Andrea Vidali, M.D. , Endoemetriosis Specialist, Obstetrics & Gynecology / General Obstetrics & Gynecology, Reproductive Endocrinology
City: New York, NY, USA
Philosophy: Current scientific evidence points to the coelomic theory of endometriosis
Medication: The approach to endometriosis has to be holistic and address not only the disease itself but also potentially associated conditions. At this time, since we do not have medical candidates for curing endometriosis, the first essential step in the treatment of endometriosis is excision surgery. Additionally, I rely on hormonal contraception, preferably progestins either orally or in the form of IUD to control bleeding or adenomyosis-related factors, if present. I do not rely on GnRH agonists or antagonists as in my experience the risk profile and efficacy profile not better than progestins make them undesirable.
Approach to Persistent Pain: I would like to affirm that I follow all the patients I operate on until they are well. I see the patients periodically as long as necessary. I always have a plan post-operatively especially if history, lab work, and initial examination have highlighted the possibility of the coexistence of additional pain generators. I do recommend physical therapy to most if not all patients and rely on a network of physiatrists.