Those living with endometriosis are often misdiagnosed and misunderstood. Many patients wait up to 10 years to receive the treatment they need and deserve. Even worse, they may receive poor treatment, which can affect their fertility unnecessarily. At Seckin Endometriosis Center (SEC), we always advocate for a patient-centered and individualized care approach. We design our standard of care to be empathetic, rational, and scientific. We also aim to maximize patient comfort and put the patient’s goals first.
Our mission is to share our experience of over 40 years in exclusive endometriosis treatment and to provide a resource the community can trust.
The information here outlines the best treatment options available, which can help you make informed choices. We hope that this site will help you understand how our perspectives on the disease are different from that of most healthcare centers. These philosophies shape and influence our treatment approach for the best possible outcome, with compassion being always at the core.
Pain during the journey of endometriosis may occur, but suffering is optional.
Dr. Seckin unique perspective on endometriosis
Experience teaches us that there is more to endometriosis than what you see in routine diagnosis. Many doctors fail to recognize more than 50% of lesions during surgical treatment. Thus, standard surgery may not result in complete or long-term symptom relief. There are even increased risks of recurrence or progression of the disease.
Our center understands the variety of ways this disease can manifest. Although endometriosis is synonymous with chronic pelvic pain, the reality is that the disease can begin much earlier. Other aspects that precede pelvic pain often include gastrointestinal and urinary symptoms. Our surgical procedures further factor in the impact of fibrosis on the pain that is unique to endometriosis. We consider all these aspects during diagnosis and treatment.
An innovative approach to treatment
One of the innovations that set our approach apart from other healthcare centers is our patented Aqua Blue Contrast™ technique (ABCT).
Peritoneal endometriosis lesions present themselves in both pigmented and non-pigmented forms. The non-pigmented ones are particularly difficult to see under bright laparoscopic light. Our ABCT visualization strategy helps us to “uncover” these non-pigmented lesions and help in complete excision.
The non-pigmented fibrotic lesions house endometrial glands and result in inflammatory responses that promote the growth of adhesions and fibrosis. We study the entire area around both pigmented and non-pigmented lesions and remove them completely using a ‘cold excision’ technique without the use of heat or electricity. This prevents damage to healthy tissues.
We pride ourselves in being one of the very few healthcare centers having the expertise to perform unique techniques such as ovarian suspension, uterine suspension, and omental transposition. These techniques aim to maximize excision rates while restoring or preserving anatomical structure and function.
Another unique aspect of our treatment approach is that we believe in meticulous control of bleeding at the capillary level. This reduces adhesions and potential scar tissue between the bowels and the organs of the reproductive tract.
Compassion individualized care
Endometriosis is a deeply personal disease. Many patients have had multiple ineffective or even traumatic experiences within the healthcare system. They may struggle to fully explain their experiences or even have a general distrust of physicians. We encourage an open space for each patient to share their symptoms and experiences. We fully believe that we can help patients with endometriosis and restore their quality of life.
Many describe varying degrees of nerve pain, painful bleeding, and gastrointestinal symptoms. Others may have experienced the unfortunate consequences of recurrent miscarriages, failed IVF cycles, and broken relationships. Each symptom helps to draw a roadmap into the patient and helps us create an individualized approach. When patients say that they have pain during sex or suffer from sciatic pain, we draw from experience as to what could be the likely cause of these symptoms.
For instance, with bowel endometriosis, we try to understand not just the associated pain with bowel movements, but the discomfort, the nature of bowel movements, the pattern of fecal discharge, and the presence of bloating, gas, or nausea. In-depth questioning helps us know how the symptom is affecting the patient’s quality of life, rather than just checking off a box on paper.
Endometriosis can be managed with medications or other therapies, but the most effective treatment plan involves multimodal care with surgery.
Methodical diagnosis approach
We use several diagnostic tools to evaluate the presence of endometriosis. Each technique helps, but each comes with limitations. So, we do not make a presumptive diagnosis based on a single test alone.
After the initial medical history, we perform a comprehensive physical exam of the cervix, cul-de-sac, rectovaginal septum, and pelvic side wall. Initial imaging techniques often include a pelvic MRI or sonography. However, these imaging techniques can only detect lesions if they are more than 1 cm. So, many early-stage endometriosis patients will have no abnormal findings.
Everything discussed so far helps to set the stage for further surgery planning.
Patient-centered disease staging
Societies such as the American Society of Reproductive Medicine (ASRM), the American Association of Gynecologic Laparoscopists (AAGL), and the Enzian system of classification have all staged endometriosis based on symptom severity. However, Dr. Seckin believes that this system is not practical since symptom severity typically does not correlate with disease staging. It is common that a patient with stage 4 endometriosis may not experience debilitating symptoms, while a woman in excruciating pain may only have stage 1 disease based on the Enzian system.
Apart from the standard four-stage classification system, Dr. Seckin’s classification also considers a fifth stage that characterizes extra-pelvic endometriosis. He prefers using a descriptive classification that is based on visual inspection inside the pelvis and abdomen, and the extent of symptoms.
Unfortunately, pharmaceutical companies tend to sell the fact that you can diagnose endometriosis without surgery. Endometriosis can only be diagnosed by laparoscopic excision surgery followed by a histological examination under a microscope by a pathologist.
Low recurrence rates
Conventional treatment approaches result in the recurrence of endometriosis symptoms as high as 30 to 40%. At SEC, our recurrence rates have been less than 10%.
However, the concept of recurrence needs to be looked into with the right perspective. A patient coming back with fertility concerns is different from one coming back with pain or other gynecological issues. This should not be considered as traditional recurrence. Less than 10 to 15% of the lesions removed during laparoscopic deep excision surgery recur. This is likely due to the large extent of fibrosis (scarring) near these lesions. While there is a slim chance that peritoneal endometriosis may recur, ovarian endometriomas rarely do if resected completely.
Another reason for recurrence could be patients not practicing effective post-operative medical management, such as stopping periods to prevent retrograde menstruation. Therefore, educating the patient is also at the core of our philosophy to increase disease awareness and minimize recurrence.
At SEC, we believe that endometriosis is not only about a particular individual but also about factors surrounding the individual. This forms the cornerstone of our compassionate and empathetic approach to patient care.
Get a Second OpinionOur endometriosis specialists are dedicated to providing patients with expert care. Whether you have been diagnosed or are looking to find a doctor, they are ready to help.
Our office is located on 872 Fifth Avenue New York, NY 10065.
You may call us at (646) 960-3080 or have your case reviewed by clicking here.