Dr. Sherif Tawfeek
Dr. Sherif Tawfeek, Gynecology & Minimal Invasive Surgery, Endometriosis Specialist.
City: Midland, WA, Australia
Philosophy of Endometriosis Care: Autoimmune
What type of surgery do you perform for endometriosis?: Ablation for minimal ends or infertility reasons and excision for aggressive surgery in chronic pain.
Medication: Zoladex or progesterone depends on age and severity of symptoms.
Approach to Persistent Pain After Surgery: Address other non-gyne causes and include a holistic team approach, pain specialist, physio, dietician, etc…
Dr. Jaime Alfredo Calderon Tapia
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
Dr. Cristobal Gerardo Rodriguez-Valero
Dr. Cristobal Gerardo Rodriguez-Valero, M.D., Endometriosis Specialist, Gynecologist, Minimally Invasive Gynecologic Surgeon
City: Monterrey, Nuevo Leon, México
Philosophy: Epigenetic theory: despite Sampson’s theory being well accepted it does not integrate the diagnosis in teenage patients and others, I believe epigenetic englobes a more acceptable theory conjoined with other theories like Mullerian malformations.
What type of surgery do you perform for endometriosis?:
Excision
Medication:
In some specific cases, previous to surgery, we decide to manage with DIENOGEST, orlissa or visanette , commercial names, to suppress disease and prepare for excision in surgery better.
Approach to Persistent Pain After Surgery: Multispeciality management with Psychology and pelvic floor therapist.
Dr. Paulami Guha, MD, FACOG
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.
Dr. Victor Rubio
Dr. Víctor Rubio
Victor Rubio – Gynecology & Minimal Invasive Surgery, Endometriosis Specialist
Summary: Based in Chihuahua, Dr Rubio Mexico (Dr Víctor Rubio) is a skilled gynecologist and minimally invasive surgeon who is deeply committed to helping patients manage endometriosis. With years of experience and a focus on excision surgery, Victor Rubio provides individualized care grounded in the embryogenetic theory of endometriosis development.
Dr Víctor Rubio prioritizes patient well-being through both surgical and non-surgical approaches. For those delaying pregnancy, he may prescribe Dienogest to manage symptoms and protect ovarian health. After surgery, he supports healing with pelvic floor physiotherapy to address persistent pain and promote long-term relief. Known for his compassionate, patient-first care, Dr Rubio Mexico ensures every treatment plan is tailored to the individual’s needs and life goals. Victor Rubio is dedicated to improving the quality of life for those navigating the challenges of endometriosis.
City: Chihuahua, Mexico
Philosophy: Embryogenetic Theory
What type of surgery do you perform for endometriosis?: Excision
Medication: Dienogest 2mg oral every 24 24 hours. At the time of the diagnosis, if the patient does not want to become pregnant until she does, after surgery, in endometriomas, depending on age, ovarian reserve, and size.
Approach to Persistent Pain After Surgery: Pelvic Floor Physiotherapy.
Dr. Kenneth I. Barron
Kenneth I. Barron, Gynecology & Minimal Invasive Surgery, Endometriosis Specialist.
City: Charlottesville, Virginia
Philosophy:
Excision
Medication:
Approach to Persistent Pain After Surgery:
I always continue to take care of my patients after surgery. There can be more than one pain generator co-existing with endometriosis. If pain persists post-operatively I re-evaluate the patient for other sources of pain, if not already recognized pre-operatively, such as myofascial pain, neuropathic pain, primary uterine pain, bowel and bladder-related pain.
Dr. Tarek Toubia
Dr. Tarek Toubia, Gynecology & Minimal Invasive Surgery, Endometriosis Specialist.
City: Hopkinsville, Kentucky
Philosophy:
Multifactorial origin for a complex disease (with emphasis to genetic and embryonic theories) and thus treatment approach needs to be personalized and multidisciplinary.
What type of surgery do you perform for endometriosis?:
Excision
Medication: I use hormonal suppression with combined contraceptives or some progestational agents when someone does not want surgical treatment and is desiring contraception. I use GnRH antagonists for patients who are suffering from pain symptoms and desiring to delay surgical intervention and not attempting conception.
Approach to Persistent Pain After Surgery:
Also postoperative hormonal suppression to decrease risk of recurrence
Dr. Marcelo Lontra
Dr. Marcelo Lontra, Gynecology & Minimal Invasive Surgery, Endometriosis Specialist.
