Archives

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3 years ago

Dr. David Rosen

Dr. David Rosen, M.B., B.S.,

Dr. David Rosen – Endometriosis Specialist, Gynecologist, Minimally Invasive Gynecologic Surgeon

Summary: Dr David Rosen gynaecologist is a highly skilled endometriosis specialist based in Kogarah, NSW, Australia. With extensive experience in treating endometriosis, Dr. David Rosen gynaecologist, provides individualized care, focusing on excision surgery to remove all deposits rather than relying on less effective treatments like diathermy. His approach is designed to address the unique needs of each patient, ensuring the best possible outcomes.

For treatment, Dr David Rosen utilizes a range of therapies including OCP, progesterone IUDs (Mirena), and GnRH analogs (Zoladex), along with laparoscopy when necessary. He collaborates with pelvic floor physiotherapists and pain specialists to help manage chronic pain, offering a multidisciplinary approach to care.

As a dedicated gynaecologist, Dr David Rosen provides ongoing support through regular follow-ups and personalized pain management plans to improve quality of life for his patients.

City: Kogarah, NSW, Australia

Philosophy: The cause of endometriosis is unknown – deep infiltrating disease arising from the uterosacral ligaments and incorporating the ovaries and bowel shows a very different natural history to peritoneal gunpowder or vesicular deposits yet both can cause severe symptoms in women. Accordingly, each patient is approached individually however the overarching philosophy is extensional surgery to remove all deposits (versus “diathermy to endometriosis” which can often leave deep deposits of endometriosis especially in the Pouch of Douglas)

Medication:

OCP, Progesterone IUD (Mirena), Long acting oral Progestagens (Visanne), GnRH analogs (Zoladex / Synarel) and analgesia for chronic pain.
Endometriosis requires a visual diagnosis in all but the most severe cases (when a DIE scan or ultrasound demonstrating endometriotic cysts of the ovary can make the diagnosis pre-operatively). Depending on severity of symptoms, age and physical examination, patients who present with a possible history of endometriosis will undergo laparoscopy or be initially tried on medical therapy (OCP, Mirena IUD). Laparoscopy is never diagnostic alone : if there is endometriosis present it will be excised. Furthermore, if medical therapy is trialled and pain persists then laparoscopy is the next step.
Stronger medications, such as Visanne or Zoladex, are utilized to manage recurrent or chronic pain prior to more definitive measures, or to determine if the chronic pain is indeed gynaecological in origin.
Analgaesic medication is used in conjunction with my pelvic floor physiotherapy colleagues and Pelvic pain team.

Approach to Persistent Pain After Surgery: Endometriosis represents a chronic disease and I believe that pain pathways are laid down over years, like a highway of stimuli from the source in the pelvis, to the sensory cortex and back to the pelvis. As such, it is not unusual to experience recureent symptoms in the same areas as the initial presentation, even if the stimulus is minor. Whilst all physicians hope that their patients experience rapid and permanent relief from excising disease, I am aware of the concept of visceral sensitization and the strategies needed to reduce chronic pain symptoms for this group of women. Accordingly all endometriosis patients are reviewed annually until they feel they no longer need to be seen, offered hormonal therapy following surgery if fertility is not immediately desired and then work as a team to strategize the best plan for chronic pain sufferers, often involving clinicians listed below..

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3 years ago

Dr. Stylianos Kogeorgos

Dr. Stylianos Kogeorgos, M.D.

Dr Stylianos Kogeorgos – Endometriosis Specialist, Gynecologist, Minimally Invasive Gynecologic Surgeon

Summary: Dr Stylianos Kogeorgos is a dedicated endometriosis doctor in Athens, Greece, specializing in the diagnosis and treatment of endometriosis. As a highly skilled gynecologist and minimally invasive surgeon, Dr Kogeorgos offers personalized care to women affected by this complex condition. He recognizes that while the exact cause of endometriosis is still unclear, factors like hormones, immune system responses, and genetic influences play a significant role in its development.

Dr. Kogeorgos uses a range of treatments to manage symptoms, including progestogens, hormonal contraceptives, and intra-uterine devices (IUDs), with a focus on improving quality of life. His approach also includes extensive follow-up care for patients post-surgery, emphasizing pelvic floor therapy and collaboration with pain specialists to manage persistent pain.

