Ottawa Woman’s Rare Surgery Restores Life After Endometriosis

Danika Fleury, a 34-year-old elementary school teacher from Ottawa, has regained her quality of life after undergoing a rare surgical procedure at The Ottawa Hospital in September 2023. Fleury, who suffered from endometriosis for over a decade, had never received a formal diagnosis until this year. The condition, characterized by the growth of endometrial-like tissue outside the uterus, affects at least one in ten women in Canada, according to The Endometriosis Network Canada.

Fleury’s health deteriorated significantly in 2022 when she was diagnosed with breast cancer. The hormone-sensitive nature of her cancer forced her to stop taking birth control, a medication that had previously managed her endometriosis symptoms. Following a mastectomy that removed her cancer, her endometriosis symptoms worsened, leading to debilitating pelvic pain and difficulties with mobility.

Seeking relief, Fleury consulted multiple gynecologists but faced challenges due to the complexity of her condition and lengthy wait times. Finally, she was referred to The Ottawa Hospital’s Shirley E. Greenberg Women’s Health Centre, where Dr. Sony Singh, the department head of obstetrics, gynecology, and newborn care, identified her case as one of deep endometriosis that required a complex surgical approach.

Complex Surgery Offers New Hope

Dr. Singh explained that Fleury’s condition necessitated a specialized procedure known as pelvic-neurosurgery, or neuropelveology, which involves the removal of endometrial tissue from around the pelvic nerves and organs. This type of surgery had never been performed at The Ottawa Hospital before.

Using advanced imaging techniques, including virtual reality, the interdisciplinary team of radiologists, gynecologists, and surgeons meticulously planned the operation. “We wanted to get a complete excision,” Dr. Singh noted, emphasizing the challenges involved in navigating the delicate structures of the pelvis.

Despite the inherent risks, Fleury chose to proceed with the surgery. The operation successfully excised the endometrial tissue affixed to her ovaries, uterus, bowel, and pelvic nerves. Following the surgery, she experienced immediate relief from her endometriosis pain, though she still faces some challenges, including occasional electric shock-like sensations and leg weakness. Nonetheless, she described the surgery as “absolutely life-changing.”

Call for National Action on Endometriosis Care

Pelvic-neurosurgery remains uncommon, with few centres offering such specialized care in Canada. Dr. Nucelio Lemos, a urogynecologist based in Toronto, highlighted the need for more centres of excellence to address the gap in treatment options. He noted that neuropelveology is a relatively new field, developed in the early 2000s, and the scarcity of trained specialists has limited access to necessary surgeries.

Fleury’s surgery was made possible through grants from the provincial government and funding from the hospital. However, Dr. Singh expressed concern that these resources are inadequate to ensure broader access for patients nationwide. Many individuals with endometriosis face limited options for care unless they can afford treatment abroad.

Advocates, including Dr. Singh, are urging the federal government to implement a coordinated national action plan for endometriosis, similar to initiatives already in place in Australia and France. “This will make a positive return on investment,” he argued, emphasizing that improved access to care can lead to healthier families and a more productive workforce.

Fleury is now eager to share her story and advocate for others affected by endometriosis. As she continues her recovery, she looks forward to returning to her role as a French immersion teacher at Broadview Public School, as well as enjoying her passions for hiking and travel. “The best thing that’s happened to me is regaining the quality of life that I’d lost,” she said. “It’s really given me back my spark and my light and my hope for the future.”