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Pediatric endometriosis
Endometriosis is classified as a disease of reproductive age. In reality endometriosis affects a much wider category, being either undiagnosed or misdiagnosed. One of the origin theories of endometriosis demonstrates that endometriosis is caused by a genetic defect that we are born with and over time, when women reach puberty, under the influence of estrogen, it activates and starts to cause pain. In most cases, different kind of pain appears with or after the first period. However, there are also cases when pelvic pain occurs before menstruation. It would be
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Pudendal Neuralgia. Decompression of the pubic nerve. Risks and side effects
Pudendal neuralgia is an extremely frequent urological, gynecological, and neurological pathology, but extremely underdiagnosedThe most common symptoms of pudendal neuralgia are:urinary disorders - similar to urinary infections which are often confused with and improperly treated; most of the time, PN is diagnosed as 'interstitial cystitis', an extremely rare pathology that definitely requires histopathological confirmation.vaginismus - most of the time patients cannot have a normal sexual lifedigestive disorders - especially in the lower digestive tract - constipation, rectal tenesmusperineal pain, pelvic painpain/paresthesia at the level of the internal face of the
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Pudendal Neuralgia
Another important cause of pelvic pain, and missdiagnosed, along with endometriosis/adenomyosis, is represented by pudendal neuralgia (external pubic nerve). This delay in diagnostic happens because there is still no well-established specialty for this pathology (a few exceptions). I am convinced that until recently (about a year ago), attributing the presence of pelvic pain to endometriosis/adenomyosis, I 'missed' this diagnosis many times. However, the pain in this pathology is different from that caused by pelvic endometriosis/adenomyosis from many points of view. That is why the discussion/dialogue with the patient
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How you can find meaning in suffering
Endometriosis is a disease that significantly reduces the quality of life. It affects all aspects of one’s life, limiting or making it impossible to have a social life, a sexual life, to work and to have a family. Some find relief in alternative therapies, others manage to get excision surgery that improves their lives. Unfortunately, not all find relief with surgery, even if it was performed by a specialist. Sometimes additional therapies and treatments are needed to fix all the other comorbidities associated with endometriosis. Most people affected by endometriosis also
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Toxicity of Positive Thinking for people suffering from endometriosis
“Other people have it worse than you! You should be thankful for the good things in your life/Things could be worse”. How many times have you heard those frases? While recovering from extensive surgery, while struggling to function in day to day activities, while living in pain, while struggling to conceive, while trying to get over pregnancy loss, while trying to convince doctors that your pain is real, while your relationships fall apart, people find it appropriate to “comfort” you by burdening you with positive incentives. Positive thinking and the
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Right to reply- public criticism in Delo, newspaper from Slovenia
A few patients from Slovenia made me aware that in an article about endometriosis patients and their struggles, there is also criticism about me. The article is called “A silent disease we should talk about out loud” and based on google translation it also mentions that more and more patients are travelling abroad for surgery, because of the lack of treatment in their country. https://www.delo.si/novice/slovenija/tiha-bolezen-o-kateri-bi-morali-glasno-govoriti/ In the said article, Prof. Dr. Eda Vrtačnik Bokal, Ph.D. med. the head of the Clinical Department of Reproduction at the University Medical Center Ljubljana and the
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Memoriu către membri ai parlamentului României-endometrioza/adenomioza
Stimati senatori si deputati, Vă adresez acest memoriu pentru a vă solicita implementarea unei propuneri legislative destinate sănătății femeii, care să includă endometrioza și adenomioza. Consider că, în calitate de deputati și senatori si membri al unuia dintre partidele politice care se află la guvernare, sunteți în măsură să discutați în Parlamentul României aceste două afecțiuni medicale care sunt o problemă de sănătate publică. Pentru a sprijini acțiunile comunității pacientelor cu endometrioză, în noiembrie 2020 am adresat o scrisoare deschisă Guvernului României și Ministerului Sănătății, în care ofer informații despre impactul socio-economic al acestor
