Abhishek Mangeshikar, M.D., Endometriosis Specialist, Minimally Invasive Gynecologic Surgeon.
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.