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Common Questions about Endometriosis

On the Know & Do Better Podcast we featured Dr. Lora Liu, a board-certified, minimally invasive gynecologic surgeon who specializes in the management of difficult gynecological surgeries, including severe, endometrial losses, difficult hysterectomy, large fibroid removal, and other complex gynecological conditions. 

About Dr. Lora Liu

Dr. Liu completed a four-year OB-GYN residency training at North Shore, Ellijay Lenox Hill Hospital in Manhattan, New York, followed by a rigorous two-year fellowship in minimally invasive gynecologic surgery at the Mayo Clinic, where further expertise was developed in robotic, laparoscopic and vaginal surgery with a special interest in laparoscopy and robotic endometriosis surgery. She also has research in gynecological surgery that has resulted in presentations at numerous professional meetings, as well as publications and peer-reviewed journals. 

What is Endometriosis?

Endometriosis is abnormal tissue that is found in the pelvic cavity and the abdominal cavity typically is outside of the uterus. The tissue is found outside of the uterus and can implant on the pelvic sidewalls. It can plant on the bowels, the bladder, diaphragm, long colon, appendix, and ovary. 

Endometriosis Symptoms & Diagnosis

The average time that it takes to get diagnosed with Endometriosis is ten years. That’s ten years that women are going from doctor to doctor. Unfortunately, the only way to diagnose and treat is going to be with a laparoscopy. A lot of the most common symptoms are very painful and heavy periods that affect your life such as calling out sick for work because you’re in so much pain that you can’t even get to work. Other symptoms include painful sex, especially with deep contact, a lot of bowel dysfunction, and bladder dysfunction, especially around the time of your period. 

Endometriosis Research

There’s research out there that is looking more like a cellular level RNA sequencing, looking more into genetics. Endometriosis might be pathogenesis but research hasn’t concluded. All we can do is treat it and manage it.

Surgical Treatment of Endometriosis

Typically, if a patient comes with heavy periods and suspected endometriosis, OBGYNs puts a patient on birth control pills that aids in limiting the symptoms. However, if a patient is having a hard time finding birth control that works for them and they’ve gone to physical therapy for pain management yet still have debilitating periods, surgery may be needed to increase their quality of life.

Many times Dr.Liu has seen patients where MRI, ultrasound, and  CT scans show up with negative, normal pelvis, with no pathology found. Yet going in for surgery, she sees there’s tons of disease. Since it’s not these big, bulky masses.

To perform a minimally invasive surgery is called a laparoscopy, so the patient is totally asleep. Dr. Liu inflates their belly up with gas and then sticks a small camera down into their belly to see their diaphragms or liver lobes, gallbladder, stomach, and appendix. Then, she looks at the pelvis, uterus, fallopian tubes, ovaries, and bladder rack behind the uterus. A lot of endometriosis hides under the retroverted uterine space, the most dependent part of a woman’s body. To remove the abnormal tissue is called an excision. It is then sent to the pathologist, who looks at it under a microscope to get a diagnosis. It is a tiny incision about 8 millimeters deep where patients go home the same day with over-the-counter pain relief. 

Thank you, Dr. Lora Liu. Listen to the Know & Do Better Podcast on Spotify, Apple Podcasts, and YouTube. 

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