• Dubai - United Arab Emirates
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Dr Charles has undertaken thousands of major benign gynaecological procedures using keyhole surgery. In particular, Dr Charles is a specialist in the treatment of gynecological pathologies causing chronic pelvic pain and infertility including endometriosis, fibroids, ovarian cysts and pelvic adhesions.

The majority of his surgeries involve complicated procedures, many of which are referred to him by other consultants and from other parts of the UAE and GCC.

Dr Charles does not believe that in removal of the ovaries for treatment of endometriosis, as the correct treatment is removal of endometriosis which makes removal of the ovaries unnecessary.

Further, removal of the ovaries is associated with numerous adverse health effects ranging from increased risk of heart attack to bone fracture to dementia.

Also, hysterectomy is not the solution for treating endometriosis related pain especially if fertility is desired and the uterus is not diseased, a hysterectomy can always be avoided

Dr Charles believes that the effect of endometriosis on a woman’s quality of life can almost always be alleviated , if not eliminated through appropriate surgery.

A combination of surgical treatment and either preoperative or postoperative medical therapy has been suggested for endometriosis. Surgical treatment followed by medical treatment may prolong the pain-free (or reduced-pain) interval compared to surgery alone. However, there is insufficient evidence to support the conclusion that hormonal suppression in association with surgery for endometriosis is associated with a significant benefit in terms of pain, recurrence or infertility.

Endometriosis-associated pain has been well studied, and all the established medical therapies provided a better outcome than placebo. However, none seems to be markedly better than another.

  • Surgical excision is effective for relieving pain associated with endometriosis.
  • There is no evidence that medical therapy improves fecundity
  • Comparing medical treatment to no treatment or placebo, the common odds ratio for pregnancy was 0,85% (95% CI 0.95, 1,22) In minimal–mild endometriosis: suppression of ovarian function to improve fertility is not effective and should not be offered for this indication alone.
  • In severe disease: There is evidence to show that surgical treatment is effective in increasing spontaneous pregnancy rate and also success rate of IVF.
  • In minimal–mild endometriosis: ablation/ excision of endometriotic lesions plus adhesiolysis to improve fertility is effective compared to diagnostic laparoscopy alone
  • In moderate–severe endometriosis: No Randomized Controlled Trials or meta-analyses are available to answer the question whether surgical excision enhances pregnancy rates, although there is evidence from small studies to suggest that in expert hands , pregnancy rates are increased and also success rates of ivf.
  • A surgical approach, by normalizing pelvic anatomic distortion and by adhesiolysis, may enchance fertility. Anyway more severe/advanced forms requires a multidisciplinary approach.
  • After surgical removal of endometriosis: there seems to be a negative correlation between the stage of endometriosis and the spontaneous cumulative pregnancy rate, but statistical significance was only reached in one study
  • Laparoscopic cystectomy for ovarian endometriomas >4 cm diameter improves fertility compared to drainage and coagulation.
  • Coagulation or laser vaporization of endometriomas without excision of the pseudocapsule is associated with a significantly increased risk of cyst recurrence