Ottawa Teacher Finds Hope After Rare Endometriosis Surgery

Danika Fleury, a 34-year-old elementary school teacher from Ottawa, has achieved a remarkable turnaround in her health following a rare surgical procedure at The Ottawa Hospital. This fall, Fleury underwent a complex surgery to address her severe endometriosis, a condition she had suffered from for over a decade without a formal diagnosis.

Endometriosis occurs when tissue similar to the lining of the uterus grows outside of it, impacting at least one in ten women and girls in Canada, according to The Endometriosis Network Canada. The disease is chronic and currently has no cure. Fleury’s symptoms escalated after she was diagnosed with breast cancer in 2022, which necessitated the cessation of birth control that had long managed her endometriosis symptoms.

As her endometriosis worsened, Fleury experienced debilitating pelvic pain, issues with nerve and muscle function, and difficulty walking. “For me, it became really debilitating and disabling,” she recalled. After consulting several gynecologists and facing numerous barriers including long wait times, she was referred to The Ottawa Hospital’s Shirley E. Greenberg Women’s Health Centre.

Complex Surgery Offers New Life

Dr. Sony Singh, the head of obstetrics, gynecology, and newborn care at The Ottawa Hospital, assessed Fleury’s case and identified it as deep endometriosis involving pelvic nerves. He described the condition as complex and stated, “It was with advanced imaging that we realized this is not just another case of endometriosis.”

The surgical approach employed was pelvic-neurosurgery, or neuropelveology, which had never been performed at The Ottawa Hospital prior to Fleury’s operation in September 2023. An interdisciplinary team, including radiologists and gynecologists, utilized advanced imaging and virtual reality technology to map out her disease, enhancing their surgical precision. “We wanted to get a complete excision,” Dr. Singh explained, emphasizing the importance of the meticulous planning involved.

Fleury’s surgery involved excising endometrial tissue that was adhering to her ovaries, uterus, and pelvic nerves. Although she experienced some postoperative pain, she noted that the pain from her endometriosis “went away almost immediately.” While she occasionally feels electric shock-like sensations in her pelvis, she regards the surgery as “absolutely life-changing.”

A Call for National Action

The rarity of pelvic-neurosurgery highlights a broader issue in Canada regarding the treatment of endometriosis. Dr. Nucelio Lemos, a urogynecologist in Toronto, pointed out that there are very few centres across the country offering this specialized care. He noted, “We definitely need to push for the creation of centres of excellence that will help cover that gap.”

The funding for Fleury’s surgery came from provincial grants and hospital resources, but Dr. Singh warns that this is insufficient for making such procedures widely accessible. Many patients are left with limited options and may have to seek treatment abroad.

Singh is advocating for the federal government to develop a coordinated national action plan for endometriosis, similar to those implemented in Australia and France. “This will make a positive return on investment,” he said, highlighting the societal benefits of restoring individuals to health and productivity.

Fleury is eager to share her story to help raise awareness about endometriosis. She looks forward to returning to her teaching position at Broadview Public School and engaging in activities like hiking and travelling that were previously hindered by her condition. “The best thing that’s happened to me is just regaining the quality of life that I’d lost,” she reflected. “It’s really given me back my spark and my light and my hope for the future.”