Dr. Carlos Alberto Serrano Flores, Gynecology & Minimal Invasive Surgery, Endometriosis Specialist.
City: Puebla, Mexico
Philosophy of Endometriosis Care: Müllerianosis, Epigenetic, Genetic, and Immunological Theories.
What type of surgery do you perform for endometriosis: Excision
Medication: For patients who do not require surgery, who do not desire fertility, or who do not desire surgery: Oral contraceptives, progestins, Levonorgestrel IUD (especially for those with associated adenomyosis), Analgesics, multivitamins, smooth muscle relaxants, etc. Patients who require surgery in the pre-and postoperative period and without desire for short-term fertility, 6 months to 2 years, preferably progestins. Amitriptyline, Gabapentin in patients with chronic pelvic pain and central sensitization. For all patients, multivitamins, natural anti-inflammatories, acupuncture, psychological and psychiatric therapy.
Approach to Persistent Pain After Surgery: Most patients who require surgery have other added pain syndromes; therefore, surgery is only a complement to the resolution of pain. Patients must be evaluated with a chronic pelvic pain approach, taking into account each aspect that can trigger this problem. They must be evaluated by pain specialists, we always treat central sensitization, and myofascial compromise with pelvic floor rehabilitation, we treat psychologically and psychiatrically, we improve the metabolic environment with nutrition; and we address pain from a holistic approach. We have a large multidisciplinary group focused on patients with endometriosis.