QC: Surgical vs. Non-Surgical Endo Management: Risks, Tools & Truths With Dr. Jeff Arrington

Introduction to Quick Connect

Speaker 1
0:00

Life

moves

fast

and

so

should

the

answers

to

your

biggest

questions
.

Welcome

to

EndoBattery's

Quick

Connect
,

your

direct

line

to

expert

insights
.

Short
,

powerful

and

right

to

the

point
.

You

send

in

the

questions
,

I

bring

in

the

experts

and

in

just

five

minutes

you

get

the

knowledge

you

need
.

No

long

episodes
,

no

extra

time

needed
,

and

just

remember

expert

opinions

shared

here

are

for

general

information

and

not

for

personalized

medical

advice
.

Always

consult

your

provider

for

your

case-specific

guidance
.

Got

a

question
?

Send

it

in

and

let's

quickly

get

you

the

answers
.

I'm

your

host
,

alana
,

and

it's

time

to

connect
.

Meet Dr. Jeff Arrington

Speaker 1
0:41

Today

I

have

an

incredible

expert

joining

us

Dr

Jeff

Arrington
.

If

you've

spent

any

time

in

the

endometriosis

community
,

you've

probably

heard

his

name
.

Dr

Arrington

isn't

just

an

excision

specialist
.

He's

a

fierce

advocate

for

informed

consent

and

breaking

down

the

barriers

that

keep

so

many

from

accessing

proper

endometriosis

care
.

His

passion

goes

beyond

the

operating

room
.

He's

fighting

for

real

change
,

pushing

back

against

misinformation

and

making

sure

that

patients

have

the

knowledge

and

options

they

deserve
.

Managing Endo Without Excision

Speaker 1
1:10

Let's

dive

in
.

What's

the

best

way

to

manage

endometriosis

symptoms

if

you

can't

afford

excision
?

Speaker 2
1:17

Hard

part
,

best

way
.

I

don't

know

if

there's

a

best
,

best

way
.

It's

basically

trying

to

find

things

that

help

each

individual

patient
.

I

mean

there's

a

bazillion

hormones

that

can

be

used
.

Between

all

the

different

birth

controls
,

progesterone-only

medicines
,

iuds
.

There's

the

medicines

that

put

you

into

menopause

a

slew

of

different

hormones

that

patients

can

try

Patients

head

to

head
.

They're

all

proven

about

the

same
.

Some

patients

may

respond

differently

to

others
.

I

throw

out

a

lot

of

other

things

that

are

very

low

risk
.

Some

patients

find

benefits
,

some

don't
.

So

supplements

like

magnesium
,

omega-3s
,

turmeric
,

anti-inflammatory

type

things
,

anti-inflammatory

diet
,

physical

therapy
,

acupuncture
,

acupressure
,

and

there's

some

places

that

do

dry

needling
.

There's

a

very

number

of

things

that

patients

can

try

that

some

get

benefit

from

and

some

don't
,

but

they're

really

low

risk
.

I'm

fortunate

enough

here

in

Utah

to

have

a

couple

of

really

good

chronic

pelvic

pain

clinics

I

went

at

the

University

of

Utah

and

one

with

Intermountain

Healthcare

for

patients

that

really

need

a

complex

approach
,

medical

approach
,

to

pelvic

pain
.

Those

are

nice

resources

for

me

to

have
.

Round Ligament Pain and Endometriosis

Speaker 1
2:30

Is

there

a

connection

between

round

ligament

pain

and

endometriosis
?

And

I

think

where

this

question

came

from

is

the

correlation

of

round

ligament

pain

specifically

during

pregnancy

and

then

after

pregnancy

got

worse

until

excision
.

Speaker 2
2:43

Not

that

I'm

aware

of
.

I

can't

think

of

a

reason

why

they

would

be

correlated
,

unless

if

there's

endometriosis

in

the

inguinal

canal

that

could

mimic

around

ligament

pain
.

If

there's

really

deep
,

thick

endometriosis

that's

binding

or

shortening
,

pulling

on

the

round

ligaments
,

technically

I

guess

that

could

give

some

pain
,

but

not

that

I'm

aware

of
.

Speaker 1
3:01

What

are

the

biggest

surgical

risks

associated

with

deep

excision
?

Risks of Deep Excision Surgery

Speaker 2
3:06

I

mean

typical

ones
,

deep

excision
,

certainly

bleeding
.

You

have

to

be

aware

of

where

the

blood

vessels

are
,

how

to

manage
.

We

try

to

take

really

good

care
.

Most

of

the

endometriosis

specialists

are

very

good

surgeons
,

very

meticulous

anatomists
,

and

we're

aware

on

how

to

avoid

blood

vessels
.

But

sometimes

that

happens

and

you

need

to

know

how

to

manage

stuff

quickly
.

Speaker 2
3:26

Certainly

injury

to

organs
,

either

bowel
,

ureters

or

bladder
,

but

again
,

most

of

us

are

very

comfortable

working

around

those

and

if

there

is

an

injury

to

the

bowel

or

the

bladder

or

the

ureter
,

really

the

key

is

just

getting

it

taken

care

of

at

the

time

of

surgery

and

as

long

as

we

do

that

at

the

original

surgery
,

the

risk

of

complication

afterward

is

really

low
.

It's

the

unrecognized

ones

that

are

problematic
.

Really
,

over

the

last

10

years

or

so

we're

learning

a

lot

more

about

the

pelvic

nerves

and

we

used

to

go

in

and

just

cut

away

at

will
.

But

having

a

better

understanding

of

the

hypogastric

nerves

and

the

splenic

nerves

for

bladder

and

bowel

function
,

those

are

fairly

high

risk

for

deep

excision
,

just

because

some

of

the

common

areas

for

deep

endometriosis

are

the

pararectal

areas

in

the

uterus
,

sacral

ligaments
,

and

that's

right

where

all

those

nerves

run
,

and

so

we

have

to

really

be

aware

of

those

nerves
,

what

their

functionality

is
,

and

do

our

best

to

preserve

as

much

as

we

can
.

Speaker 1
4:18

Also

is

there

more

risk

with

deep

endometriosis
,

with

ureter

involvement

without

proper

care

being

severed
.

The

ureters

being

severed
.

Speaker 2
4:31

Oh

yeah
,

surgery

done

by

an

endometriosis

specialist
.

Probably

I

would

have

to

look

it

up

but

I

would

put

money

on

that
.

We

have

a

much

lower

complication

rate

than

regular

gynecologists

doing

regular

things
.

There

are

more
.

It's

more

common

to

have

a

ureter

injury

from

just

a

straightforward

common

hysterectomy

than

it

is

for

an

excision

specialist

doing

complex

deep

endometriosis

work
.

Episode Closing and Contact Info

Speaker 1
4:55

That's

a

wrap

for

this

Quick

Connect
.

I

hope

today's

insights

helped

you

move

forward

with

more

clarity

and

confidence
.

Do

you

have

more

questions
?

Keep

them

coming
,

send

them

in

and

I'll

bring

you

the

expert

answers
.

You

can

send

them

in

by

using

the

link

in

the

top

of

the

description

of

this

podcast

episode

or

by

emailing

contact

at

endobatterycom

or

visiting

the

endobatterycom

contact

page
.

Until

next

time
,

keep

feeling

empowered

through

knowledge
.