Stage 1 Endometriosis

Stage 1 endometriosis is characterized by minimal, superficial lesions or implants on the pelvic lining/ovaries with no significant scarring or adhesions.

Stage 1 endometriosis, also known as minimal endometriosis, is the earliest and least severe form of the condition. In this stage, small patches or isolated implants of endometrial tissue are found outside the uterus, typically on the pelvic lining or ovaries. These implants are small and superficial, measuring only a few millimeters in size. At this stage, there is minimal scarring or adhesion formation.

Despite being classified as the least severe, stage 1 endometriosis can still cause symptoms and discomfort for some individuals. Common symptoms include mild pelvic pain, particularly during menstruation, and possibly pain during intercourse. However, some women with stage 1 endometriosis may have no noticeable symptoms at all.

Diagnosing stage 1 endometriosis typically involves a laparoscopy, a minimally invasive surgical procedure, during which a thin tube with a camera is inserted into the abdomen to visualize and assess the pelvic structures. If stage 1 endometriosis is detected, appropriate management options may include pain medication, hormonal therapy, or lifestyle changes. It’s crucial for individuals experiencing symptoms or fertility concerns to consult with a healthcare professional for a comprehensive evaluation and personalized treatment plan. Early detection and management can help minimize the impact of the condition on a person’s overall health and quality of life.

Stages of Endometriosis (Image source: Springer Nature Switzerland AG, 2022)

Symptoms of Stage 1 Endometriosis

Stage 1 endometriosis is the mildest form of the condition, and noticeable symptoms may not always be present. However, some individuals with stage 1 endometriosis may experience the following symptoms:

Mild Pelvic Pain: Women may experience mild, intermittent pelvic pain or discomfort, especially during menstruation (dysmenorrhea). The pain can vary from person to person and may be felt in the lower abdomen or back.
Pain During Intercourse: Some women with stage 1 endometriosis may have pain or discomfort during or after sexual intercourse (dyspareunia).
Mild Menstrual Irregularities: Menstrual cycles may be slightly irregular, with variations in flow or length.
Fatigue: Fatigue or tiredness may occur during menstruation due to hormonal changes and pain.

Importantly, some individuals with stage 1 endometriosis may have no noticeable symptoms and may only discover the condition incidentally during medical evaluations for other concerns, such as infertility investigations.

It’s crucial to understand that the severity and presentation of symptoms can differ significantly among individuals.

Additionally, some women may have stage 1 endometriosis and experience severe pain, while others with more advanced stages may have milder symptoms.

If you suspect you may have endometriosis or are experiencing any symptoms of concern, it’s essential to request an appointment with New York Gynecology Endometriosis (NYGE) to seek medical advice and evaluation.

Life-threatening Complications in Stage 1 Endometriosis

In Stage 1 endometriosis, life-threatening complications are rare because the disease is in its early and least severe form. However, it’s important to note that endometriosis, regardless of its stage, can cause various health challenges and negatively impact a person’s quality of life. While life-threatening complications are not typically associated with Stage 1 endometriosis, the condition can progress over time and may lead to more severe symptoms or fertility issues if left untreated.

It’s crucial for individuals with endometriosis to seek medical attention, adhere to their healthcare provider’s recommendations, and actively manage the condition to prevent potential complications in the future. Regular follow-ups with a healthcare professional can help monitor the progression of the disease and address any emerging concerns.

Diagnosis of Stage 1 Endometriosis

The diagnosis of Stage 1 endometriosis typically involves a combination of the following steps:

Medical History: Your healthcare provider will begin by taking a detailed medical history, including asking about your symptoms, menstrual cycle, and any previous medical conditions or surgeries.
Physical Examination: A pelvic examination may be performed to check for any abnormalities or signs of endometriosis.
Imaging Studies: While Stage 1 endometriosis may not always be visible on imaging, an ultrasound may be conducted to rule out other possible causes of pelvic pain and to assess the pelvic structures.
Laparoscopy: The gold standard for diagnosing endometriosis is through a surgical procedure called laparoscopy. During laparoscopy, a thin, lighted instrument (laparoscope) is inserted through a small incision in the abdomen to visualize the pelvic organs and look for endometrial implants, lesions, or adhesions. Biopsies of suspicious areas may be taken for further confirmation.
Histology: Biopsy samples obtained during laparoscopy are sent to a pathologist for examination under a microscope to confirm the presence of endometrial tissue outside the uterus.

Early diagnosis and intervention can lead to more effective management and improved quality of life for individuals with endometriosis.

Surgical Treatment for Stage 1 Endometriosis

Surgical treatment for Stage 1 endometriosis typically involves a minimally invasive procedure called laparoscopy. The main goals of surgical treatment are to diagnose the condition definitively and to remove or ablate (destroy) any endometrial implants or lesions found during the procedure. Here’s how surgical treatment for Stage 1 endometriosis is usually conducted:

Laparoscopy

Laparoscopic surgery is performed under general anesthesia. A small incision is made near the navel, and a thin, lighted instrument called a laparoscope is inserted to visualize the pelvic organs and identify endometrial implants.

