because the misplaced tissue can affect nearby organs and cause long-term symptoms.

Each month, the tissue outside the womb also breaks down and bleeds. Unlike menstrual blood inside the womb, this blood cannot leave the body. The trapped blood can trigger inflammation. Repeated inflammation may produce scar tissue, which can contribute to chronic pain and other problems.

The article says endometriosis can cause severe pain and fatigue and make pregnancy difficult. Kelly had daily pain for about three and a half years, while her symptoms began in her teens. Her disease also involved her bowel, making her case more complex and requiring several specialist teams during surgery.

Endometriosis is estimated to affect about one in 10 women. That figure shows the condition is widespread, but it does not show how many people need complex hospital treatment. The article distinguishes between having the disease and needing specialist surgery, so the two groups should not be treated as identical.

Some patients have complex disease involving organs such as the bowel or bladder. These cases may require endometriosis surgeons, colorectal surgeons, urologists, radiologists and specialist nurses. Kelly is one example: her bowel involvement meant she needed bowel and bladder specialists during surgery.

The article gives no figure for the number of patients likely to need hospital specialist care. It does report that Welsh centres face limited theatre time, dedicated-team shortages and possible transfers to England. If capacity falls, patients with complex disease could face long waits or travel for treatment, but the scale is not quantified.

Endometriosis can grow on or affect organs beyond the reproductive system, including the bowel and bladder. Surgery becomes more complex when disease involves these areas. A single gynaecology team may not provide all the expertise needed to assess and treat the affected organs safely.

Kelly’s endometriosis was also in her bowel. She was told her operation needed endometriosis specialists together with bowel and bladder specialists. In practice, her treatment was left untouched after a bowel surgeon was unavailable. The article also describes accredited centres needing colorectal surgeons, urologists and radiologists as part of their specialist service.

This multidisciplinary approach depends on staff being available at the same time and having protected operating and planning time. Welsh clinicians say that capacity is limited. Without dedicated teams, operations may be delayed, stopped or postponed, leaving patients in pain and potentially increasing waits for care.

BSGE accreditation sets standards for specialist endometriosis centres. Accredited centres must have named gynaecologists, specialist nurses, colorectal surgeons, urologists and radiologists. Their rotas must include dedicated time for endometriosis care at least six times a year. Surgeons must also perform a minimum number of operations annually.

Welsh clinicians say hospitals often lack enough theatre time to meet the surgical volume threshold. Lutfi Shamsuddin said his centre sometimes relies on the goodwill of radiologists or urologists instead of having their work planned into the service. Complex cases also need a multidisciplinary team available together.

These pressures threaten accreditation at Welsh centres. Cardiff and Vale placed its specialist centre on a risk register because changes could lead to closure unless standards are met. Clinicians blame limited resources and funding differences between Wales and England. They want sustainable funding or a national service.

Accreditation signals that a centre has the staff, experience and organisation required for complex endometriosis care. If Welsh centres cannot meet BSGE requirements, their services could be downgraded. This matters because patients may lose access to coordinated specialist treatment close to home.

The article warns that failure could cause a skills exodus. Specialist clinicians might leave, making it even harder for centres to maintain the required teams and surgical volume. Large numbers of Welsh patients could also be sent to England for treatment. Kelly was already discussing a possible transfer to Bristol.

The immediate effect could be more travel and longer waits for patients. Kelly said another Welsh centre might take up to two years, depending on clinical need. Welsh clinicians are calling for a nationally commissioned service or a different funding model. The Welsh government is discussing regional or national options.

Specialist NHS services are funded and commissioned through public health bodies that plan capacity, staff and facilities. In Wales, health boards organise services, while England uses its own NHS commissioning arrangements. The article does not explain every payment rule, but clinicians specifically identify funding differences between Wales and England as a problem.

Complex endometriosis care costs more because it needs dedicated theatre time and several professionals, including gynaecologists, colorectal surgeons, urologists, radiologists and specialist nurses. If Welsh funding does not reflect those costs, centres may struggle to provide enough operations or protected staff time. Patients may then be referred across the border.

Welsh gynaecologists called for a nationally commissioned service or a funding model reflecting the true cost of specialist care. The deputy minister said the current arrangement was not sustainable and was considering regional or national options. The article does not state exact funding amounts or referral rules.