Endometriosis
A Chronic, Progressive Inflammatory Condition Demanding Early Intervention
Endometriosis is a chronic, progressive inflammatory condition that, if left untreated, can lead to significant sequelae with a profound effect on the quality of life for millions of women worldwide. It is estimated that approximately 10% of women globally are affected by different aspects of this multifaceted inflammatory disease.
Unfortunately, endometriosis can begin at a very young age, as early as early adolescence, and its inflammatory residual effects may continue for decades, even after menopause, if it remains undiagnosed and untreated.
The Progressive and Destructive Impact of Endometriosis
Given the inflammatory and progressive nature of endometriosis, early diagnosis and proper curative and preventative intervention are crucial to halt the ongoing insult to the woman's pelvic organs.
The progressive, inflammatory, and destructive effect of endometriosis directly involves the reproductive organs, causing long-standing effects on fertility, which presents a significant challenge for women battling infertility.
Furthermore, this destructive inflammatory process damages the complex autonomous network of pelvic nerves, leading to significant hyperexcitement and, consequently, pelvic nerve dysfunction (pelvic neuropathy). This complex cascade of events has significant consequences for a woman's quality of life by causing progressive pain and resulting in significant pelvic floor dysfunction affecting the functionality of vital pelvic organs.
Affected Pelvic Organs
Lower Urinary Tract
Symptoms can include urinary urgency, frequency, difficulty emptying the bladder, multiple episodes of getting up at night to urinate (nocturia), and a phantom feeling of recurrent UTI that does not respond to antibiotic regimens.
Lower Gastrointestinal Tract
This may lead to constipation, diarrhea, fecal urgency, bloating, and difficulty emptying the bowel.
Reproductive Organs
Common symptoms include irregular and painful menses, pain with intercourse (dyspareunia), heavy menstrual bleeding, and, ultimately, infertility.
Pelvic Floor Muscles
These muscles are often affected due to persistent pelvic nerve hyperexcitement, leading to reflex contraction, which causes additional pain, vaginismus, and discomfort during vaginal penetration.
The impact of this progressive, inflammatory, and neuropathy-driven effect of endometriosis significantly diminishes a patient's quality of life. It is critically important to break this vicious cycle as early as possible to prevent long-term damage to vital female organs.
Obstacles to Early Diagnosis and Treatment
Despite significant scientific progress, the early detection and diagnosis of endometriosis remain a challenge. The average time to diagnosis is estimated to be between 7 to 11 years, which is unacceptable.
Patient Dismissal of Symptoms
Women often view menstrual pain and pelvic discomfort as common and normal, tending to dismiss their symptoms until they become severe.
Healthcare Provider Dismissal
Unfortunately, the dismissive culture is not limited to patients. Many healthcare providers, including gynecologists, tend to ignore or dismiss a patient's early symptoms, or at best, initiate palliative care using non-steroidal anti-inflammatories and oral contraceptives. Most initial treatments are palliative, acting as a "Band-Aid strategy," rather than being curative.
Lack of Specific Diagnostic Tools
Clinicians' dependence on confirmatory paraclinical tools, such as imaging and lab tests, is a major obstacle. Currently, there is no specific or sensitive test to confirm endometriosis, and the condition often does not reveal itself on imaging, especially in its early stages.
Hesitation toward Surgical Intervention
As of today, surgical exploration (laparoscopy) remains the only definitive way to diagnose and confirm the presence of endometriosis and related inflammation. Clinicians often hesitate to offer surgery to adolescents and young women, preferring palliative care. This approach, despite its patient-advocacy facade, often delays the early diagnosis and leads to significant quality-of-life impact later in life.
Lack of Specialized Surgical Training
The lack of adequate surgical training for endometriosis management often results in unsuccessful resolution of pain and subsequent recurrence. Optimal surgical exploration requires the complete removal (excision) of all endometriosis lesions and related inflammatory nodules. Since endometriosis often involves delicate but vital organs like the ureter, bowel, rectum, and pelvic nerves, the surgical resection of aggressive implants from these areas is technically challenging and requires extensive expertise and skills.
This current state emphasizes that the delayed detection of endometriosis costs millions of women their quality of life and costs healthcare systems billions of dollars to manage the often severe and irreversible damage.
The PelviQuest Project
Revolutionizing Endometriosis Management
It is critical to create a task force to find a solution for the endometriosis dilemma affecting over 10% of women. Current guidelines, some unchanged for over 50 years, require a significant update.
The key missing first step is early detection with acceptable precision and accuracy. A reliable diagnostic tool with high sensitivity and specificity is critically needed to change the entire game. The significant limitations of traditional imaging and blood tests mandate finding a different route.
Dr. Shakiba, a leading endometriosis surgeon and specialist with over 20 years of experience managing complex endometriosis patients in the New York and New Jersey area, is taking significant steps to address this. His extensive experience, surgical skill in minimally invasive excision of endometriosis using robotic and laparoscopic platforms, deep knowledge of pelvic nerve pathology, and strong background in research have led him to initiate the PelviQuest Project to solve the dilemma of early diagnosis.
Leveraging AI and Data for Early Diagnosis
Dr. Shakiba's focus is on creating a universal database of all patients presenting to his clinic, scientifically tracking all patient symptoms and physical exams and matching them with intraoperative findings during surgery.
Using advanced biostatistical analysis and the power of AI technology, the PelviQuest Project aims to:
- ✓Diagnose endometriosis simply based on standardized questionnaires and physical exams, constantly supported by research matching data with intraoperative findings.
- ✓Revolutionize the staging of endometriosis intraoperatively using AI technology.
The PelviQuest platform, which includes a dual app for patients and healthcare providers, combined with long-term AI technology, will provide significant insight for the early diagnosis of endometriosis.
Global Partnership and Universal Standards
The PelviQuest Project is actively seeking to partner with expert-level endometriosis surgeons worldwide to enrich the database volume and ultimately improve the sensitivity and specificity of the predictive value of the collected data.
The ultimate goal of the PelviQuest app:
Provide millions of patients worldwide with quick and easy access to answers regarding their pelvic health.
Offer a universal approach for gynecologists and other healthcare providers for the management of endometriosis, from the first patient visit to surgery.
Create an excellent outcome monitoring tool to manage patients' symptoms postoperatively.
Serve as a reliable, universal, and self-correctable tool for endometriosis research for years to come.
This universal tool is hoped to solve the most critical dilemma - early diagnosis - and open a new window for the healthcare community to revise outdated guidelines and train a new generation of surgeons proficient in endometriosis surgery and, more importantly, pelvic nerve surgery.
The PelviQuest Project is fully funded by Dr. Shakiba and is underway to revolutionize the quality of life of millions of women suffering from pelvic pain.
Investment opportunities for universal expansion are welcome.