Gabriel Mitroi, M.D., Endometriosis Specialist, Obstetrics & Gynecology,
City: București, Romania.
Philosophy: Scientific studies point towards a genetic origin. I think, for now, until a specific method of treatment is found, excision remains the only method that offers various benefits to the patients.
Medications: I prescribe birth control pills after surgery for a few months and before surgery if the patient is in too much pain and painkillers do not work. For adenomyosis, I prescribe the Coil.
Imaging: I have a radiologist in my team specialized in MRI for endometriosis. I use the MRI in cases with suspicion of extensive Deep Infiltrating Endometriosis to be able to plan my time better and to have all specialists on stand-by/assisting me and of course, to inform the patients about the stay in the hospital, possible complications and the complexity of the surgery (bowel, bladder, ureteral reimplantation, etc).
Approach to persistent symptoms: I maintain contact with all patients after surgery for as long as is needed, so in case of persisting pain, I reassess the potential sources of pain and make recommendations based on the type of pain and symptoms and I usually recommend a nonsteroidal anti-inflammatory drug or Mirena coil if the source of pain points towards adenomyosis. I also refer patients to pain therapy. Unfortunately, I am not aware of any pelvic floor therapists in my country.