Endometriosis and pelvic pain are commonly misunderstood and mistreated. Successful treatment of endometriosis and pelvic pain requires addressing several essential issues in two basic categories; (1) correctly performed surgical removal of the endometriosis implants and (2) treatment of co-conditions and/or underlying conditions often associated with endometriosis. Unfortunately, many patients with endometriosis are not having either of these areas treated correctly. There is a lot of unnecessary pain and suffering as a result of the inadequate diagnosis and treatment of endometriosis.
Currently, the standard approach used by the majority of general OB/GYN’s for surgical treatment of endometriosis is ineffective and out of date. Coagulation (cauterization) or burning of the endometriosis implants is the most common surgical approach, which results in only a partial destruction of the disease. The remaining disease not removed at surgery continues to grow with return of symptoms relatively quickly (months to a year or two). In contrast, wide excision is the surgical technique used by Dr. Cook at Vital Health Endometriosis Center. The technique is similar to that used to treat skin cancer. The disease is removed with what appears to be a margin of normal tissue (in the case of endometriosis implants it includes the endometriosis and some of the surrounding normal looking peritoneum that lines the inside of the body). As patients are becoming more informed about the importance of wide excision in the treatment of endometriosis, I am now seeing operative reports where the physician statewide excision was performed but in reality, only smaller biopsies were removed leaving a fair amount of endometriosis behind. This inadequate surgery often results in patients undergoing multiple ineffective surgeries. There is no medical cure for endometriosis. It must be completely removed surgically with true wide excision.
It is well documented in the scientific literature that endometriosis specialists have higher success rates and lower recurrence rates compared to general OB/GYN’s. This should not be surprising. The concept of better outcomes with medical specialties and subspecialties is the basis of the current medical training and certification system with a variety of different medical subspecialties. Most nationally recognized endometriosis surgeons provide excellent treatment with wide excision. This is an important first step, but it is not the complete picture.
The second basic part of treating endometriosis and pelvic pain is that of treatment of co-conditions and even underlying conditions associated with endometriosis. This does not refer to pharmaceutical medical treatment, rather treatment of what is known as chronic inflammatory disease. The best approach to these conditions is integrative or functional medicine. The objective of this approach is truly becoming healthy. Surgery can remove disease but it cannot make a person healthy. The majority of people in the United States are not healthy. They may not be overtly sick, but they are not healthy. This chronic disease usually presents later in life, but with endometriosis is often necessary to address and correct these issues to get better. It includes a lot of things such as chronic inflammation, an imbalanced microbiome with resulting dysbiosis, hormonal and metabolic imbalances, lack of physical activity, poor sleep and too much stress. Many people are aware of some of these issues but do not understand their importance nor do they commit the necessary time required. Addressing these issues are especially important in patients with endometriosis and pelvic pain. It is often impossible for endo patients to recover their health without addressing these issues.
Our philosophy at Vital Health Endometriosis Center is not just treating symptoms, but one of truly removing the disease and restoring a person’s health. We do not want you to live with endometriosis, we want you to heal from the disease and move on with your life. We want endometriosis to be something in your past. This is why we have a whole integrative component as part of our endometriosis treatment program. At VHI we offer the most comprehensive approach to treating all aspects of your endometriosis and pelvic pain. Combining laparoscopic wide excision surgery with a holistic functional medicine approach to look at the whole body and treat underlying imbalances provides the best approach to the treatment of endometriosis and pelvic pain.