According to Healthcare Bluebook, the cost of laparoscopic excision of endometriosis can vary depending on the location, healthcare provider, and type of insurance. On average, the cost of the procedure can range from $4,000 to $15,000. It’s important to note that these are estimated costs and may not reflect the actual cost you may incur.

To obtain an accurate cost estimate, it is advisable to request an appointment with New York Gynecology Endometriosis (NYGE).

Excision or Ablation

In Stage 1 endometriosis, both excision and ablation are possible surgical treatment options, depending on the specific characteristics of the endometrial lesions and the surgeon’s expertise. Here’s an explanation of each procedure:

Excision: Excision involves surgically removing the endometrial lesions or implants. The surgeon carefully cuts away the affected tissue, ensuring that the entire lesion is removed, including any deep-seated parts. This method aims to completely eliminate the endometriotic tissue, reducing the likelihood of recurrence.
Ablation: Ablation, also known as vaporization or coagulation, uses heat (laser or electrical energy) to destroy the endometrial lesions. The heat energy effectively destroys the tissue on the surface, but it may not penetrate deeply into the lesion. As a result, there is a higher chance of residual tissue remaining, which can potentially lead to a higher chance of recurrence compared to excision.

While both excision and ablation can be used for Stage 1 endometriosis, excision is generally considered more effective for completely removing the endometrial tissue and reducing the risk of recurrence. However, the choice of the surgical technique depends on various factors, including the size and location of the lesions, the surgeon’s expertise, and the individual patient’s preferences and needs.

Robotic Surgery

Robotic surgery is an advanced and minimally invasive approach for treating Stage 1 endometriosis. During the procedure, small incisions are made in the abdomen, and a robotic surgical system is used to control precise movements of surgical instruments. The surgeon can visualize the pelvic organs in high-definition 3D, identify and remove or ablate endometrial implants, and potentially address any adhesions. Robotic surgery offers advantages such as improved precision, reduced tissue trauma, shorter hospital stays, and potentially faster recovery compared to traditional open surgery.

However, the choice of surgical approach should be discussed with a qualified healthcare professional based on individual needs and circumstances.

Pankaj Singhal, MD, MS, MHCM

Master Surgeon in Robotic Surgery

Dr. Pankaj Singhal, a globally recognized endometriosis surgeon, possesses over 25 years of expertise in laparoscopic excision surgery, enabling him to tackle even the most challenging endometriosis cases with confidence. Dr. Pankaj treats patients with diverse endometriosis-related conditions, ranging from ovarian endometriomas to severe deep infiltrating endometriosis that affects the bowels and other organs.

Dr. Pankaj prioritizes minimally invasive surgery and provides comprehensive personal care. Additionally, he is the owner and founder of New York Gynecology and Endometriosis (NYGE), and has dedicated his life to advocating for, respecting, and treating women suffering from this little-known disease. He is one of the few surgeons in the entire United States who have completed over 5,718 robot-assisted gynecologic surgeries.

We Accept Most Major Insurance Plans

Convenient Billing Options for Comprehensive Coverage.

Surgeries are typically covered by health insurance. However, the extent of coverage can vary depending on the specific insurance plan and policy. Some insurance plans may cover a broad range of surgical procedures, including both elective and necessary surgeries, while others may have limitations or exclusions for certain procedures.

In some cases, certain insurance plans or programs may fully cover the cost of surgery, leaving the patient with no financial responsibility.

Hear From Our Clients

NYGE has truly changed my life. I had previous endometriosis surgery costing 15k by one of the well known providers out there in NYC which was a 6 hour drive for me to only require surgery again 2 years later.

The doctors are excellent and knowledgeable from their excision abilities and understanding of the disease, to their surgical skills, to their patient care. I am 6 weeks out from surgery and they still will check in on me and answer any and all questions that I have.

I am so beyond grateful to have found them.

Dr Singhal is an Amazing and Excellent Doctor! He explains things thoroughly and was kind and has an excellent bedside manner! He reassured and comforted me about the procedure and what my options would be.

Took the time to answer all my questions and concerns. His Staff is excellent as well. Returning calls, and always there to answer questions. There was never a long wait to see him.

He is truly one of the Best Surgeons and Doctors! I highly recommend him!!

Dr. Singhal and Dr. McLean are very thorough and knowledgeable surgeons. They set clear expectations for my two surgeries. I was operated for stage 4 endometriosis by Dr. Singhal and Dr. McLean.

The surgical incisions are very small and barely noticeable. The surgeries relieved the GI symptoms I was experiencing, such as painful bowel movements, bloating, and distention.

I would highly recommend them to anyone needing their expertise.

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