City: Porto Alegre, Brazil
Philosophy:
Endometrial stem cell recruitment theory
Bone marrow–derived stem cell theory
Molecular genetic changes in endometriosis
Epigenetic and microrna alterations in endometriosis
What type of surgery do you perform for endometriosis?:
Excision
Medication:
Progestins for pain;Dienogest Dienogest;2mg per day
Aromatase inhibitors for reduce pain, intestinal symptoms, urinary symptoms and
decrease the volume of laparoscopically visible endometriosis.
Gonadotropin Releasing Hormones (GnRH) antagonists for pain
Approach to Persistent Pain After Surgery:
Dr. Romeo Lucas
Dr. Romeo Lucas
Dr Lucas – Gynecology & Minimal Invasive Surgery, Endometriosis Specialist.
Summary: Based in Freeport, Maine, Dr Lucas OBGYN is a dedicated gynecologist and minimally invasive surgeon at the New England Center for Pelvic Health, specializing in endometriosis care. With a commitment to patient-centered treatment, Dr. Romeo Lucas performs thorough excision surgery and collaborates with other specialists when needed to ensure comprehensive care.
Dr. Lucas believes in transparent communication and detailed documentation. If full excision isn’t possible during surgery, he carefully records and reviews all findings with the patient, offering appropriate referrals when necessary. Grounded in the coelomic metaplasia theory, he approaches endometriosis as a complex condition often requiring multidisciplinary insight. Through his work at the New England Center for Pelvic Health, Dr. Lucas OBGYN helps patients better understand their diagnosis and treatment options, empowering them to make informed decisions on their journey toward relief.
City: Freeport, Maine
Philosophy: I employ excision to the fullest extent that I am comfortable operatively. I may call for an intraoperative consult as needed. I may ask for certain specialists to be present or available if I have a high suspicion before surgery. Even if I am unable to excise or there is no surgeon available to excise, I thoroughly document the lesions (digital pictures) remaining and review them with the patient post-operatively. I then provide a referral as needed/desired.
Theories of endometriosis origin: Most likely due to coelomic metaplasia. Certainly, there are cases owing to menstrual regurgitation (i.e., imperforate hymen) or seeding during surgery (i.e., abdominal wall endometriosis after cesarean delivery). However, in such cases, it seems possible, if not likely, that there is an aberrant immunologic process allowing for unaddressed proliferation of that tissue.
What type of surgery do you perform for endometriosis?: Excision
Dr. Joseph Njagi
Dr. Joseph Njagi
Dr Joseph Njagi – Gynecology & Minimal Invasive Surgery, Endometriosis Specialist.
Summary: Based in Kerugoya, Central Kenya, Dr Joseph Njagi is a highly experienced gynecologist specializing in minimally invasive surgery and the expert care of endometriosis. With a deep understanding of the condition, Dr Joseph Njagi follows the retrograde menstruation theory to guide his treatment philosophy. He focuses on excision surgery for endometriosis, a proven technique to remove diseased tissue and provide lasting relief.
Dr Njagi takes a patient-centered approach, using NSAIDs and combined oral contraceptives (COCs) to manage pain and prevent the regrowth of endometrial cells post-surgery. When persistent pain occurs after treatment, he conducts comprehensive evaluations—including medical history reviews, imaging analysis, and one-on-one consultations—to tailor each patient’s care. Through ongoing follow-up and thoughtful adjustments, Dr Njagi ensures his patients receive continuous, personalized support throughout their healing journey.
City: Kerugoya, Central Kenya
Philosophy:
Retrograde menstruation theory
What type of surgery do you perform for endometriosis?: Excision
Medication: I incorporate NSAIDs for pain management after surgery. I also use COCs for pain management and to limit the growth of endometrial cells.
Dr. Chauncey Stokes
Dr. Chauncey Stokes
Dr Stokes OBGYN – Gynecology & Minimal Invasive Surgery, Endometriosis Specialist
Summary: Dr Stokes OBGYN is a respected gynecologist and minimally invasive surgeon based in Lansdowne, VA, offering expert care to patients facing endometriosis and chronic pelvic pain. As an experienced OB GYN in Lansdowne, VA, Dr Chauncey Stokes combines surgical skill with a deep understanding of the complex nature of endometriosis. Practicing near Virginia Heart in Lansdowne, Virginia, he performs advanced excision surgery and provides comprehensive, compassionate care.
