The information provided by Advanced Healthcare for Women and E. Daniel Biggerstaff, III, M.D. is for informational purposes only. As each woman is unique, do not rely on this information for diagnosis and treatment. We cannot guarantee the accuracy of the content and advise that you see a qualified Health Care Professional for individual needs and care

What To Ask A Physician

A physician’s skill and success in treating patients through routine care or surgery relate directly to how frequently he or she sees patients with a given condition and performs surgery to treat the condition.  If you have symptoms suggesting endometriosis or have known endometriosis with recurring pain or infertility, you should ask a physician a few questions before entrusting your health to him or her for further diagnosis or treatment.  Dr. Biggerstaff respects your right to ask questions and seek information before making important personal health decisions.

First, ask the physician how often he or she sees patients with endometriosis, how often they treat them with surgery and their success rate in surgery. You may also wish to ask:

  1. How frequently do you treat endometriosis laparoscopically?
  2. How do you routinely treat endometriosis surgicallyexcision or vaporization/cauterization?
  3. How do you treat severe endometriosis – excision or treatment with medication?
  4. Do you excise endometriosis from vital structures such as the bowel, bladder, ureter, and major blood vessels?
  5. If I have severe endometriosis, do you treat it with laparoscopy or with a large laparotomy incision?
  6. If suture repair is necessary at the time of surgery (as with endometriosis that extends through the wall of the bladder), do you do this at laparoscopy, or do you make a large laparotomy incision?
  7. If I have adenomyosis (endometriosis in the muscle of the uterus), do you perform laparoscopic presacral neurectomy?


Answers to these questions can give you an idea of the experience, expertise and communications skill of a physician treating endometriosis. If you are not satisfied with the answers you receive, consider selecting a different provider.

As you look at to your treatment options, remember these basic facts:

  1.  A physician who treats any condition surgically on a regular basis will demonstrate more skill than if he or she only performs a certain surgical procedure only occasionally.
  2. Excision is a more effective and safer way to remove endometriosis than vaporizing or cauterizing it, especially when it invades surrounding tissues.
  3. Surgically removing severe endometriosis results in better outcomes than taking medication. These only temporarily suppress the disease or relieve the symptoms.
  4. All endometrial tissue must be removed to relieve pain and improve fertility.
  5. Laparoscopy is the best way to treat endometriosis, because it provides a physician with a closer and more complete view of the disease.  Smaller incisions make for quicker recovery, less pain and lower risk of infection after surgery. 
  6. If necessary, repair of vital structures such as the bladder at laparoscopy rather than laparotomy results in a much quicker recovery.
  7. Currently, there are only two ways to effectively eliminate the pain caused by adenomyosis – presacral neurectomy and hysterectomy.  Fortunately, both can be performed at laparoscopy.


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