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Excision vs ablation
Excision doesn't damage the tissues, therefore a biopsy of the excised tissues can be obtained, confirming the diagnosis. When it is done by an experienced endometriosis specialist, excision surgery has a low rate of recurrence, reducing the symptoms and improving fertility, thus having a positive impact on the patient's life. The effectiveness of excising implants has been noted in clinical trials and through direct patients’ observation . Both methods noted that excision of endometriosis resulted in fewer symptoms years after surgery in comparison with patients who underwent ablation surgery, and the
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Memoriu către membri ai parlamentului României-endometrioza/adenomioza
Stimati senatori si deputati, Vă adresez acest memoriu pentru a vă solicita implementarea unei propuneri legislative destinate sănătății femeii, care să includă endometrioza și adenomioza. Consider că, în calitate de deputati și senatori si membri al unuia dintre partidele politice care se află la guvernare, sunteți în măsură să discutați în Parlamentul României aceste două afecțiuni medicale care sunt o problemă de sănătate publică. Pentru a sprijini acțiunile comunității pacientelor cu endometrioză, în noiembrie 2020 am adresat o scrisoare deschisă Guvernului României și Ministerului Sănătății, în care ofer informații despre impactul
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Awareness without borders
Awareness doesn’t just mean showing numbers and statistics. By now almost everyone in the endometriosis community is aware of the many aspects and problems the disease causes. The difficulties lie essentially in the medical systems and in the political decisions taken by each state. But what about people outside the endometriosis community? What about the people who are just now finding out that they have something called endometriosis? They are just starting on the bumpy road that lies ahead, not knowing the many challenges they will face. For them, people like
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Testimonial de Martie
În cadrul campaniei de conștientizare a endometriozei prezentăm o serie de mărturii ale pacientelor. Vom vorbi despre boală, despre impactul ei asupra vieții și experiența operației. Echipa centrului de endometrioză întâlnește cazuri ce prezintă forme agresive ale bolii, unele necesitând intervenția tuturor specializărilor ce compun echipa multidisciplinară. Complexitatea patologiei și nivelul de afectare al organelor pot indica gradul de risc pentru complicații ulterioare și un timp de recuperare mai lung. Cazul de mai jos reprezintă un exemplu în care s-a apelat la ileostomă
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One year post excision-Ireland to Romania
Our job is done when you don’t need us anymore and when you can say with all confidence that you feel healthy and ready to go on with your life. We are very grateful for the feedback you give us as it helps us evaluate our work. We continue to publish stories and impressions regarding the lives of patients one year after the surgery. One of our patients was kind enough to answer a few questions. She told us about her experience before, during and after the surgery and
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When there is hope!
This is a comment left on our Facebook page from a patient who travelled to have surgery with Dr Mitroi. It took me a bit to collect years of stories in one review, but I hope we can still add to this
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Când există speranță!
Acesta este un comentariu lăsat de o pacientă de ale noastre din Slovenia. Într-o lume în care pacientele cu endometrioză și adenomioză sunt neglijate există și medici care au ales să le ajute. A fi medic înseamnă să percepi medicina și în dimensiunea sa umanistă, nu numai în latura sa tehnică. Cu alte cuvinte, știință în medicină trebuie să aibă și conștiință! Vasile Astarastoae A durat ceva timp pentru a putea rezuma povestea multor ani într-un singur comentariu dar sper că mai putem inca contribui la aceasta postare. Ps: îmi cer scuze pentru lungimea
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Thoracic endometriosis syndrome
Thoracic endometriosis syndrome: a review of diagnosis and treatment is a review study done by Nezhat et al., focusing on thoracic endometriosis syndrome. Thoracic endometriosis is endometriosis found within the lung parenchyma or on the pleural surface. Some studies mention endometriosis on the diaphragm as part of the thoracic endometriosis as well. Thoracic endometriosis syndrome consists of a range of clinical manifestations such as catamenial pneumothorax, hemothorax, hemoptysis, and pulmonary nodules. The review mentioned above concluded that thoracic endometriosis syndrome can cause incapacitating symptoms for some patients. Symptoms are nonspecific, so a
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How far can you travel to have excision surgery?
