Dr. Jaime Alfredo Calderon Tapia, M.D., Endometriosis Specialist, Gynecologist, Minimally Invasive Gynecologic Surgeon
City: Morelia, Michoacan, Mexico
Philosophy: None of the theories explain all the cases, i think all the theories (retrograde menstruation, coelomic metaplasia, embryonic remnants, transformation/induction) interact as initiating factors with genetics, menstrual fluid obstruction and propagating factors (oxidative stress, hormones, apoptosis suppression, immune dysfunction) to explain the superficial and deep endometriosis. it’s our duty to know all the interactions to try the solve most of the cases and try to explain to the patient her condition and potential solution
What type of surgery do you perform for endometriosis?:
Excision
Medication: non-inflammatory steroid drug as the first line for dismenorrea without demostrable endometriosis implant\nhormonal contraceptive phil in the second line of dismenorrea with our demonstrable endometriosis implant\nprogesterone treatment (intrauterine levonorgestrel device or dienogest) encases with fail of the first and second medical treatment line, in cases in which the patient condition or desire the surgical approach is not considered, or in patients with a high risk of postsurgical recurrence to try to avoid or reduce it.
Approach to Persistent Pain After Surgery: I submit the case to all my team for a second time, discussing the causes of the persistence of the symptoms that including (a physical therapist, psychologist, bowel surgeon, urologist, gynecological urologist, and pain expert) and later get opinions of other endometriosis colleague around the world mainly Latin America, i am blessed to have a good relationship with experts in chile, Argentina, Brazil and here in Mexico to discuss the cases. with these meetings, I reduce the rate of failure