Gupta AK, Renaud HJ, Wang T, Cooper EA, Mann A, Polla Ravi S
10.1111/rda.13696 12
excision and why incomplete excision can be worse than no surgery What peek and shriek means and when doing less is actually safer Why insurance reimburses a 15-minute ablation the same as a multi-hour excision The shocking reality that there is no laparoscopic billing code for some complex procedures Why removing ovaries does not cure endometriosis even though its often presented as a solution The statistic that expert excision may result in only 1019% recurrence or persistence over 7 years , compared to much higher rates in non-specialist settings Why women with endometriomas have over 50% likelihood of bowel involvement How deep infiltrating disease near the ureter and hypogastric nerves can impact bladder, bowel, and sexual function Why hysterectomy may help adenomyosis , but does nothing for disease outside the uterus What questions immediately reveal whether a surgeon is truly trained in complex endometriosis surgery Why physical therapy before surgery can dramatically improve outcomes How fatigue, bloating, and shoulder pain after surgery are normal and what symptoms are true red flags Why endometriosis lesions can produce aromatase , allowing them to create their own estrogen supply The role of multidisciplinary teams colorectal surgeons, urologists, thoracic surgeons in advanced disease How IVF stimulation can exacerbate endometriosis and why patients should be counseled about this risk Why many recurrences are actually persistent disease that was never fully removed This episode is essential listening for anyone navigating surgical decisions for endometriosis
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Prior to surgery is it beneficial to use decompressive therapy including compression garments, manual lymphatic massage and lymph-press or pneumatic devices to reduce inflammatory fluid in the legs
