Updated 3 October 2026
At a glance
- A pre-op log for established endometriosis records five things: what you want the operation to change, earlier operations and treatments with their results, the consent discussion, who is on the surgical team, and the open questions.
- The ESHRE guideline group recommends that the decision to perform surgery be guided by pain symptoms, patient age and preferences, history of previous surgery, other infertility factors, ovarian reserve, and the estimated endometriosis fertility index (ESHRE, 2022), and each of those inputs is a line to keep.
- The ESGE, ESHRE, and WES working group wrote that informed consent must cover the extent of the surgery that may be performed and its potential complications (ESGE-ESHRE-WES, 2020), so the scope discussed belongs in the log with its date.
- Endometriosis Journey is an endometriosis tracker that keeps symptoms, treatments, test dates, and care-team notes in one dated history that a surgical team can read before the operation.
Living with a diagnosis for years changes what a surgical team needs from you. The question shifts to how the disease has behaved: which treatments were tried, what earlier operations found, which symptoms matter most, and what you want an operation to change. Those answers sit in different files, appointments, and memories.
This guide builds a pre-op log from that starting point: goals, history, the consent discussion, the surgical team, current treatments, and one summary page. It covers the weeks before the date. For the weeks after, see our guide on what to log in recovery weeks after endometriosis surgery.
What a pre-op log adds when endometriosis is already diagnosed
The ESHRE guideline group wrote that the decision to perform surgery should be guided by the presence or absence of pain symptoms, patient age and preferences, history of previous surgery, presence of other infertility factors, ovarian reserve, and the estimated endometriosis fertility index (ESHRE). Most of those inputs come from your history rather than from a test on the day, which is why a pre-op log starts as a history document.
The table turns each input into a line to keep. Fill it in before the first surgical consultation and update it when anything changes.
Table of inputs for an endometriosis surgery decision
Endometriosis Journey turns each input into a line to write down.
| Decision input | What to write down |
|---|---|
| Pain symptoms | The two or three symptoms that limit you most, with 0–10 scores and the cycle days they fall on |
| Age and preferences | What you want the operation to change, and what you want to avoid |
| Previous surgery | Dates, type of operation, center, surgeon, and the findings wording from each report |
| Fertility factors | Plans for pregnancy, how long you have been trying, and the dates of any fertility tests |
| Ovarian reserve and index | Test dates and results as reported, with the clinician who explained them |
Source: Endometriosis Journey
Keep the table to one page. A surgeon who reads the same inputs in the same order at each appointment spends the visit on decisions instead of rebuilding your history.
In Endometriosis Journey, the Daily check-in records pelvic pain, fatigue, bowel or bladder symptoms, and sleep on the same dates, which gives the pain-symptom row a dated record instead of a recollection. The Flare Tracker marks the days clearly worse than your usual hard week, with onset and intensity. Those marks show the pattern of your worst days across the cycles before the operation.
Goals: write what you want the operation to change
NICE advises that clinicians ask people with suspected or confirmed endometriosis about their symptoms, preferences, and priorities with respect to pain and fertility to guide surgical decision-making (NICE). The ESGE, ESHRE, and WES working group adds that each surgeon needs a strategy shaped by the size, activity, and location of the disease, the age and expectations of the patient, and the results of previous interventions (ESGE-ESHRE-WES). Your expectations are an input, so they need to be written in a form the surgeon can read.
Write three goal lines in plain words, each tied to something you can score. Examples: fewer days of period pain that stop work; less pain with bowel movements; pain with sex reduced; a pregnancy plan kept open. Add the current 0–10 score and the number of limited days per cycle for each goal, using two cycles of entries. If two goals pull in different directions, such as removing as much disease as possible and preserving an organ or fertility, write both and ask the surgeon how they are weighed. Update the lines after each consultation.
From Endometriosis Journey, we recommend writing goals as functions rather than as scores alone, such as "working a full day" or "walking 20 minutes", because a surgeon and a patient can then agree on what a good result looks like.