For women seeking support from an experienced endometriosis doctor in Athens Greece, Dr Kogeorgos combines evidence-based treatments with compassionate, patient-centered care.

City: Athens, Greece

Philosophy: Endometriosis is an estrogen-dependent disease but its exact etiology remains unclear but several regulatory factors are known to support the development or maintenance of the disease.
There are many theories also like, Uterine Peristalsis, Hormones, Lymphatic System, Immune System, Oxidative Stress, Apoptosis genetic and epigenetic factors.
These theories should be taken as hypotheses that need further research to be validated. This is why it is so crucial to keeping investing and funding in endometriosis research within the medical community.
We will be working to support increased research funding, awareness, and advance policy around endometriosis.

Medication: There is no single option that is clearly superior to others, when it comes to symptomatic endometriosis.

Progestogens cause changes in the micro-environment of the deep endometriosis lesion and brings positive results.
The combined hormonal contraceptive (OCP) and the Gnrh agonists are not inferior to progestogens in symptom control.
The intra-uterine Levonorgestrel device (Mirena) is also associated with improved symptoms and reduction in the size of deep endometriosis lesions.
We present all options with the appropriate explanation of the goal and risks of therapy and we start with the commonly used options of a combined hormonal contraceptive or progestogen pill.

Approach to Persistent Pain After Surgery: I liberally use and encourage pelvic floor therapy and pain specialist consultation and follow-up pre and post-operatively.

Patients are followed up closely after operations routinely followed up at 6 months, 12 months, and yearly after that regarding pain, fertility outcomes, gastrointestinal complaints, etc.
The feeling of pain in endometriosis appears to be associated with complex changes in the peripheral as well as central nervous systems, for persistent pain after surgery, if the surgery was complete we try to start clinical treatment for those women not desiring pregnancy in order to induce ovulation suppression.
Treatments as physical therapy to treat myofascial pain, physical activity, acupuncture and nutrition may play an important role.
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3 years ago

Mr Waseem Kamran

Mr Waseem Kamran

Mr Waseem Kamran – Consultant Surgical Gynecologist, Endometriosis Specialist

Summary: Mr Waseem Kamran is a highly skilled consultant surgical gynecologist and endometriosis specialist based in Dublin, Ireland. With a deep understanding of the genetic and embryonic origins of endometriosis, Mr. Waseem Kamran brings a comprehensive approach to diagnosis and treatment. His approach to endometriosis is based on the principles of radical cytoreduction, similar to that used in metastatic disease processes, ensuring the best possible outcomes for his patients.

With a focus on excision surgery (performed in 99% of cases), Mr. Waseem Kamran specializes in removing endometrial tissue to improve quality of life. He also uses hormonal treatments like progestogens and GNRH analogues, both before and after surgery, to manage symptoms.

For patients dealing with persistent pain post-surgery, Mr. Waseem Kamran often recommends hormone treatment and medications like pregabalin, particularly when deep nerve surgery has been performed. His care is tailored to each patient’s needs, ensuring a compassionate and effective approach.

City: Dublin, Ireland

Philosophy: Genetic- Embryonic origin and hence disease distribution can occasionally pose diagnostic dilemma
Treatment approach is the one used for metastatic disease process- radical cytoreduction

Surgery technique: 

99% excision
1% ablation in certain cases- ovarian/spleen

Medication: progestogens- pre and post-op
GNRH analogues- pre-op in a select number of cases

Approach to Persistent Pain After Surgery: Hormone treatment
Pregabalin especially if deep nerve surgery is done

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3 years ago

Dr. Aoife O Neill

Dr. Aoife O Neill, Minimally Invasive Gynecologic Surgeon, Endometriosis Specialist

City: Dublin, Ireland

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3 years ago

Dr. Jessica Kresowik

Dr. Jessica Kresowik, Endometriosis Specialist, Minimally Invasive Gynecologic Surgeon, Reproductive Endocrinologist

City: Iowa City, Iowa, USA

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3 years ago

Dr. Jordan Klebanoff

Dr. Jordan Klebanoff, M.D.

Endometriosis Specialist, Gynecologist, Minimally Invasive Gynecologic Surgeon

Summary: If you’re seeking expert care for endometriosis, Dr Jordan Klebanoff is a trusted specialist dedicated to helping women improve their quality of life. As both a gynecologist and minimally invasive surgeon, Dr Klebanoff brings deep expertise and compassionate care to each patient he treats in Philadelphia, PA.