Dr Chauncey Stokes believes emotional support is essential to long-term healing. He incorporates oral contraceptives, antiestrogen medication, antidepressants, and neuromodulators into his treatment plans, tailoring care to each patient’s needs. When pain persists after surgery, he evaluates psychological and lifestyle factors and may include dietary changes, counseling, and exercise. Dr. Stokes, OBGYN is committed to helping patients reclaim quality of life through thoughtful, individualized care and evidence-based therapies.
City: Lansdowne, Virginia
Philosophy: Please refer to the uploaded document for further discussion. In short, I believe that endometriosis starts with the early development of the embryo. We can operate and remove endo, but understanding the origin is still perplexing. With more genetic research, we may have better answers to the question. For now, extensive excision seems to afford the best relief in the short term. Long-term relief usually requires more aggressive surgical intervention. For most patients, they have had their children. For others, they have been so debilitated by the disease that they opt for aggressive therapy at the exclusion of childbearing. Emotional/psychological support during the management of this disease is crucial to success because of its chronicity.
What type of surgery do you perform for endometriosis?: Excision
Medication: Oral contraception, antiestrogen meds, antidepressants, gabapentin, and Lyrica. I typically offer the younger females a trial of oral contraceptives followed by antiestrogen medication. I will add antidepressants and neuromodulators as needed, especially if the initial regimen is not sufficient. Counseling and relaxation techniques are considered as an adjuvant to the medical therapy, just to get some relief
Approach to Persistent Pain After Surgery: I initially use a questionnaire to help determine if patients have had sexual abuse and other psychological factors that may play into the overall management. If they are positive, I may refer them out for further evaluation or before initiating medical treatment. I advise weight loss for those women with increased BMI. I try to avoid chronic pain clinics due to the concern about addiction. I have used them in the past when major meds for management have been unsuccessful. I have those who have used acupuncture, but the results have been unpredictable. Exercise can be beneficial, along with alterations in diet. I work with a nutritionist to assist with developing anti-inflammatory diets. The truth is that some of these patients are difficult to manage, and we have little left once we have exhausted surgical and medical treatments. The initial questionnaires do help us to delineate those who may be difficult to treat. We try to set expectations and promote small successes as a step in the right direction.
Dr. Joseph Chen
Dr. Joseph Chen
Dr Joe Chen – Gynecology & Minimal Invasive Surgery, Endometriosis Specialist.
Summary: Dr Joseph Chen, also known as Dr Joe Chen or Chen Joseph, is a skilled endometriosis specialist in Oakland, California, offering expert care for patients dealing with this complex condition. With a deep understanding of extra-pelvic endometriosis, Joseph Chen MD believes in addressing multiple theories of endometriosis origins, including retrograde menstruation, colemic transformation, and lymphatic dysregulation. His holistic approach to treatment includes excisional surgery in Omaha, NE, along with systemic and localized progestin suppression to manage symptoms and prevent recurrence.
Dr Joe Chen also ensures comprehensive care by screening for additional pain triggers such as neuropathic pain, IBS, and pelvic floor dysfunction. His approach to persistent pain after surgery involves careful reevaluation and collaboration with the patient to decide whether further excision surgery is necessary. With his expertise and personalized care, Dr Joseph Chen strives to improve his patients’ quality of life and fertility outcomes.
City: Oakland, California
Philosophy: As a provider who sees and addresses extra-pelvic endometriosis on a consistent basis, I am a believer that many of the origin theories, including retrograde menstruation, Mullerian and colemic transformation, as well as dysregulation of lymphatic transportation, are all relevant causes for this chronic condition. We know that premenstrual, postmenopausal, and non-female cases of endometriosis do occur, and thus, we need to be cognizant of the challenges regarding the current understanding of this disease.
Medication: I will routinely use progestin components for systemic suppression, as well as localized progestin protection for pain control. I routinely encourage patients to consider the use of systemic progestin suppression to prevent recurrence following excisional surgery – an approach that I have seen tremendous success in.
Approach to Persistent Pain After Surgery: Similar to my presurgical approach, I will often reevaluate to determine if the other pain triggers following surgery have been addressed. With patients who desire future fertility, repeating imaging and further systemic suppression are important to prevent worsening symptoms. With careful counseling and detailed discussion about the risks, benefits, and alternatives for reoperation, can we consider repeating the excision surgery.
