When should you consider surgical management of chronic pelvic pain conditions? In this episode of the BackTable OBGYN podcast, Dr. Mark Dassel, a MIGS surgeon at Intermountain Health in Salt Lake City, joins hosts Dr. Mark Hoffman and Dr. Amy Park to discuss medical and surgical management strategies for chronic pelvic pain, particularly endometriosis.

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SYNPOSIS

Dr. Dassel emphasizes the importance of stopping the hormonal triggers associated with pain and explores various medical treatments, including hormonal therapies and the role of contraceptives. He also highlights his approach to surgical interventions such as endometriosis excision, endometrioma removal, and hysterectomy, and the importance of holistic treatment plans involving pelvic floor physical therapy and central pain modulators. The episode also covers the complexities of diagnosing and treating pelvic pain, the role of early intervention, and the value of multidisciplinary care.

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TIMESTAMPS

00:00 - Introduction

07:55 - Differentiating Causes of Chronic Pelvic Pain

10:13 - Multidisciplinary Care and Costs

14:26 - Acute vs Chronic Pain

17:00 - Centralized Pain

18:46 - When to Offer Surgery

23:42 - Fertility and Endometriosis

33:25 - Hormonal Suppression Post-Surgery

37:24 - Pelvic Floor Botox and Physical Therapy

44:42 - Hysterectomy for Pelvic Pain

51:53 - Nerve Ablation and Pain Management

57:10 - Final Thoughts