Dr. Paulina Carrillo, MD
Gynecology & Minimally Invasive Surgery, Endometriosis Specialist
Summary:
Dr. Paulina Carrillo is a gynecologist and endometriosis specialist based in Mexico City, Mexico. She performs endometriosis excision surgery and provides individualized care that considers each patient’s symptoms, reproductive goals, and quality of life. Her advanced training includes surgery for deep endometriosis, minimally invasive gynecologic surgery, hysteroscopy, and clinical neuropelveology.
Dr. Carrillo views endometriosis as a complex, multifactorial, chronic inflammatory disease that requires a multidisciplinary approach. Her treatment plans may combine excision surgery with hormonal therapy, pelvic floor physical therapy, pain management, nutritional support, and psychological care. For patients with persistent pain after surgery, she conducts a comprehensive reassessment to identify possible causes, including residual or recurrent endometriosis, adenomyosis, pelvic floor dysfunction, and neuropathic pain. She considers additional surgery only when objective evidence indicates that it is likely to provide meaningful benefit.
Dr. Carrillo earned her Doctor of Medicine degree at Universidad Popular Autónoma del Estado de Puebla and completed her residency in Gynecology and Obstetrics at Hospital Español de México. She is certified by the Mexican Board of Gynecology and Obstetrics. Her additional training includes a Surgical Fellowship in Advanced Surgery in Deep Endometriosis at IFEMEndo in Bordeaux, France, and a Fellowship in Advanced Laparoscopy with Multidisciplinary Endometriosis Management at Instituto Doyenne in Mexico City. She also completed advanced hysteroscopy training at the University of Naples Federico II and laparoscopic surgical training at Saint Louis University. Her credentials include ISON Level 1 in Clinical Neuropelveology, GESEA Level 2 in Minimally Invasive Gynaecological Surgery, GESEA Level 1 in Endoscopy, a Diploma of Advanced Laparoscopy in Gynaecology, and advanced endometriosis courses at CICE and IRCAD in France.
City: Ciudad de México, Mexico
Philosophy of Endometriosis Care: I view endometriosis as a complex, multifactorial, chronic inflammatory disease rather than a condition explained by a single theory. My clinical approach is informed by the integration of several complementary mechanisms, including Sampson’s theory of retrograde menstruation, coelomic metaplasia, Müllerian remnants, stem cell involvement, genetic and epigenetic susceptibility, immune dysfunction, and neuroangiogenesis. Because of this multifactorial pathogenesis, I believe treatment should be individualized and multidisciplinary. Surgery addresses the anatomical disease, while long-term management may also include hormonal therapy, pelvic floor physical therapy, pain management, nutritional support, and psychological care according to each patient’s goals, symptoms, and fertility plans.
What type of surgery do you perform for endometriosis: Excision
Do you include imaging in pre-surgical planning: Yes. Imaging is an essential component of my preoperative planning. I use expert transvaginal ultrasound and pelvic MRI with an endometriosis-specific protocol when deep endometriosis is suspected or when mapping of disease extent is required. Imaging is used to assess ovarian endometriomas, adenomyosis, rectosigmoid, urinary tract, parametrial and other deep pelvic involvement, and to anticipate surgical complexity. It also helps determine whether a multidisciplinary team, such as colorectal or urologic surgery, should be involved. I counsel patients that negative imaging does not exclude superficial endometriosis.
Medication: Medical therapy is an important component of individualized endometriosis care, but it should not be considered a substitute for appropriate surgical management when surgery is indicated. I prescribe hormonal therapies primarily to suppress disease activity, control symptoms, reduce recurrence risk, and preserve quality of life. Depending on the patient’s age, symptoms, reproductive goals, and disease severity, I may recommend progestins (particularly dienogest), combined hormonal contraceptives, levonorgestrel-releasing intrauterine systems, or GnRH agonists in a few selected cases. Nonsteroidal anti-inflammatory drugs are used for symptom control when appropriate. Medical treatment is integrated with pelvic floor physical therapy, nutritional counseling, pain management, and psychological support when indicated. Treatment decisions are individualized and made through shared decision making with each patient.
Approach to Persistent Pain After Surgery: Persistent symptoms after surgery require a comprehensive reassessment rather than the assumption of recurrent disease. I recognize that persistent pelvic pain may result from residual or recurrent endometriosis, adenomyosis, pelvic floor dysfunction, neuropathic pain, central sensitization, bladder pain syndrome, irritable bowel syndrome, or other pain generators. My approach includes a detailed clinical reassessment, expert imaging when indicated, and multidisciplinary evaluation. Treatment is individualized and may include pelvic floor physical therapy, hormonal therapy, pain medicine, nutritional support, psychological care, and selective reoperation only when there is objective evidence that surgery is likely to provide meaningful benefit. My goal is to improve function, quality of life, and long-term symptom control while avoiding unnecessary repeat surgery.