Course 1: The Contemporary Approach to Advanced Endometriosis and Pelvic Pain
Sunday, March 30, 2025 | 1:00 pm - 5:00 pm PST

 

Course Faculty: Cara King, DO; Ashley Gubbels, MD; Megan Wasson, DO; Wendy VanBuren, MD

Course Description:

This course will provide a comprehensive overview of the contemporary approach to diagnosis and management of advanced endometriosis and pelvic pain. Utilizing interactive lectures, surgical videos and expert panelist discussions, participants will learn tools to improve endometriosis care through a modernized patient centered approach. Strategies to decrease diagnostic delays through a better understanding of the disease process coupled with implementation of advanced diagnostic imaging in practice will be discussed. An overview of the benefits and methods to implement endometriosis centers that provide multi-disciplinary care and collaboration with other surgical and non-surgical specialties will be presented.

Participants will learn innovative surgical techniques to enhance diagnosis and surgical management of advanced stage endometriosis. Additionally, panelists will describe systematic, minimally invasive surgical approaches to deep infiltrating endometriosis, obliterated cul-de-sacs, and extra-pelvic disease. Finally, this course will discuss the importance of neuropelveology and its significant impact on the contemporary approach to diagnosis and management of endometriosis.

Course Objectives:

At the conclusion of this activity, the participant should be able to:

1. Utilize a patient-centered approach to endometriosis care to decrease delay in diagnosis and improve outcomes.

2. Understand how to collaborate and implement multi-disciplinary care for endometriosis patients using best practice care models.

3. Apply a systematic surgical approach to advanced stage pelvic and extra-pelvic disease.

4. Understand neuropelveology and its impact on the contemporary approach to diagnosis and management of endometriosis.

Needs Assessment/Gap Analysis/ The Problems:

1. Endometriosis is a complex, chronic disease that significantly impacts quality of life and poses a significant economic burden to healthcare systems. While there have been significant advancements in care, there continues to be a delay in diagnosis, limited access to endometriosis surgeons, incomplete treatment of advanced stage disease, and discordant approaches to outcomes reporting leading to research limitations.

2. Patients often experience a delay in diagnosis, leading to years of suffering, risk for central sensitization of pain and potential impact on fertility. While the gold standard for diagnosis has been diagnostic laparoscopy with pathologic confirmation, advancements in imaging techniques have improved diagnosis allowing for referrals, counseling, and optimized surgical planning. Challenges with implementations include availability, the learning curve associated with training providers/technicians, which affects the sensitivity and specificity, and insurance coverage.

3. Endometriosis surgeries are complex due to the fibrotic and inflammatory nature of the disease. The presence of bladder, ureter, bowel, and extra pelvic disease often requires a multidisciplinary surgical approach with other surgical services. Endometriosis centers provide a multidisciplinary approach through collaboration with gynecologic and non-gyn surgical specialists, pelvic floor physical therapists, behavioral medicine, pain management, nutritionists, etc. Due to the complexities of the healthcare system, patients often experience many barriers to accessing proficient endometriosis specialists.

4. There is a need for an updated approach to endometriosis care that recognizes the modern understanding of the disease process, highlights the need for advanced diagnostic imaging modalities, supports endometriosis centers to improve patient access and decrease time to diagnosis, recognizes the need of a multi-disciplinary approach to care, supports innovations in surgical techniques and standardizes outcomes reporting to improve research and care for endometriosis patients. 

Course Agenda