There are several qualifications that you want in an endometriosis specialist. You should use this page and the ones titled “Finding the Right Endometriosis Specialist” and “What to Ask an Endometriosis Specialist” together in your search. The following five points are absolute musts. There should be no compromise. Even three or four out of five isn’t enough. You should be able to find this information in online reviews, from other patients, and/or by calling the specialists directly and asking.
An endometriosis specialist
Every endometriosis specialist is a gynecologist, but not every gynecologist is an endometriosis specialist.
A gynecologist specializes in women’s reproductive health. So, going to one as a starting point for your pelvic pain or other symptoms is not a bad idea. Because they may be able to refer you to a specialist if they aren’t one themselves.
To be an endometriosis specialist, they should have specific training in endometriosis cases. This could be from a residency program, by working with doctors who have handled such cases, or by seeking their own special endometriosis training.
Many gynecologists have little, if any, experience in dealing with endometriosis patients. It is not a requirement in medical school, which is something I continue to work on changing.
Large volume of cases in laparoscopy
You want a specialist who has had a large volume of cases in laparoscopy. Laparoscopic surgery is when the doctor makes tiny incisions in the abdominal and pelvic region, and inserts a laparoscope to see inside the abdomen and pelvic cavity and identify any endometriosis. Endometriosis surgery, as complicated as it is, does not require you to have open surgery like heart surgery. It also does not require you to have huge scars. It is a minimally invasive surgery.
Deep excision surgery
If surgery is what you need to remove the endometriosis, your specialist’s method for removal should be deep excision surgery using cold scissors, or using a low-voltage carbon dioxide laser. Both methods can be done laparoscopically. The deep-excision method with cold scissors is the only one I use and the closest method we have for a cure. The low-voltage carbon dioxide laser is a special kind of instrument that can produce results similar to cold scissors. No other kind of laser surgery should be acceptable. They can do more harm than good, no matter how skilled the surgeon is.
Experience with the bowel area
Your specialist should have experience with the bowel area, namely the rectum. Or, your specialist should have a bowel specialist on their surgical team. Endometriosis is a disease of the area between the posterior vagina and anterior rectum. To think that only the vagina or uterus are involved is a fallacy. The rectum is almost always involved. If the specialist is afraid to do anything around the rectum, you need to find another specialist.
Doing a vaginal/rectal exam
In relation to No. 4, the specialist should do a vaginal/rectal exam when you visit them. And that should be the first question you ask before making an appointment: “Do you do a full vaginal/rectal exam?” If they say no, say thank you and find another specialist. Many only do a vaginal exam, but that’s not enough. As I stated, endometriosis is almost always in the bowel area and a source of your pain. A rectal exam helps the doctor feel where the rectum meets the cervix. This is the most common area for endometriosis to be. If your doctor does not do a full vaginal/rectal exam, I don’t know how they could possibly know everything that is going on in your body.