Ottawa Teacher Regains Life After Rare Endometriosis Surgery

A rare and complex surgery at The Ottawa Hospital has transformed the life of Danika Fleury, a 34-year-old elementary school teacher suffering from severe endometriosis. After enduring debilitating symptoms for over a decade without a formal diagnosis, Fleury found hope in a procedure that has significantly restored her quality of life.

Endometriosis, a condition affecting at least one in ten women and girls in Canada, occurs when tissue similar to the uterine lining grows outside the uterus. The disease is chronic and currently has no cure. Fleury’s situation worsened following a breast cancer diagnosis in 2022, which necessitated the cessation of birth control that had previously managed her endometriosis symptoms. The combination of hormonal changes and the progression of her endometriosis led to severe pelvic pain and mobility issues.

Fleury, who had undergone a mastectomy to treat her cancer, faced increased challenges as her endometriosis symptoms intensified. “For me, it became really debilitating,” she recalled. She sought assistance from various gynecologists but encountered significant barriers, including lengthy wait times and the complexity of her condition.

In 2022, she was referred to The Ottawa Hospital’s Shirley E. Greenberg Women’s Health Centre, where Dr. Sony Singh, head of obstetrics, gynecology, and newborn care, took charge of her case. Upon evaluation, Dr. Singh and his team determined that Fleury’s endometriosis was particularly severe, involving her pelvic nerves. This led to the decision to perform a complex surgery known as pelvic-neurosurgery, or neuropelveology, a procedure that had never before been performed at The Ottawa Hospital.

Advanced Surgical Techniques Transform Patient Care

The surgery, conducted in September 2023, required an interdisciplinary team of radiologists, gynecologists, and surgeons who utilized advanced imaging and virtual reality technology to map Fleury’s condition accurately. “We were able to visualize her disease using virtual reality, translating MRI images into a format that was easily understandable,” Dr. Singh explained.

Prior to the operation, the team practiced on cadavers and synthetic tissues to ensure precision. Dr. Singh emphasized the importance of thorough planning due to the delicate nature of the surgery, where nerve damage could result in severe complications. Despite the risks, Fleury was determined to proceed, believing it could significantly improve her life.

Following the surgery, Fleury reported that the pain associated with her endometriosis diminished almost immediately. Although she still experiences occasional electric shock-like sensations and some difficulty with leg strength, she described the surgery as “absolutely life-changing.”

Call for Enhanced Endometriosis Care in Canada

Despite the success of Fleury’s surgery, access to such specialized care remains limited in Canada. Dr. Nucelio Lemos, a urogynecologist in Toronto, noted that pelvic-neurosurgery is rare, with few centers outside Ontario offering this level of treatment. He advocates for the establishment of dedicated centers of excellence to address the growing need for specialized endometriosis care.

Dr. Singh, who performed Fleury’s surgery, is among those calling for a national action plan to address the gaps in endometriosis treatment across Canada. He cites successful models in countries like Australia and France, which have implemented coordinated strategies to improve care for patients suffering from this condition. “This will yield a positive return on investment,” he stated, emphasizing the benefits of returning patients to their normal lives.

Fleury hopes that by sharing her journey, she can advocate for others facing similar struggles. 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 to hiking and traveling—activities that her condition had previously hindered. “Regaining the quality of life that I lost is the best thing that’s happened to me,” she shared, expressing renewed hope for the future.