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I've always heard that the best long term treatment for this was a complete hysterectomy, including the ovaries, because if they are left in, other endometriosis tissue outside the uterus, will continue to grow and bleed causing pain and more scar tissue.
However, if the woman wishes to retain her fertility, other treatments may work, but often endometriosis causes so much scar tissue, the conceiving is often difficult, if not impossible.
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My wife had Stage 4 Endometriosis about 10 years ago. She would be in very bad pain when it flared up. Multiple Doctors could not figure out what was going on. This went on for years. Finally a Doctor that was referred to us by her gynecologist ( he could not even diagnose it) knew right away what it was. She went in for surgery that lasted 9 hours. She had to have a full hysterectomy. Doctor said it was all over her organs, partially down her leg. He said it was like chipping off concrete. He tried to save her ovaries, but said they could not be saved. We were done having kids so that was not a factor for us. The one thing he did say after the surgery, which originally was supposed to be 2 hours, turned into 9, that she would have a lot of scar tissue.
She is doing fine now.
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