How far can one travel for medical care? Why despite being such common illnesses, some endometriosis and adenomyosis patients need to go abroad for care? We caught up with one of our patients who traveled from the Philippines to have surgery with Dr Mitroi, to see how she is. A year ago you travelled to Romania to have your surgery. How are you now and how was your recovery? J.My recovery period has a lot of ups and downs. The first 3 menstruations post-surgery were really intense and painful but these were
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Excision technique- Bucharest Endometriosis Centre
Endometriosis surgery is one of the most complex laparoscopic procedures, requiring meticulous exposure and dissection of the abdominal and pelvic organs. Therefore, it is necessary to use at least four trocars: a trocar placed at the level of the navel through which a laparoscope is inserted and, three trocars operators placed at both iliac (right, left) and the suprapubic level. During operations for deep endometriosis, the patient is placed on the operating table in 'lithotomy position' (gynaecology position). This facilitates access to the vagina and rectum, something that is necessary
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The role of physiotherapy after surgery
The first steps after surgery can be very hard due to post op pain, which can cause some difficulties. Also depending on the type of anaesthesia used and the way that gravitational forces work when lying on the back, when wanting to sit up or get out of bed, we can feel dizziness, nausea, difficulty in breathing, and general pain in the muscles or pain at the incisions. Physiotherapy is, therefore, recommended/used to help patients that have such symptoms. The post operative physiotherapy program aims to help patients in a few
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One year after excision surgery
Sophia is one of the endometriosis patients that after more than 25 years since her symptoms have started, and after being dismissed by doctors in her country, she decided to go abroad for surgery. One year after her surgery with Dr Mitroi, Sophia is doing well and as she says, able to fight for her rights to medical care and help others as well. At what age you have had your first symptoms? S. I started having symptoms when I was 13 years old. I remember going to the ER and
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GnRH side effects
Some side effects of GnRH are usual menopause symptoms such as hot flushes, mood changes, anxiety, vaginal dryness, headaches, dizziness, nervousness, irritability and sleeplessness, depression and other mood disorders. Other side effects are more severe such as pain & fibromyalgia, musculoskeletal & articular disorders, memory and psychotic disorders, autoimmune thyroiditis, blood sugar rise, difficulty breathing, chest pain, liver function abnormality, vision abnormality and others. Drugs such as Zoladex, Lupron, Diphereline, were originally developed for prostate cancer patients and at the moment are used to treat patients with endometriosis and fibroids. In
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Peer vetted endometriosis surgeon
We are happy to announce that Dr. Gabriel Mitroi has joined our platform after passing iCareBetter video vetting for endometriosis excision experts. iCareBetter logo has been added to Dr. Mitroi’s name in Nook's Doctors list so we all know that he has passed the assessments of the top experts. Our mission is to facilitate the delivery of high care to patients by helping patients choose their doctors early in their patient journey. We invite all doctors who are passionate about improving endometriosis care to join us. You can learn more
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Extrauterine adenomyoma
Adenomyois is the presence of endometrial tissue in the myometrium. The uterus has layers and normally, the endometrium and myometrium do not mix. In adenomyosis they do mix. Uterine adenomyoma is a circumscribed nodular aggregate of benign endometrial glands surrounded by endometrial stroma with leiomyomatous smooth muscle bordering the endometrial stromal component. It may be located within the myometrium, or it may involve or originate in the endometrium and grow as a polyp (pubmed). Four theories are proposed in the literature for the pathogenesis of extrauterine adenomyoma: the Müllerian duct fusion defect theorythe
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Why surgery is indicated and why some patients are scared of having (another) surgery? by Dr Gabriel Mitroi
I am often asked by patients who are coming for a consultation and have been suffering for years with deep endometriosis affecting the intestines, bladder, etc., a very pertinent question: Why should I have surgery if the disease has no cure and after surgery, it will recur? This question has to do mainly with the fact that patients that have been suffering for years with pelvic pain (5-10 years) and have had bad medical experiences. Endometriosis patients that most of the time put their own diagnosis, have been neglected by various
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Endometriosis de la A la Z-Manual de endometriosis
Endometriosis de la A la Z-in spanish! Finally, after a couple of months, our guide is now available in Spanish as well. Many thanks to the ladies who helped us with translation. You can download the guide here Endometriosis de la A la Z
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Post-operative pain following endometriosis surgery
Surgery for deep infiltrating endometriosis is one of the most complex laparoscopic operations. As I often tell my patients, these surgeries are sometimes a major "injury" to the body, a major physical trauma. This is due to the extensive dissection that must be performed in a narrow space (pelvic space), a ‘crowded place’ of visceral structures (internal genital organs, rectum, bladder, ureters), vessels and nerve fibers. During these interventions organs are pulled, sometimes damaged, nerve fibres may be sectioned during the excision of the endometriosis lesions, meaning that sometimes the patient can
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Excision vs ablation
Excision doesn't damage the tissues, therefore a biopsy of the excised tissues can be obtained, confirming the diagnosis. When it is done by an experienced endometriosis specialist, excision surgery has a low rate of recurrence, reducing the symptoms and improving fertility, thus having a positive impact on the patient's life. The effectiveness of excising implants has been noted in clinical trials and through direct patients’ observation . Both methods noted that excision of endometriosis resulted in fewer symptoms years after surgery in comparison with patients who underwent ablation surgery, and