Endometriosis is a female disease in which endometrial-like tissue is found outside of the uterus in other parts of the body. Lesions are characterized as estrogen-dependent, benign, inflammatory, stem-cell driven and at times progressive with diffuse fibrosis, deep infiltration, and resistance to apoptosis (cell death) and progesterone. This tissue, which normally lines the uterus, is associated with monthly menstruation and is often characterized by abnormal painful and heavy periods, as well as pelvic pain, severe cramps, and pain with sex. (dyspareunia).
Endometriosis is a painful reproductive disorder that affects 176 million women worldwide . The economic impact of the disease is staggering: Businesses lose billions of dollars each year in lost productivity and work time because of the disease. A leading cause of infertility and chronic pelvic pain, it has also been linked to other health concerns, including certain autoimmune diseases, fibroids, adenomyosis, interstitial cystitis, and even certain cancers. It is also one of the leading reasons for laparoscopic surgery and hysterectomy in the United States.
Where does it occur in the body?
Typical: It typically develops on the pelvic structures including the ovaries, fallopian tubes, bladder and bowels (intestines).
Common: It is common for the disease to develop on the top of the vagina (anterior cul-de-sac) and in the peritoneal cavity between the rectum and the posterior wall of the uterus (posterior cul-de-sac).
Rare: The disease can spread to the diaphragm, lungs, kidney, appendix, and, surprisingly, the gastrocnemius (calf muscles).
What are the stages?
American Society of Reproductive Medicine Severity Classifications
What are the Descriptive Classifications?
Because the 4 commonly used classifications of the disease do not have any correlation to a patient’s symptoms or the nature of the infiltration itself, we often use a more descriptive system:
Painful menstrual cramps (dysmenorrhea or "killer cramps")
Heavy menstrual bleeding (menorrhagia)
Chronic pelvic pain
Pain upon intercourse (dyspareunia)
Abdomen pain and bowel dysfunction that includes painful bowel movements, diarrhea, bloating, gassiness or cramps
Bladder dysfunction, such as painful urination
Weakness, numbness or pain in nerves (neuropathy)
Personality changes (depression, stress, apathy)
What is the first step needed in order to diagnose?
Before any imaging is done, you should speak with a GYN physician who is familiar with diagnosing endo and can provide a full comprehensive pelvic exam. Between the physical exam and informing them of your symptoms and past medical history, a physician will have a better understanding if imaging tests are needed.
What are the imaging tests used to identify?
In order to properly diagnose a patient with endo, one or multiple of the following imaging tests must be conducted in order to ensure that a patient is in need of surgery:
What imaging tests help definitively diagnose during surgery?
While in an operating room, a well-trained and experienced GYN surgeon will be able to visualize any anatomical abnormalities or endometriosis lesions through the following tests:
How is it detected?
While a physical exam and other imaging tests can give insight into whether or not a patient may have endo, the only way to definitively diagnose endometriosis is through laparoscopic excision surgery. This must be accompanied by a biopsy sample that is sent to pathology in order to confirm a diagnosis of the disease.
What are the treatments?
There is currently no cure for endo but there are surgical and non-surgical treatment options for pain and infertility related to the disease.
What are non-surgical ways that can relieve symptoms?
It is important to note that the following methods are not treatments of the disease itself, but rather are a mean to control a patient’s pain and symptoms. They provide a relief, not a cure.
What surgical procedures can be performed during surgery?
There are a variety of surgical treatments that a patient can undergo to treat endo depending on the severity, stage, and abundance of the endometrioma lesions.
As a patient, your health and wellbeing come first. Having had decades of experience, we know that this is the most important aspect in treating the disease. Every patient is different and therefore every patient must be heard.
Menoka M. was experiencing severe pelvic pain for the past seven years and was not diagnosed with endo for nearly five years. After seeing many doctors and having several surgeries, Menoka found us and was soon scheduled for laparoscopic deep excision surgery. Read about Menoka's journey here, as well as how she is doing now.
You can read more stories of patients with endo, of varying stages, in our testimonial section.
Our office is located on 872 Fifth Avenue New York, NY 10065. You may call us at 212-988-1444 or have your case reviewed by clicking here.
I have struggled with endometriosis and adenomyosis since first starting my period at 13. I was diagnosed at 21 and what followed was a series of unsuccessful surgeries and treatments. My case was very aggressive and involved my urinary tract system and my intestines. After exhausting all of my local doctors I was lucky enough to find Dr. Seckin. We…
Like so many women who have tirelessly sought a correct diagnosis and proper, thorough medical treatment for endometriosis, I found myself 26 years into this unwanted journey without clear answers or help from four previous gynecological doctors and two emergency laparoscopic surgeries. I desperately wanted to avoid the ER again; a CT scan for appendicitis also revealed a likely endometrioma…
I am so grateful to Dr Seckin and Dr. Goldstein. My experience was nothing short of amazing. I was misdiagnosed with the location of my fibroids and have had a history of endometriosis. Dr. Seckin was the one who accurately diagnosed me. Dr Seckin and Dr. Goldstein really care about their patients and it shows. They listened to my concerns,…
When I think of Dr. Seckin these are the words that come to mind. Gratitude, grateful, life-changing, a heart of gold. I feel compelled to give you a bit of background so you can understand the significance of this surgery for me.
I am passionate about Endometriosis because it has affected me most of my life and I have a…
Dr. Seckin and Dr. Goldstein radically changed my quality of life. They treat their patients with dignity & respect that I've personally never seen in the literally 25+ doctors I've seen for endometriosis.
This summer, I had a surgery with Dr. Seckin & Goldstein. It was my first with them, but my 5th endo surgery. I couldn't believe the difference,…
I was in pain for 2 years. I was getting no answers, and because dr Goldstein and dr seckins were willing to see and treat me I'm finally feeling almost back to normal. They were very down to earth and helpful in my time of need. Dr Goldstein was easy to talk to and caring, she took care of me…
Dr. Seckin is one of the best endometriosis surgeon. Every time I go to the office, he really listens to me and is always concerned about my issues. Dr Seckin's office staff are a delight and they always work with me. I feel I can leave everything to them and they will take care of it. Thank you to the…
Fast forward 5 years to find out incidentally I had a failing kidney. My left kidney was only functioning at 18%. During this time, I was preparing all my documents to send to Dr. Seckin to review. However, with this new information I put everything on hold and went to a urologist. After a few months, no one could figure…
I had a wonderful experience working with Dr. Seckin and his team before, during and after my surgery. I came to Dr. Seckin having already had laparoscopic surgery for endometriosis 5 years prior, with a different surgeon. My symptoms and pain had returned, making my life truly challenging and my menstrual cycle unbearable. Dr. Seckin was quick to validate my…
I came to Dr. Seckin after years of dealing with endometriosis and doctors who didn't fully understand the disease. He quickly ascertained what needed to be done, laid out the options along with his recommendation and gave me the time to make the right decision for me. My surgery went without a hitch and I'm healing very well. He and…
Dr. Seckin brought me back to life! I am now 3 weeks into my recovery after my laparoscopy surgery, and I feel like a new and improved woman! Being diagnosed with Endometriosis, then 25yrs old in 2015, and discovering the severity of my case being stage 4, made me devastated. Dr. Seckin's vast knowledge of the disease, sincere empathy, and…