How do you know when to have surgery again? Especially if you've had a hysterectomy.

See title. I had a hysterectomy about 1.5 years ago and have had great relief. Unfortunately, my ovary has become painful most days each week. I've had a few episodes of not being able to stand up straight from it and even went to the ER once for it.

Have had ultrasounds and they don't show anything (like cysts).

Anyway, having had so much relief, I feel like I shouldn't be complaining, but I also don't like having this near daily pain again.

My concern is they won't find anything. I had just two lesions in my first surgery and one lesion in my hysterectomy, so it seems I have superficial endometriosis.

So when do you know to have another excision?