Dr. Ruy Machado Jr.
Dr. Ruy Machado Jr – Endometriosis Specialist
Summary: Dr. Ruy Machado Jr. is a dedicated endometriosis specialist based in São Paulo, Brazil, known for his expertise in excision surgery. Dr. Ruy Machado’s approach to care is rooted in the cellular metaplasia and autoimmune theories, offering patients a comprehensive understanding of their condition. He often uses medications like dienogest both before and after surgery to manage symptoms effectively. For more severe cases, such as grade 4 endometriosis, Dr. Machado incorporates goserelin acetate post-surgery for up to six months. With 17 years of experience in laparoscopy and robotic surgery, Dr. Ruy Machado prioritizes nerve-preserving excision techniques, resulting in minimal persistent pain after surgery. When symptoms do persist, they are typically managed with continuous dienogest, anti-inflammatory medications, or levonorgestrel IUDs. His patient-centered approach ensures individualized treatment and long-term relief for those living with endometriosis.
City: São Paulo, Brazil
Philosophy of Endometriosis Care: Believe mainly in the theory of cellular metaplasia and the autoimmune theory.
What type of surgery do you perform for endometriosis: Excision
Medication: I often use medications; I often use Dienogest and goserelin acetate. I use dienogest both before and after surgery to control symptoms. Gosserlin acetate is used exclusively after surgery in cases of grade 4 endometriosis for a period limited to 6 months.
Approach to Persistent Pain After Surgery: I have been treating endometriosis for laparoscopy for 17 years, and more recently, for robotic surgery. In recent years, we have had very few patients with persistent symptoms after the surgeries we practice using nerve-preserving disease excision techniques. The cases we had improved only with the use of continuous dienogest, anti-inflammatory drugs, or the use of a levonorgestrel IUD. Over these years, we re-operated on only 2 patients for persistent symptoms.