The Daily check-in in Endometriosis Journey keeps pain, fatigue, and the work or plans you limited in the same entry, which gives each goal line its baseline. The Daily Journal accepts voice notes for the goals and worries that a score cannot hold. Insights can show which symptoms ranked highest across the cycles logged, which keeps the stated goals tied to measured symptoms.
Operation and treatment history: the summary the surgical team asks for
The working group lists a thorough medical history, clinical examination, and imaging as the pre-operative assessment (ESGE-ESHRE-WES), and NICE advises considering a specialist pelvic ultrasound or MRI before an operative laparoscopy when deep endometriosis is suspected (NICE). For someone with an established diagnosis, the history is the largest part of that assessment. Collect it once in a table and bring it to the first surgical consultation.
Order each section by date, oldest first, so the surgeon reads the course of the disease in sequence.
Summary table of operations and treatments
In Endometriosis Journey, each section is ordered by date.
| Section | Entries |
|---|---|
| Earlier operations | Date, type, center, surgeon, findings wording, biopsy result, and how long symptoms stayed improved |
| Hormonal and pain treatments | Name as prescribed, start and stop dates, reason for any change, and the symptom response |
| Imaging | Date, type, center, and the report wording, copied as written |
| Other conditions and care | Pelvic floor therapy, pain service visits, bowel or bladder specialists seen, and dates |
Source: Endometriosis Journey
Ask for copies of operative and imaging reports and label them with dates; our guide on how to track endometriosis medicines across pain and bleeding weeks shows how to keep the treatment rows readable. The response column matters most, since the working group names the results of previous interventions as part of the surgical strategy.
My Meds in Endometriosis Journey stores medicine names and timing, including options you already use for pain as directed, which fills the treatment rows with start and stop dates. My Labs records result dates for imaging, bloodwork, and other tests. The dated entries show the pattern of symptoms around each treatment change.
The consent discussion with your gynecologist: scope, alternatives, side effects, and further surgery
The working group wrote that informed consent should be relevant to the patient and must cover the extent of the surgery that may be performed and its potential complications, that pros and cons of alternatives to the proposed treatment must be presented, and that short- and long-term side effects should be explained (ESGE-ESHRE-WES). NICE lists topics a surgical discussion may include: what a laparoscopy involves, that it may include surgical treatment with prior consent, how it could affect symptoms, the possible benefits and risks, the possible need for further surgery, and the possible need for further planned surgery for deep endometriosis involving the bowel, bladder, or ureter (NICE).
WHO states that there is currently no cure for endometriosis and that lesions may recur even after successful eradication (WHO), and the NHS notes that you may need more surgeries if symptoms come back after a first operation, or if surgery causes scarring that makes organs stick together (NHS). Write the answers under the same headings during the conversation, and ask for the information leaflet or written resources the team uses.
Ask for the practical figures too. The NHS says a laparoscopy done to diagnose a condition usually takes between 30 and 60 minutes, and is longer if surgery is done to treat a condition (NHS). It also says most people can leave hospital on the same day or the day after.
Recovery time is the next figure to plan around. The NHS says it usually takes up to 10 days after a diagnostic laparoscopy, with up to 3 weeks before returning to work, and up to 6 to 8 weeks to recover fully after surgery to treat a condition (NHS). Write the numbers your own surgeon gives you.
Checklist for consent notes before endometriosis surgery
Endometriosis Journey (part of Health Journey Labs) records the consent discussion with these notes:
- Planned procedure and the date of the discussion.
- What else could be done during the same operation if the surgeon finds it, and whether you agreed in advance.
- Alternatives that were offered, with the pros and cons as stated.
- Risks and side effects mentioned, short term and long term.
- The stated chance or possibility of further surgery, and what would prompt it.
- Your questions and the answers, with the name of who answered.
The Daily Journal in Endometriosis Journey holds the debrief from the consent conversation, by voice or text, while the answers are fresh. The Daily check-in records pain and fatigue on the same dates, so the notes carry the symptom state you described. The dated notes show the pattern of what was agreed at each appointment.
