Endometriosis - the first treatment program in response to the avalanche of disease
Endometriosis affects up to 2 million Polish women. "The scale of the disease is a veritable tsunami, which is why the National Health Fund (NFZ) program, launched on July 1st, which included endometriosis treatment in the guaranteed benefits package, is a crucial step," emphasizes Włodzimierz Migacz, director of the Katowice Oncology Center. The National Health Fund has allocated PLN 24 million for comprehensive treatment at eight specialized centers, including the one in Katowice. This topic was also discussed by experts in the Sejm during the last meeting of the Parliamentary Committee for Women's Health, which took place on July 24th.
There is more than one common denominator in these women's stories, but one dominates: the pain is indescribable .
"I didn't faint like other girls, but I had trouble walking a few meters from the table to the sofa. I didn't know which would be better: crouched or standing upright. I'd lie down, writhe in pain, and then simply fall asleep with it," says Katarzyna Malinowska. First, painkillers in increasingly larger doses, then finally an ultrasound and the diagnosis: endometriosis .
She was quite lucky in all this – she's been living in the UK for several years, so a year and a half ago she underwent surgery to remove her endometriosis at a British public hospital in Bedford. But she waited two years for it, and today she blames herself for it: the delay was not only a result of the waiting lists but also a new job she took and didn't want to risk being fired. As a result, she's now experiencing an early menopause , having undergone a full hysterectomy . But her bowel was saved. If the surgery had been performed earlier, when she was still living in Poland, the story would have had a less drastic ending than her menopause at age 38.
These patient stories are moving testimonies of pain, but also of hope. After years of misunderstanding and misdiagnosis, now, in Poland, they can count on faster help, access to specialists, and support from the public healthcare system.
The program includes pharmacological and surgical treatment, as well as dietary, psychological, and physiotherapy care. This is an important step in the comprehensive care of women with advanced endometriosis . When the uterine lining grows in the abdominal cavity, causing excruciating pain, a wide range of options is needed.
"These can be very complex surgeries that require ureteral transplantation or intestinal resections. Sometimes we even see endometriosis deeply infiltrating the diaphragm, and sometimes even lung lesions. The process of training surgeons to perform the procedures is long and time-consuming," explains Włodzimierz Migacz, director of the Katowice Oncology Center . "We currently have a contract for 45 patients, and as the procedures progress, we will discuss further cases with the National Health Fund. I believe we will reach ninety patients this year. I hope the contract will be revised depending on the feasibility of performing these procedures," he says. Flasher .
"This is a tsunami that will flood our centers. A huge number of patients from all over Poland are calling to seek consultations and possibly qualify for surgical treatment. This is a significant challenge for our center, which is an oncology center treating cancer patients. We want to help every patient who comes to us, because we know that while private centers perform this procedure, it is very expensive, associated with numerous potential complications and a long hospital stay," explains Włodzimierz Migacz.
Endometriosis is a chronic condition in which tissue similar to the endometrium (the mucous membrane lining the uterus) appears outside the uterine cavity – most often in the abdominal cavity, ovaries, fallopian tubes, bladder, or intestines. The most common symptoms include painful periods, chronic pelvic pain, infertility, and dyspareunia.
That's why, during the recent (July 24th) meeting of the Parliamentary Committee for Women's Health, Undersecretary of State in the Ministry of Health, Professor Urszula Demkow, emphasized that therapy should be comprehensive and long-term. It must include both pharmacological and surgical treatment, and be tailored to the individual patient – her needs, disease stage, medication tolerance, and preferences.
Surgery for advanced endometriosis is a complex surgical procedure, similar to cancer treatment.
– Although we have the Da Vinci robot at the center and we also use it to perform surgical procedures for the most severe forms of infiltrative endometriosis , this only partially facilitates the procedure – emphasizes director Włodzimierz Migacz.
Treating this insidious disease takes time. Patients spend longer than usual in the hospital because they undergo complex surgeries. Sometimes it takes ten days, and if complications arise after surgery, it can take up to several weeks.
