Dr. Ana Gabriela Sierra Brozon / Minimally Invasive Gynecological Surgery
City: Mexico City, Mexico
Philosophy of Endometriosis Care: Our approach to the treatment of endometriosis is based on the mesodermal origin theory, which suggests that individuals are born with endometriotic-like cells due to embryological misdifferentiation of the mesoderm. This theory posits that endometriosis is not solely a retrograde menstruation phenomenon but rather a condition that originates during fetal development, where misplaced Müllerian or mesothelial cells retain their potential to differentiate into endometrial-like tissue later in life.
This perspective explains why endometriosis can be diagnosed in prepubertal patients, postmenopausal women, and even in cases without functional menstruation. It also underscores the importance of a comprehensive excision-based surgical approach, as the disease is not merely a result of refluxed endometrial tissue but rather a condition embedded in the developmental blueprint of the pelvic structures. Understanding endometriosis from a congenital standpoint allows us to refine treatment strategies, emphasizing early diagnosis, precision excision surgery, and a multidisciplinary approach to improve patient outcomes.
What type of surgery do you perform for endometriosis: Excision
Medication: Hormonal treatment, primarily progestins, only when necessary; anti-inflammatory diet; pelvic floor physiotherapy; anti-
Approach to Persistent Pain After Surgery: If the patient persists with neurological alterations, I perform an extensive neuropelviology evaluation and interconsultation with pain management specialists.