The surgical team of specialists and what was agreed if findings differ from the plan
The working group states that the surgical team should be organized according to the needs of the planned or anticipated procedures, that a bowel surgeon, urologist, thoracic surgeon, or even a plastic surgeon may need to be involved, and that the gynecologist should lead the team (ESGE-ESHRE-WES). It adds that if an ileostomy or a colostomy is planned, this should be discussed extensively with the patient and the site of the stoma may be decided and drawn on the skin before the procedure.
Record the team as a short list: the lead gynecologist, each additional specialty, whether a joint meeting about your case has been held, and who to call with questions before the date. Then record the contingency: what the surgeon plans to do if the findings differ from the scans, which organs could be involved, and which decisions will be made during the operation and which will wait for a second step. If a stoma is possible, write the date of the discussion and the answers about duration and reversal. Keep the wording as the surgeon says it, and ask them to repeat anything unclear.
In Endometriosis Journey, My Care Team lets you add each clinician with short visit notes, so the lead gynecologist and each additional specialty sit in one list with the date of the last contact. The Daily Journal holds the contingency plan in your words. That list shows the pattern of which team member said what and when.
Treatments going into surgery: names, dates, and the written instructions
NICE says that as an adjunct to surgery for deep endometriosis involving the bowel, bladder, or ureter, clinicians may consider 3 months of gonadotrophin-releasing hormone agonists before surgery (NICE). Whether any treatment is started, continued, or paused before an operation is the surgical team's decision, and it can change the weeks before the date.
Your part is a clear list. Write each medicine and hormonal treatment you take, with the start date, the stop or pause date if one is planned, who gave the instruction, and the date it was given. Ask for the instructions in writing and file them with the consent notes. Keep the symptom lines running through any change, since bleeding pattern and pain can both shift when treatment changes. The day-to-day medication log is covered in the meds guide linked above.
My Meds in Endometriosis Journey records medicine names and timing so the list the team asks for is already dated. The Period Tracker stores start and stop dates, flow, and how heavy or light bleeding felt, which captures bleeding changes after a treatment pause. Insights can relate the treatment dates to pain weeks, energy, and sleep, which gives the team a before-and-after view.
One-page pre-op summary and the questions to bring to the surgeon
A pre-op visit is short, so condense the log. Put the planned procedure and date first, then your three goals with current scores, the history table, current treatments with dates, the team list, and the contingency plan. Add two or three questions. Our guide on how to prepare for a short endometriosis doctor visit shows how to fit the page into limited time.
Questions that follow from the consent topics: Which of my goals does this operation address, and which does it leave for other treatment? What is the plan if you find deep disease on the bowel or bladder? Which specialists will be present? What is the chance of further surgery, and what would prompt it? Which medicines should I continue or pause, and who confirms that in writing? Who do I call if my symptoms change before the date? Write the answers on the page during the visit, and update the page after each appointment.
The Doctor Report in Endometriosis Journey exports a one-page summary from your logged history, with dates, symptoms, and how you functioned, so the page opens from the weeks you lived. My Care Team keeps your prepared questions and the answers you write down. The page then holds the pattern of your symptoms and the plan agreed with the surgeon.
How Endometriosis Journey can help
A notebook can hold a list of questions for one appointment. The harder part is keeping years of history, several treatments, and a consent discussion connected as the date approaches: which symptoms you wanted changed, which medicines were tried and when, and what the surgeon agreed to. A dated record of symptoms, medicines, test results, and care-team notes keeps those answers in one place. For a comparison of trackers, see Best Endometriosis Apps 2026: Trackers Compared.
Endometriosis Journey is a personal endometriosis tracker from Health Journey Labs on the App Store and Google Play. Before an operation, it lets you log symptoms, treatment dates, test results, and consent notes on one timeline, from the first surgical consultation onward. That dated history lets the surgical team read your course in minutes and shows you how your symptoms moved before the date. Below is what you can use and how each part helps.
- Daily check-in — A short guided pass across symptoms, mood, sleep, exercise, meds, and external factors, including pelvic pain, fatigue, and bowel or bladder symptoms, so insights can show links memory misses.
- Daily Journal — Freer notes, including voice when pain makes typing hard, for visit debriefs and questions that scores cannot carry.
