Dr. Anshumala Shukla Kulkarni
Dr. Anshumala Shukla Kulkarni
Anshumala Shukla Kulkarni – Gynecology & Minimal Invasive Surgery, Endometriosis Specialist.
Summary: Dr Anshumala Shukla Kulkarni is a compassionate endometriosis specialist based in Mumbai, Maharashtra, with expertise in gynecology and minimally invasive surgery. Her approach to treating endometriosis is rooted in understanding the complexities of immune dysregulation and coelomic metaplasia, which play key roles in the development of the condition. Anshumala Shukla offers a variety of treatment options tailored to each patient’s needs, including low-dose oral contraceptive pills to reduce the risk of recurrence after surgery and progesterone therapy for patients who are not ready for surgery or have minimal symptoms.
When addressing persistent pain after surgery, Dr Kulkarni takes a thorough, patient-centered approach. She recommends re-evaluating imaging to rule out other causes of symptoms and revisiting surgery if there is no improvement with medical management. Dr Anshumala Shukla focuses on providing comprehensive care to enhance her patients’ well-being and quality of life.
City: Mumbai, Maharashtra
Philosophy: Immune dysregulation, coelomic metaplasia
Medication: Low-dose oral contraceptive pills for post-operative long-term reduction of recurrence, progesterone for post-operative or those not willing to undergo surgery, young patients with minimal symptoms
Approach to Persistent Pain After Surgery: Relook imaging, rule out other causes for symptoms, relook surgery if no response to medical management.
Dr. Abhishek Mangeshikar
Abhishek Mangeshikar, M.D.
Abhishek Mangeshikar – Endometriosis Specialist, Minimally Invasive Gynecologic Surgeon
Summary: Dr Abhishek Mangeshikar is a trusted endometriosis specialist and minimally invasive gynecologic surgeon based in Mumbai, Maharashtra, India. Dr Mangeshikar’s approach combines the Mulleriosis and genetic-epigenetic theories, focusing on how abnormal cells formed during embryonic development become activated later in life. His treatment plans include postoperative use of oral contraceptive pills, Dienogest, or Mirena IUDs, especially for adenomyosis, alongside personalized pain management with medications like Gabapentin and NSAIDs. Dr Abhishek Mangeshikar emphasizes long-term patient care, with regular follow-ups to monitor pain, fertility, and overall quality of life. He incorporates multidisciplinary support, including nutrition and pelvic floor physiotherapy, to aid recovery. With recurrence rates under 10% for deep endometriosis, Dr Mangeshikar’s expert surgical and medical care offers hope for lasting relief and improved well-being. Patients appreciate his compassionate, patient-centered approach that addresses both physical symptoms and emotional health.
City: Mumbai, Maharashtra, India.
Philosophy: A combination of Mulleriosis and the genetic-epigenetic theory. During embryo formation and separation of the Mullerian system, abnormal cells are laid down, which during certain “epigenetic” events, like hormonal changes at menarche, trigger activation of these abnormal cells.
Medication: Postoperatively: 3-6 months of OC pills or Dienogest, Mirena (LNG IUD) in cases of adenomyosis.
Tailored pain regimens for patients with chronic pain managed by our pain specialist, usually with Gabapentin, Lyrica, NSAIDs, or Narcotics
In case a patient has to wait for surgery, we may preoperatively suggest OC pills or Dienogest.
Approach to Persistent Pain: Patients are routinely followed up at 6 months, 12 months, and yearly after that with quality of life questionnaires regarding pain scores, fertility outcomes, gastrointestinal complaints, etc. Chronic pain caused by a certain degree of central sensitization is managed by our pain specialist. Nutrition and pelvic floor physiotherapy form an important part of the recovery process. Recurrence rates are less than 10 % over 5 years for deep endometriosis lesions, for endometriomas, less than 20%. These cases would require another surgical intervention.
