BY PAUL MACKOUL, MD – LAPAROSCOPIC GYN SURGEON AND CO-FOUNDER OF CIGC
Endometriosis is a GYN condition that happens when tissue from the uterus grows outside of it, sometimes implanting on other organs in the pelvis. Treating endometriosis early with surgical diagnosis and removal addresses symptoms such as pain and infertility. Endometriosis has no cure but should always be treated by a specialist. The physicians at The Center for Innovative GYN Care® (CIGC®) are trained to diagnose and remove this disease effectively, using CIGC’s state-of-the-art DualPortGYN® technique for endometriosis excision.
Surgery is a very important part of the treatment process for endometriosis. CIGC believes in access to quality care for all patients with endometriosis when it is necessary. In this regard, we are in network with most major insurance plans. We don’t believe patients should have to pay out of pocket for essential surgery and you should be able to use your insurance. Access to affordable, high quality specialists is essential to ensure that all patients with endometriosis receive the best care possible.
Stages of Endometriosis
Endometriosis is classified into four stages — minimal, mild, moderate or severe — depending on the location, depth and spread of the disease. These stages do not necessarily align with a patient’s symptoms, as patients with stage 4 endometriosis may experience little or no symptoms, while patients with stage 1 endometriosis may be in debilitating pain. There are also three primary types of endometriosis, which describe the area affected by the disease.
Symptoms of Endometriosis
The most common symptom of endometriosis is pain. Pain may be experienced during a patient’s period, during bowel movements, during sexual intercourse or chronically throughout the pelvic area, gastrointestinal system and lower back. Endometriosis can also cause other symptoms such as abnormal bleeding, chronic fatigue and infertility. If you are experiencing endometriosis symptoms that are affecting your day-to-day activities, you should contact your physician immediately.
Endometriosis Causes, Risk Factors and Complications
The cause of endometriosis is still being studied, but there are several potential causes that have been identified as likely triggers. Some natural causes include genetic background, hormone production and problems with the immune system. Endometriosis can also be caused by a previous pelvic surgery, such as a cesarean section, if the surgeon displaces tissue or cells from the uterus.
There are factors that may put some patients at a higher risk than others, including family history, shorter menstrual cycles, never having given birth and starting your period at an early age.
When left untreated, a major concern with endometriosis is infertility. This is caused by inflammation and can be treated if a doctor intervenes early enough. Other complications include bowel problems and increased risk of subsequent medical conditions such as heart disease, ovarian cysts or ovarian cancer.
The proper way to diagnose endometriosis is through a laparoscopic procedure in which a doctor inserts a small, thin camera into the abdomen. This provides the doctor an accurate view of the pelvic region and allows them to look for visual signs of the disease. Some gynecologists may suggest preliminary tests like a manual pelvic exam, ultrasound or MRI, but these tests are not as reliable as a laparoscopy and shouldn’t be used to accurately confirm endometriosis.
Endometriosis Treatment Options
Surgery is typically recommended to successfully treat endometriosis and is the only way to remove lesions and make recurrence less likely. There are multiple options for surgery, including conservative measures like endometriosis excision (most effective) or endometriosis ablation, or more definitive surgeries such as a hysterectomy with removal of the ovaries.
Medication and other nonsurgical treatment methods can be used to manage pain and symptoms, but these methods don’t address the root of the problem and should only be used as a complement to surgical treatment.
Endometriosis can cause infertility. This can happen at any stage of the disease due to chronic inflammation. In fact, up to 50 percent of women with endometriosis suffer from infertility4. This occurs because the endometrial cells have “mini periods” outside the uterus each month, causing inflammation, pain, and scarring. Inflammation and scarring from endometriosis results in infertility due to:
1. Tubal Scarring, preventing transport of the egg down the tube to the uterus by blocking the tubes
2. Inflammation, which impairs fertilization between egg and sperm, transport through the tubes, and decreased implantation of the embryo into the uterine lining for pregnancy
3. Endometriomas, or the formation of large cysts of endometriosis in the ovaries, can destroy ovarian tissue and can decrease ovarian reserve — the number of eggs remaining in the ovaries — as well as decrease egg quality
Why is it essential that my endometriosis is removed by a specialist?
Although endometriosis is a relatively common condition, it is not easily diagnosed or treated. OBGYNs often delay the diagnosis with long-term medical therapy or by not performing excision surgery early in the disease process, allowing the disease to progress and cause increasing pain and infertility.
Access to a specialist, such as those at CIGC, ensures early diagnosis and treatment to control endometriosis in its early stages, which can help to preserve fertility options and control pain. At CIGC, our focus is on performing the least invasive procedures to treat your condition based on your long-term plans, taking into account your desire for fertility.
Why shouldn’t my OBGYN perform my endometriosis surgery?
Your OBGYN most likely concentrates more on obstetrics than surgery. Most OBGYNs do not have the training or surgical volume to learn and develop the best surgical techniques. The result is either a delay in care in performing surgery or inadequate removal of all endometriosis implants at the time of surgery.
Surgical specialists, on the other hand, focus solely on surgery and have the additional training and skills required to perform better and safer surgery. At CIGC, our specialists have made a commitment to minimally invasive endometriosis excision. Our specialists perform a higher volume of surgeries, see a wider range of case types and undergo more comprehensive training. Our surgeons have expertise in advanced techniques and procedures and have learned to perform even the most complex GYN surgeries with low complication rates. Whether you are undergoing a hysterectomy or excision surgery for your endometriosis, when you have it done at CIGC, you know you are working with specialists who concentrate only on this type of procedure.
Endometriosis Specialists at CIGC
Choosing the right specialist for endometriosis removal is an essential part of managing the condition. If removed incorrectly or incompletely, endometriosis can continue to cause pain and impact fertility. Our specialists understand what women with endometriosis suffer through, and we put the needs of our patients first. Many women spend tens of thousands of dollars out of pocket for specialist care. At CIGC, we accept most major insurance plans, ensuring our patients can focus on getting healthy.
The CIGC Difference
CIGC surgeons are trained in both advanced laparoscopic procedures and techniques, including gynecologic oncology practices. This gives CIGC surgeons a higher level of training and experience to deal with complex cases of endometriosis. Our exclusive procedures were designed by our specialists, which is why so many women travel from around the world for DualPortGYN endometriosis excision.
Schedule a Consultation
If you suspect you may have endometriosis, our specialists are ready to provide an evaluation of your symptoms and recommend an appropriate solution.