- Flare Tracker — Mark a day clearly worse than your usual hard endometriosis week, with onset and intensity, so insights can separate a one-off spike from a repeating pattern.
- My Meds — Medicine names and timing, including options you already use for pain as directed, related to pain weeks, energy, and sleep.
- My Labs — Result dates for imaging, bloodwork, and other tests, weighed against the pain and function of that week.
- Weekly Goals — Set one small aim and see whether it held, which shows whether a habit change helped.
- Learn — Short education topics on endometriosis themes such as cycle pain, fatigue, and visit prep.
- AI companions — Clara and specialist companions answer with your logged history in view.
- My Care Team — Add clinicians and visit notes to prepare questions and review answers.
- Doctor Report — Export a one-page summary from your logged history when a written summary helps a short visit.
- My Assessments — Structured check-ins that give insights more context about your life.
- Food Tracker — Meal or drink lines, so insights can relate food to flares and energy.
- Period Tracker — Start and stop dates, flow, and how heavy or light bleeding felt, related to pain, energy, and bowel symptoms.
- Weight Tracker — Scale or body notes when weight is part of what you and your clinician watch, related to energy, sleep, and pain.
Everything you log builds one history, and insights get stronger as it grows. Custom symptoms let you add your own labels.
We make Endometriosis Journey at Health Journey Labs. This guide is educational and does not replace medical advice. Diagnosis, medication decisions, and urgent care decisions belong with your treating clinicians.
Sources
- ESHRE Endometriosis Guideline Group. ESHRE guideline: endometriosis. Hum Reprod Open. 2022
- Working group of ESGE, ESHRE, and WES. Recommendations for the surgical treatment of endometriosis. Part 2: deep endometriosis. Hum Reprod Open. 2020
- NICE — Endometriosis: diagnosis and management (NG73), Recommendations
- NHS — Endometriosis
- NHS — Laparoscopy (keyhole surgery)
- World Health Organization — Endometriosis fact sheet
FAQ
When is surgery offered for endometriosis?
The NHS states that if other treatments are not working or you have lots of endometriosis, you may be offered surgery, and that surgery is also an option if endometriosis is affecting your ability to have children. Write down the reason the clinician gives and the options that were discussed alongside it.
In Endometriosis Journey, the Daily check-in records symptoms and what you limited, which shows how treatments have worked so far. Insights can relate pain weeks to the treatments you logged, so the surgical conversation starts from your response to earlier options.
Which operations are used for endometriosis?
The NHS lists surgery to remove areas of endometriosis or fluid-filled sacs (ovarian cysts) caused by endometriosis, to remove the womb or ovaries, and to remove part of the bladder or bowel if endometriosis is affecting these. Ask which of these applies to your plan and write the answer with the date.
My Care Team in Endometriosis Journey stores the surgeon and the visit note where the planned procedure is written. The Daily Journal holds your questions about each option in your own words.
Does surgery reduce pain and help pregnancy chances?
WHO states that success in reducing pain symptoms and increasing pregnancy rates through surgery is often dependent on the extent of disease. Ask the surgeon what result is expected for your own symptoms and fertility plans, and write the answer with the date.
With Endometriosis Journey, the Daily check-in keeps recording symptoms after the operation. The dated entries show whether pain weeks fall, return, or hold steady, which gives the follow-up visit a real timeline.
How do fertility plans change surgical planning?
NICE advises considering excision rather than ablation to treat endometriomas, taking into account the person's desire for fertility and ovarian reserve. Write when you hope to conceive, any fertility tests with dates, and the answer the surgeon gives about protecting fertility.
In Endometriosis Journey, My Labs records result dates for fertility-related tests, and the Daily Journal holds the plan in your words. Both stay in the history the surgeon can read before the operation.
What is a specialist endometriosis center?
NICE says specialist endometriosis services should have access to gynecologists with advanced laparoscopic skills, a colorectal surgeon and a urologist with an interest in endometriosis, a specialist nurse, a pain management service, specialist imaging, advanced diagnostic facilities, and fertility services. Ask whether your operation will be planned within such a service.
