What are fibroids and what is a specialist who treats this condition?

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Endometriosis & Fibroids Specialist located in Hackensack, NJ and New York City, NY

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Pelvic Pain: Simply, the pelvis is a location. It is comprised of the lower part of a woman’s abdomen which houses her uterus (womb), tubes, and ovaries. However, the environment is much more complicated than this. It also houses much of the intestinal tract—portions of the large colon and rectum, and it is a gravity-dependent resting place for much of the lower small intestines, which includes the appendix. Also, the bladder is housed in the pelvis.

Thus, “pelvic pain” is any pain arising from the reproductive organs, urinary tract, gastrointestinal tract, and the bones that make up the pelvic skeleton.

  • Pain from the uterus, i.e., fibroids, Adenomyosis, infection.
  • Menstrual pain (cramping).
  • Pain in your tube(s), from sexually transmitted infection, scarring (previous surgery or endometriosis), or even an abnormally placed and implanted pregnancy (ectopic, or tubal, pregnancy).
  • Pain related to the ovaries, such as ovarian cysts, torsion (vascular blockage of blood flow), engorgement of the veins that supply the ovary, and even malignancy.
  • Endometriosis
  • Musculoskeletal pain of the abdominal wall muscles that are present in the pelvic area, due to inflammation, hematoma (trauma), or injury (strain).
  • Neuropathic pain, due to pelvic floor muscle spasm that transmits pain signals along the nerves that run through the pelvis to include the vagina and labia.

Pelvic Pain Specialist: Dr. Ulas Bozdogan is a specialist in who diagnoses and manages pelvic pain, as he is a gynecologist, board-certified by the American Congress of Obstetricians and Gynecologists. This is the highest achievement an OBGYN doctor can attain in the specialty. But Dr. Bozdogan uses the latest state-of-the-art technology and diagnostic—and if necessary, surgical—techniques, which sets him apart from other gynecologists, which is crucial in such a devastating condition as endometriosis as well as being important in diagnosing other conditions other than endometriosis. His vast experience (thousands) in performing hysteroscopy, laparoscopy, and other procedures using minimally invasive robotic procedures increases the safety, decreases the blood loss, and makes complications of any diagnostic or therapeutic procedure less, should they be necessary, e.g., removing an ovarian cyst; excising endometriosis. His techniques also significantly decrease recovery time and postoperative pain. In fact, he even teaches procedures to other doctors who want to begin using the robot in their own practices.

Endometriosis and Infections: When you’re talking about pelvic pain unrelated to the urinary or gastrointestinal tract, the most common causes are ovarian cysts, tubal infections, and endometriosis. Ovarian cysts, for the most part, cure themselves by just waiting them out. Infections are treated with antibiotics. But endometriosis and tubal infections are the most impacting to the pelvis because of possible destruction of your quality of life and your fertility. Of ovarian cysts, tubal infections, and endometriosis, endometriosis and the scarring from infections are the ones in which you can benefit the most from a specialist in pelvic pain such as Dr. Ulas Bozdogan is.

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FREQUENTLY ASKED QUESTIONS


If I have pelvic pain or painful sex, is it likely to be endometriosis?

No, because the list of causes of pelvic pain is extensive, some gynecological, others non-gynecological. Endometriosis is only one of them, but along with a tubal infection is at the top of the list for diagnosing—or ruling out—because of what’s at stake (your fertility and quality of life).

    1. Non-gynecological
    • Irritable bowel syndrome.
    • Inflammatory bowel disease.
    • Bladder infection.
    • Appendicitis
    • Diverticulitis
    • Kidney stone.
    • Constipation
    1. Gynecological
    • Infection, most likely in the tubes..
    • Adenomyosis, which is a glandular infiltration of the muscular wall of the uterus.
    • Fibroids, which interfere with the muscular contracting of your uterus’ muscular layer, preventing the bleeding from a period to be pinched off. This causes extra cramping and uterine sensitivity.
    • Ovarian cyst(s).
    • Cancer
    • Pelvic floor spasm and neuropathic pain.
    • Endometriosis

How is one pelvic pain specialist better qualified than another gynecologist or surgeon?

Expertise can only come from experience and the use of state-of-the-art technology to get the best results. In the past, pelvic pain often meant a hysterectomy. Thankfully, those days are gone, but there is still a wide range of skills in doctors who operate on the pelvis, from those who only know how to do it with large incisions to those who use the cosmetically advantageous minimally invasive surgery such as the da Vinci robot. Dr. Bozdogan is one such doctor on the end of the spectrum that has the most experience and expertise.

Also important is a sensibility for the relationship between your pelvic floor muscles and the rest of your pelvis, each making the other worse when it comes to pain. If a doctor doesn’t appreciate this connection, treating one of them will cause a failure in treatment in both.

If surgery is needed, what will be my best chance for preservation of my fertility or relief of my pelvic pain?

After the cause is determined, treating pelvic pain is based on what the diagnostics (including ultrasound) reveal, and they can range from conservative to aggressive, depending on whether pregnancy is desired,  to what degree pain is involved, or if there are pre-cancerous tissues. Overall, for preservation of fertility, you’re going to want to leave surgery with as much reproductive tissue as you went in with; that is, with only the problem dealt with. Your best chance for this is a doctor like Dr. Bozdogan using the da Vinci robot.  

How is a surgery done with the robotic technique?

Using the advantages of the robotic approach minimizes the complications drastically compared to more invasive surgeries other doctors do, such as simple laparoscopy, open, and vaginal procedures. This is because the robot’s advantages over the others is stereoscopic visibility, 2-hand dexterity that electronically couples with advanced instrumentation for meticulous dissection, and visibility from any angle within your pelvis. The precise technique allows for meticulous handling of tissue, which also means reduced inflammation, decreasing postoperative pain and speeding up recovery tremendously.     

Summary

The term “pelvic pain” can be something difficult to pin down due to the complexity of the female pelvis. Care of conditions due to devastating problems there require an expertise both diagnostically and therapeutically, and when requiring surgery, are best addressed by a doctor like Dr. Bozdogan who understands how many influences can merge together in one location; by a doctor with the most current best practices and therapeutic approaches to restore normal anatomy, preserve fertility, and restore a pain-free life so important to patients.

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