Nadim Hawa, M.D., Endometriosis Specialist, Minimally Invasive Gynecologic Surgeon.
City: Leesburg, VA, USA
Philosophy: Multiple factors. Combination of in Sito development and endometrial transplantation. I do not believe there is only one type of endometriosis. Different origins hence different differentiation, behavior, and clinical impact. Same as fibroid. Why you have one solitary fibroid vs the bag of marbles of a uterus. Different gene expression and different behavior.
Medication: Medication and hormonal suppression serve only to relieve symptoms but not treat the disease. By stopping the dynamic motion of the uterus with suppression, you limit the superficial peritoneal inflammation and cause symptomatic relief, but you will not affect the deep lesions. since they produce their own estrogen and pro-inflammatory mediators. .I use IUD and usually insert intraoperatively after the excision surgery if the patient e desires birth control. GnRH agonist/antagonist are harmful and I do not use them
Approach to Persistent Pain: Surgery alone is not enough. Pelvic floor therapy is as important as surgery, for long term recovery.
A second excision is usually advised.
I was diagnosed with umbilical endometriosis in 10/2022. I had endo excision surgery on 6/9/2023 at Inova under the care of Dr. Hawa. From my first office visit with Dr. Hawa he was very detailed in explaining my diagnosis and treatment options. He took his time and thoroughly answered my questions and put me at ease about the surgery. He was able to remove my stage four endometriosis without damaging my fallopian tubes or ovaries. I also had to have my appendix and belly button removed by general surgeon Dr. Peters. I am now six post surgery and I am slowly starting to feel like myself again. My first cycle after the surgery was pain free. I am forever grateful to Dr. Hawa for preserving my reproductive parts. Once I am with child I plan to see Dr. Hawa as my OBGYN.