Endometriosis and pelvic pain are commonly misunderstood and mistreated. Successful treatment of endometriosis and pelvic pain requires addressing several essential issues in two basic categories; (1) correctly performed surgical removal of the endometriosis implants and (2) treatment of co-conditions and/or underlying conditions often associated with endometriosis. Unfortunately many patients with endometriosis are not having either of these areas treated correctly. There is a lot of un-necessary pain and suffering as a result of the inadequate diagnosis and treatment of endometriosis.

Currently, the standard approach used by the majority of general OB/GYN’s for surgical treatment of endometriosis is ineffective and out of date. coagulation or burning of endometriotic lesions is the most common surgical approach, which results in only a partial destruction of the disease. The remaining disease not removed at surgery continues to grow with return of symptoms quickly (months to a year or two). In contrast,Wide excision of Endometriotic implants used by Mr Raza. This technique ensures the excision of all endometriotic lesions at the margins of normal tissue. The inadequate surgery often results in patients undergoing multiple ineffective surgeries. There is no medical cure for endometriosis. It must be completely removed surgically with true wide excision.

It is well documented in the scientific literature that endometriosis specialists have higher success rates and lower recurrence rates compared to general Gynaecologists This should not be surprising. The concept of better outcomes with medical specialties and subspecialties is the basis of the current medical training and certification system with a variety of different medical subspecialties. Most nationally recognized endometriosis surgeons provide excellent treatment with wide excision. This is an important first step, but it is not the complete picture.

The second basic part of treating endometriosis and pelvic pain is that of treatment of co-conditions and even underlying conditions associated with endometriosis. This does not refer to pharmaceutical medical treatment, rather treatment of what is known as chronic inflammatory disease. The best approach to these conditions is integrative or functional medicine. The objective of this approach is truly becoming healthy. Surgery can remove disease but it cannot make a person healthy. The disease effects number of organs such as bowel, bladder, nerves (neuropathic pain), infertility and psychosexual feelings. Any treatment should look at all aspects of this disease to help in its entirety. Endometriosis centre has put the best team together to address all issues. It is often impossible for endo patients to recover their health without addressing these issues.

Our philosophy at Endometriosis centre is not just treating symptoms, but one of truly removing the disease and restoring a person’s health. We do not want you to live with endometriosis, we want you to heal from the disease and move on with your life. We want endometriosis to be a something in your past. This is why we have a whole integrative component as part of our endometriosis treatment program. We offer the most comprehensive approach to treating all aspects of your endometriosis and pelvic pain. Combining laparoscopic wide excision surgery with a holistic functional medicine approach to look at the whole body and treat underlying imbalances provides the best approach to the treatment of endometriosis and pelvic pain.

Endometriosis can present itself in a range of forms from a milder state to very severe rectovaginal disease. The treatment is very much designed based on the symptoms, findings and patients choices.
There is no fixed way to treat this so following is a brief version of various treatment options.

Medical treatment

The medical treatment can be used and justified in few instances.One of its role is in the Pre-surgical treatment of ovarian endometrioma. The Hormonal treatment can help to reduce the size of endometrioma which reduces the surgical harm to the ovaries. The Hormonal medical treatment is also justified after the operation to stop the periods so to allow more time for the excision wounds to heal. Third indication id for those patients who want to delay operation or have quite mild disease hence prefer to have medical treatment.
Mr Raza will have detailed discussion about the pros and cons of this treatment to formulate a final plan of care. There is lot of research being carried out to use various other drugs but none of them have been the answer for this problem.

Surgical treatment

Laparoscopic removal of endometrial implants remains the key part of management. The critical part of this approach remains the complete removal of endometriosis from the peritoneal cavity, ovaries, bowel and bladder. The endometriosis can lead to adherence of various structures in the abdomen. Most symptoms are secondary to this adhesive disease. The peritoneal involvement of endometriosis leads to pelvic pains and period pains. If endometriosis involved the bowel, then painful defecation, irritable bowel and bloating are the main symptoms. The bladder endometriosis leads to painful urination along with increased urine frequency. There could be number of other organ involvement giving rising to relevant symptoms. The treatment options will be to remove this adhesive disease in its entirety to have the symptoms relief.

If the endometriosis is of severe nature, then multidisciplinary approach is adopted involving all the specialities such as colorectal surgeon, urologist to make a final plan of care.

The endometriosis also effect fertility by its adhesive nature and effecting the fallopian tibes and ovaries. Surgery helps to restore the normal anatomy hence helping with functionality .

Mr Raza is a laparoscopic surgeon and adopts a wide excisional technique, which means that he believes in removing all the visible disease. This is comparatively a complex procedure and many gynecologists will burn the disease instead of removing. The ablation only technique may leave the endometriotic lesions with a risk of recurrence.

A thorough excisional technique helps to remove the visible and adjacent invisible (microscopic) endometriosis. This is the most effective approach to treat this problem.

Fertility Treatment

Once the endometriosis is excised thoroughly, the referral is made for fertility treatment if desired. Mr Raza works very closely with Mr Dimitrios Nikolaou to help with fertility.