Dr. Paulami Guha, Gynecology & Minimal Invasive Surgery, Endometriosis Specialist.
City: Jacksonville, FL
Philosophy of Endometriosis Care: Coelomic Metaplasia; blockage in the reproductive tract, treating pain symptoms; multimodal management – surgical and medical, also addressing the mental component; surgical excision of endometriosis; medical management by suppression of menstruation and; Sampson’s theory.
What type of surgery do you perform for endometriosis?: Robotic and Laparoscopic Excision
Medication: Surgical excision followed by continuous norethindrone vs progestin-only pills vs OCPs. If the patient is waiting for surgery and is in pain or heavy bleeding, I do recommend GnRH antagonists or agonists. In infertility patients, I recommend trying for pregnancy right away. Have used letrozole in adenomyosis patients who are going to try for pregnancy.
Approach to Persistent Pain After Surgery: For pain, I recommend pelvic floor physical therapy and acupuncture and also suppression of menses.