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BackTable / OBGYN / Podcast / Episode #76
Clinical Pearls: Managing Endometriosis Post-Hysterectomy
with Dr. Emad Mikhail
There are many challenges when it comes to operating on a post-hysterectomy patient, especially when they have endometriosis. In this episode of BackTable OBGYN, Dr. Emad Mikhail, an associate professor of OBGYN at the University of South Florida, discusses the intricacies of treating endometriosis after a hysterectomy.
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BackTable, LLC (Producer). (2025, January 14). Ep. 76 – Clinical Pearls: Managing Endometriosis Post-Hysterectomy [Audio podcast]. Retrieved from https://www.backtable.com
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Podcast Contributors
Dr. Emad Mikhail
Dr. Emad Mikhail is a gynecologic surgeon at Tampa General Hospital in Tampa, Florida.
Dr. Mark Hoffman
Dr. Mark Hoffman is a minimally invasive gynecologic surgeon at the University of Kentucky.
Synopsis
Dr. Mikhail shares his journey from medical school in Egypt to his current expertise in deep endometriosis surgery in Tampa, Florida. The conversation covers preoperative evaluation, the importance of understanding patient history, and surgical approaches for complex cases. He emphasizes the need for multidisciplinary collaboration, advanced imaging, and specialized surgical techniques to ensure optimal patient outcomes.
Timestamps
00:00 - Introduction
05:52 - The Role of Hysterectomy in Endometriosis
08:58 - The Role of Ovaries in Endometriosis
11:12 - Surgical Techniques and Considerations
18:11 - Evaluating Deep Endometriosis
24:32 - Post-Hysterectomy Pain and Symptoms
31:26 - Surgical Approaches Post-Hysterectomy
39:49 - The Importance of Continuous Learning
43:09 - Scar Tissue vs. Lesion
51:47 - Comprehensive Preoperative Assessment
53:59 - Conclusion and Final Thoughts
Transcript Preview
[Dr. Mark Hoffman] Hysterectomy can be part of the treatment plan for pain. For peritoneal endometriosis, it's certainly deep disease, hysterectomy is not the answer. Getting comfortable in those spaces, especially when they've had a hysterectomy, is really that pre-op workup, that pre-op history, that pre-op evaluation, getting all that imaging. At the end of the day, sending the patient to somebody who's done this a ton, there aren't a lot of mods out there, but there's enough out there doing great work that we need to understand if our patients are coming in after hysterectomy, known endometriosis, you have to have your flags raised, be aware, and think, man, this could be maybe one of the hardest cases we could see, and make sure that they get the best- our patients get the best opportunities to get a good outcome.
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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