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April 8, 2025 60 mins
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. --- 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. --- 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
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