Yes, you can still have endometriosis after a hysterectomy, though the risk is significantly reduced. During a hysterectomy, the uterus is removed, but endometrial tissue can persist in other parts of the pelvic cavity and abdomen—such as the fallopian tubes, ovaries, bladder, bowel, and abdominal walls—where it may continue to grow and cause symptoms. This condition is sometimes called "residual endometriosis" or "retained endometriosis."
The likelihood depends on several factors. If the ovaries are retained (not removed during the hysterectomy), they continue to produce hormones that can stimulate remaining endometrial tissue, making recurrent or persistent symptoms more probable. Studies suggest that 10-15% of people undergoing hysterectomy for endometriosis experience ongoing symptoms afterward. If only the uterus is removed without addressing all visible endometrial lesions, those lesions can continue to bleed and cause pain, adhesions, and inflammation.
The severity of pre-hysterectomy endometriosis, the thoroughness of surgical removal of lesions, and whether ovaries are retained all influence the risk of recurrent disease. Some people experience significant relief after hysterectomy, while others continue to struggle with pain or other symptoms. Oophorectomy (ovary removal) can further reduce hormonal stimulation of remaining tissue, though it carries other health considerations like early menopause.