You may have endometriosis. Please call and make an appointment for evaluation for endometriosis. You may be asked to check your hormone levels, ultrasound and surgery based on the findings. If you are young and have only mild disease you may wait to conceive naturally. If you have advanced stage III or IV disease, the best option is to undergo treatment within 6 months of surgery.
Most likely your disease has returned. The best treatment option is robotic assisted laparoscopic resection of endometriosis. This will give you significant pain relief. In addition, you may consider pre-sacral neurectomy, a procedure where the nerve supplying the pelvis is cut, thus reducing pain sensation. These procedures may be followed by long term continuous contraceptive pills or Lupron therapy upto 6 months.
The best treatment option is to undergo surgery and remove the ovaries which will eliminate estrogen production in your body. Estrogen is the fuel for endometriosis and its growth. Most patients with endometriosis usually undergo a hysterectomy with oophorectomy to get cured from the disease. This commonly happens in their 40’s after completion of their families.