"What we're doing now meets our current center's current capabilities, but there are certainly many more patients in need," says Włodzimierz Migacz . "We'll know exactly how many patients there are when we see the waiting list. We'll be finalizing the program with the Ministry of Health and the National Health Fund by the end of the year," he adds.
– Patients with the most severe forms of endometriosis can count on free and comprehensive care financed from public funds – announced Izabela Leszczyna, the former Minister of Health, when introducing the program.
Eight centers in Poland began implementing a comprehensive endometriosis treatment program on July 1st. The National Health Fund allocated PLN 24 million for this purpose this year. The new procedures include not only surgical and hormonal treatment but also support from a dietitian, psychologist, physiotherapist, and nurse. Importantly, there is no regionalization , meaning women from across the country can be treated at any center. Thanks to comprehensive treatment, a greater number of radical surgeries will be possible, while sparing all organs, so that patients can achieve pregnancy .
University Hospital in Krakow
Opole Oncology Center
Military Clinical Hospital in Lublin
Katowice Oncology Center
Military Medical Institute in Warsaw
Pomeranian Hospitals (Tricity)
Polish Mother's Health Center Institute in Łódź
Greater Poland Oncology Center
In practice, this means better diagnostics, greater access to treatment, and modern surgeries – including those using the Da Vinci robot, as at the Katowice Oncology Center. Last year alone, 170 endometriosis surgeries were performed there. This year, over 100 have been performed. The center has experience treating the most severe cases, which often require complex procedures: bowel resection, removal of parts of the bladder or ureter.
The University Hospital in Krakow has also been treating advanced endometriosis for years – over 90 surgeries were performed there in 2024 alone. Dr. Paweł Basta emphasizes that thanks to funding from the National Health Fund, the number of procedures will double or even triple. The goal of treatment is not only to remove the lesions but also to preserve women's fertility.
The problem is that the disease may affect up to 2 million women in Poland.
"This is a huge number of patients. The disease is still poorly recognized, and the time from the first symptoms to diagnosis can be dramatically long," the expert said during a recent speech at the Parliamentary Committee on Women's Health. "On the one hand, the cause is a lack of awareness among patients themselves, and on the other, a lack of competence among primary care physicians and some gynecologists," pointed out Prof. Ewa Wender-Ożegowska, national consultant in obstetrics and gynecology.
The former Minister of Health announced that the ministry is working on developing expert guidelines for gynecologists to improve diagnosis of the disease in outpatient clinics. The average time to receive an endometriosis diagnosis in Poland is still 8 to 12 years – too long to effectively treat and limit the disease's effects.
A pilot diagnostic program using the minimally invasive EndoRNA test offers an opportunity for earlier detection of endometriosis . The program, led by the Medical Research Agency, aims to enroll 500 patients. Over 200 have been recruited so far.
– The test is intended to aid in the diagnosis of women with vague lower abdominal pain when other methods fail – explained Prof. Wender-Ożegowska.
During the aforementioned meeting of the Parliamentary Group on Women's Health, special attention was also paid to the issue of eligibility for surgical treatment. Until now, as Professor Demkow admitted, chaos reigned.
"Some patients who did not require surgery were operated on, while others, whose indications were clear, did not receive such treatment. Therefore, it was crucial to develop a classification scale for assessing the severity of deep endometriosis, which would allow for accurate qualification for surgical treatment," said the Undersecretary of State.
The long-awaited system reform is the result of years of commitment from patients and organizations like the " Pokonać Endometrióza " Foundation. Its president, Lucyna Jaworska-Wojtas , recalled that for years women were forced to finance their treatments themselves, often at the expense of their family life and mental health.
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- About 2 million women in Poland suffer from it.
- Every fourth patient requires surgical treatment
- The cost of one operation reaches PLN 40,000, previously it was fully covered by the patients.
- The National Health Fund allocated PLN 24 million for the implementation of comprehensive therapy in eight specialized centers
Updated: 31/07/2025 06:30
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