Dr Klebanoff understands that endometriosis is a complex condition with many possible causes, including embryologic, genetic, and environmental factors. He specializes in wide excision surgery, which aims to remove even microscopic disease and offer lasting relief.

For patients who aren’t considering surgery, Dr Jordan Klebanoff offers personalized medical management, including non-narcotic pain relief and hormonal therapies. He also works closely with pelvic floor physical therapists, pain specialists, and gastroenterologists to provide a comprehensive, patient-centered approach to care before and after surgery.

City: Philadelphia, PA, USA

Philosophy: I believe that we have an incomplete understanding of the origins of endometriosis, however, that the theory of retrograde menstruation as the sole explanation falls well short of describing this complex disease. My belief is that there are likely many factors to explain this disease embryologic, genetic, environmental, etc. The theory that I believe most completely and rationally explains this disease process is an issue during embryologic development. This is why I believe excision surgery most thoroughly improves quality of life. Wide excision surgery will remove microscopic disease whereas localized excisions or ablation can fall short.

Medication: For patients not immediately, or ever, interested in surgery I will utilize non-narcotic pain medications and hormonal regulation where appropriate. Whether or not I recommend hormonal suppression, most often with an oral progestin, following excision surgery is based on individual patient preference and expectation. My typical counseling for patients is that whether it be medical management or surgical management my mission will always be to continue to improve quality of life in any way that I can.

Approach to Persistent Pain After Surgery: My approach to persistent symptoms following surgery is consistent to my approach before surgery. Because pain from endometriosis is often multifactorial I work closely with pelvic floor physical therapists, pain management specialists, sexual medicine providers, and gastroenterologists both before and after surgery. My counseling of patients for any symptoms after an excision surgery patients can depend on the specific symptom or what therapies have previously been tried and failed.

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3 years ago

Dr. Soorena Fatehchehr

Dr. Soorena Fatehchehr, M.D.

Dr Soorena Fatehchehr – Endometriosis Specialist, UroGynecologist, Minimally Invasive Gynecologic Surgeon

Summary: Dr Soorena Fatehchehr, MD, is an experienced endometriosis specialist and urogynecologist in Long Beach, CA. Dr. Fatehchehr focuses on minimally invasive techniques for treating endometriosis, including excision surgery, and emphasizes the importance of individualized care. His approach to pain management post-surgery involves a combination of pelvic floor physical therapy, Botox injections, pain psychology, and relaxing exercises like yoga. For patients dealing with persistent pain, Dr. Fatehchehr recommends imaging and, in some cases, a second surgical look. He often starts treatment with temporary ovarian suppression using birth control pills, particularly after excising ovarian endometriomas. Whether you’re seeking expert care for endometriosis or need ongoing support, Dr. Soorena Fatehchehr offers a comprehensive, patient-centered approach to help you on your journey to better health.

City: Long Beach, CA, USA

Philosophy: Excision of endometriosis

Medication: Temporary ovarian suppression with birth control pills after excision of ovarian endometrioma

Approach to Persistent Pain After Surgery: It depends on the timeline of the persistent pain, location and severity: Usually 3 months post op: Pelvic floor physical therapy, Botox injection to the pelvic floor, pain psychologist, pain management, relaxing work out including yoga. If the pain persists for a year then imaging and possible second look.

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3 years ago

Dr. Marc Possover

Dr. Marc Possover, Endometriosis Specialist, Gynaecologist, Minimally Invasive Gynecologic Surgeon

City: Zürich, Switzerland

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3 years ago

Dr. Andres Sacristan

Dr. Andres Sacristan, Endometriosis Specialist, Gynaecologist, Minimally Invasive Gynecologic Surgeon

City: Madrid, Spain

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3 years ago

Dr. Karina Datsun

Dr. Karina Datsun, Endometriosis Specialist, Gynaecologist, Minimally Invasive Gynecologic Surgeon

City: Glasgow, Scotland

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3 years ago

Dr. Marcello Ceccaroni

Dr. Marcello Ceccaroni, Endometriosis Specialist, Gynaecologist, Minimally Invasive Gynecologic Surgeon

City: Verona, Italy

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3 years ago

Dr. Antonio Lagana

Dr. Antonio Lagana, Endometriosis Specialist, Gynaecologist, Minimally Invasive Gynecologic Surgeon

City: Sicily, Italy

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