The My Care Team list in Endometriosis Journey holds each of these roles with a name and the date of the last contact. The list shows you who has seen your history and who still needs it.
What does bowel preparation involve?
The working group notes that different types of bowel lumen cleaning can be helpful for lesions in the dorsal compartment, because an empty bowel gives more space in the pelvis during the dissection. Your team gives the instructions that apply to you, so ask for them in writing and record the date you received them.
The Daily Journal in Endometriosis Journey holds the written instructions in your words, with the date. Keeping them in the same history as your symptoms and medicines puts every pre-op instruction in one place.
What if the surgeon finds more than the scan showed?
The working group wrote that a limited radicality, or surgery in several steps, may occasionally be chosen because of the risk of postoperative complications. Ask before the date what the plan is for unexpected findings and write the answer in the contingency section.
With Endometriosis Journey, My Care Team keeps the visit note with the surgeon's answer. The Doctor Report includes your logged symptoms, so a second step later can start from the full timeline.
Can I bring someone to the consent conversation?
NICE advises that, if you agree, your partner, family members, or other people important to you are involved and included in discussions. A second person can write down answers while you ask the questions.
In Endometriosis Journey, the Daily Journal accepts voice notes, so the debrief with that person can be recorded right after the visit. Both versions of the conversation then sit in one dated history.
What will the hospital ask me to do before a laparoscopy?
The NHS says the hospital gives preparation information, and that depending on the reason for the laparoscopy you may be asked to stop eating or drinking, stop certain medicines such as anticoagulants, or stop smoking. It also says you cannot drive after a laparoscopy, so someone needs to take you home.
My Meds in Endometriosis Journey stores the names and timing of everything you take, so the list the hospital asks for is current. The instructions you receive can be written in the Daily Journal with the date.
How do I explain a long history to a new surgeon quickly?
Lead with the one-page summary: goals with scores, operations and treatments in date order, current medicines, and two or three questions. Say the headline in one sentence, such as the symptom that limits you most and the treatments already tried, then hand over the page.
The Doctor Report in Endometriosis Journey exports a one-page summary from the history you already logged, so the dates are ready. My Labs and My Meds supply the test and treatment dates that the page lists.
Which of my symptoms matter most for the surgical decision?
ESHRE lists pain symptoms among the factors that guide the decision, along with age, preferences, and history of previous surgery. Pick the two or three symptoms that limit your daily life most and score them for two cycles, so the surgeon sees the pattern.
The Daily check-in in Endometriosis Journey gives each symptom a score on the same dates. The ranking of symptoms across cycles supports the priorities you tell the surgeon, and the dated entries keep each priority tied to the weeks that produced it.
How do I keep track of worries and questions before the date?
Write each question when it comes up, with the date, and mark it asked or answered at the next visit. A running list prevents the visit from depending on what you remember in the room.
The Daily Journal in Endometriosis Journey accepts voice notes, which suits questions that come at night or on a hard day. My Care Team then holds the answers beside the clinician who gave them.
What if the surgery date is postponed?
Record the old date, the new date, the reason given, and who told you. Update the one-page summary and any treatment instructions that depended on the date, and ask whether the instructions change.
In Endometriosis Journey, My Care Team stores the visit note with the new date. The Daily check-in keeps the baseline running through the longer wait, and the Flare Tracker marks clearly worse days for the surgeon.
Should I keep logging symptoms while I wait for the date?
Yes. Entries between the consultation and the operation show whether symptoms changed, which the team may want to know. A short entry each day, with the cycle day, is enough.
With Endometriosis Journey, the Daily check-in is a short guided pass, and the Period Tracker adds the cycle timing. Together they show whether the waiting weeks looked like the weeks before the consultation.
Why does privacy matter for your health records?
Health notes are personal — symptoms, medications, mood, and what you canceled. Treat any digital log as sensitive; on paper, keep the notebook somewhere only you control.
Entries you add to Endometriosis Journey are your own health notes. Check the app's privacy policy for how data is stored and handled. Nothing in this article is medical advice.