Dr. Sadikah Behbehani, Endometriosis Specialist
City: Costa Mesa, California
Philosophy of Endometriosis Care: It doesn’t matter where it came from, what matters is that it’s removed. Endometriosis, like cancer, can spread via lymphatic channels and blood vessels. Also, pleuripotent stem cells in the pleura and peritoneum can lead to its development.
What type of surgery do you perform for endometriosis: I perform endometriosis excision surgery to remove the endo from its roots, but I also focus on preserving fertility. I remove endometriosis from around the fallopian tubes and ovaries routinely. My surgical strategies focus on minimizing damage to the ovaries to help preserve ovarian reserve and help with future fertility. I also perform tubal surgery when necessary. It’s important to appropriately excise the disease while minimizing damage to reproductive organs. I also excise endometriosis from the bowel, bladder, and diaphragm and perform an appendectomy when necessary.
Medication: I only recommend medication after surgery to ensure that all endometriosis has been appropriately excised. For bladder or muscular spasms, I prescribe cyclobenzaprine. For nerve pain, I prescribe gabapentin. Most of the time, I refer them to pain management, though, to take care of residual pain. I never prescribe narcotics, and I don’t send them to anyone who will.
Approach to Persistent Pain After Surgery: I work with them until their pain reaches a tolerable level. I refer them to specialists as needed (pain management, GI, PT), but I continue to oversee their treatment plan with visits q3-6 months.