Intensive Training for Endometriosis Specialists Improves Patient Outcomes

March 3, 2018

Medical professionals need better training

Endometriosis Patients Suffer When Seeking Medical Attention From Non-specialists

The existing system for the diagnosis and subsequent treatment of endometriosis relies too heavily on medical professionals who do not have advanced training in identifying and comprehensive surgical removal of the disease. As a result, women with endometriosis are left undiagnosed on average of 9 years, allowing the disease to worsen. The lack of knowledge of endometriosis by non-specialists (including OBGYNs, family doctors, or internists), leads to ineffective treatments that, rather than stemming the progression of the disease, can actually make it worse. Endometriosis specialists are essential to helping to manage the treatment of this complex condition.


The management of endometriosis usually does not require hysterectomy. Hysterectomy can be avoided until AFTER childbearing has been completed for control of pain and disease, and may not be required at all if the condition is properly managed. Endometriosis excision is the removal of the instances of the disease, and can be performed to ensure that patients maintain fertility. This procedure must be performed by advanced-trained laparoscopic endometriosis specialists to ensure the disease is removed thoroughly, while preserving the reproductive organs. This can often be a balancing act if the disease has affected the fallopian tubes or the ovaries.

Specialty management of the disease both surgically and medically will allow for:

For many patients, fertility may be the most important concern. Endometriosis patients deserve to be forewarned so that they understand the need to move rapidly towards fertility.



Non-specialists are often incorrectly considered experts by patients, but without training to recognize the disease, patients risk delays in diagnosis, and treatment.

Endometriosis usually presents as small volume disease in its early stages. It can only be diagnosed properly with a laparoscopic procedure. It is important to diagnose endometriosis at an early stage so that it can be treated effectively. Surgical removal of the endometriotic lesions followed by medical suppression can slow down its progression.

The first point of contact for almost all women who have pain is their OBGYN or PCP. Patients with pelvic pain seen by their OB will undergo a pelvic exam and ultrasound.

OBGYNs frequently refer the patient with severe pelvic pain during her cycles, (and often now progressing between cycles), to GI specialists, or an urologist.

The medical maze of multiple physicians, all of whom cannot find out why the patient has pain, leads to frustration. The patient begins to suffer physically and emotionally as the disease continues to progress. The pain can be horrific, and narcotics are inevitably used, leading in many cases to addiction, compounding the national problem of prescription drug addiction. For physicians – both OBGYNs and non-GYN specialists – narcotics are often given as a way to treat the symptoms, and to move the patient out of the office because they don’t know what else to do.


While the conversation in the news is wholly consumed by endometriosis, its in-uterine form, adenomyosis is equally difficult to diagnose, and while may be visible via MRI, this diagnostic test is expensive and often denied by insurance. Women suffering from adenomyosis typically have intense pain with each menstrual cycle. For most women, diagnosis can only be confirmed after hysterectomy through a dissection of the uterus, as regular laparoscopic diagnosis isn’t possible.


Increasingly, endometriosis specialist practices will charge patients out-of-pocket, and not take insurance in order to perform surgery. These surgeons will often charge very high rates for these procedures will charge up to $30,000 for the surgery alone.

Endometriosis patients are often desperate for relief from the pain and will go into bankruptcy if they cannot find local access to advanced laparoscopic surgeons.  It is important for women suffering from endometriosis to have the option to use their insurance for surgical specialists who are as good if not better than surgeons who do not accept insurance.


The Center for Innovative GYN Care (CIGC) is dedicated to providing information and materials for women to help navigate the complicated healthcare system. The CIGC surgeons advocate on behalf of women suffering with endometriosis. Their minimally invasive surgical specialists have seen firsthand the pain and anxiety that women from around the world face before getting a proper diagnosis, evaluation and treatment. The CIGC practice believes that removing barriers to surgery includes making it accessible and affordable, including accepting most major insurance plans.

The CIGC specialists developed DualPortGYN for laparoscopic endometriosis excision. Two 5 mm incisions (one placed at the belly button and one is placed just above the pubic bone) make it possible for women to recover from surgery in a week or less.


The CIGC state-of-the-art specialists are available at three locations in the DC metro area. Virginia patients can visit the Reston, VA location, and Saturday appointments are available. Maryland offices are located in Rockville, MD.

CIGC is dedicated to providing information and materials for women to help navigate the complicated healthcare system. The CIGC founders, minimally invasive GYN surgical specialists Dr. Paul MacKoul, MD and Dr. Natalya Danilyants, MD, developed their advanced GYN surgical techniques using only two small incisions with patients’ well-being in mind.

Their personalized approach to care helps patients understand their condition and the recommended treatment so that they can have confidence from the very start. Our surgeons have performed over 20,000 GYN procedures and are constantly finding better ways to improve outcomes for patients.

Book a consultation today with Paul MacKoul MD, or Natalya Danilyants MD.

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