AMA Dr. Ally | What role does inflammation play in endometriosis & how does PRM address that?
Dr. Ally explains how inflammation in endometriosis patients must be addressed to improve surgical outcomes and help with lifetime management of the disease.
Dr. Allyson Shrikhande is a board certified Physical Medicine and Rehabilitation specialist, Chief Medical Officer of Pelvic Rehabilitation Medicine, and an expert in women’s and men’s health and sexual health. A leading expert on pelvic health and a respected researcher, author and lecturer, Dr. Shrikhande is a recognized authority on female and male pelvic pain diagnosis and treatment.
At Pelvic Rehabilitation Medicine™, we believe that the millions of women and men who suffer from pelvic pain should have access to care that provides relief. We don’t believe “a glass of wine will fix it” or that “it’s all in your head”. We will never abandon you – and from leadership to the front office to every pelvic pain specialist you meet, so much of our team has been in your shoes and believes the pelvic pain patient deserves better. This belief is what unifies us all at PRM.
Since 2017, PRM has provided an innovative solution to a health crisis that affects 15% of women and 10% of men. Persistent pelvic pain is often overlooked, untreated, and misguided. At PRM, our mission is to decrease the time patients are suffering from pelvic pain symptoms.
We offer a proprietary, simple, office-based procedure to treat the symptoms of chronic pelvic pain. The PRM Protocol™ consists of a series of pelvic nerve and muscle treatments to directly target inflammation in the pelvis and nerve pain. Depending on the condition causing your pelvic pain, other modalities may be needed in addition to our treatment.
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So, inflammation, how is it associated with endometriosis? Endometriosis itself is, the definition, is a systemic inflammatory disease process. So conceptually, how that works in the pelvis is every time there is a menstrual cycle, there is inflammation, and then healing and scarring, inflammation, scarring, over someone's lifetime.
So conceptually, how does PRM address that? In multiple ways, and excision surgery of the endometriosis tissue itself is an option and a great starting point. In addition, how we address that is in two ways. Quite often, before surgery, what we'll do is we work to decrease that neurogenic inflammatory process in the pelvis, so that when the nerves are less inflamed, essentially, you'll recover faster post operatively.
In addition, what we do for patients after endometriosis decision surgery to address any residual neurogenic inflammation that may exist can, A, help with pain and function, because nerves are involved with both pain and function, we call this. But conceptually reversing that neurogenic inflammatory process in the pelvis will conceptually decrease the chances of the endometriosis proliferating and growing back because endometriosis itself will grow when it's surrounded by pro inflammatory cytokines.
So at PRM we are trying to keep that inflammation under control and quite often patients with endometriosis will come in once a year, just to keep it in check and do our best to try to spread out surgeries or decrease the need for a second surgery at all.
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