Scheduling Surgery

What to Expect at PRM

At PRM, we want to ensure our patients have everything they need to prepare for each of their appointments, consultations, and operations. Here, you’ll find the resources you need and answers to your questions, so you can best prepare to meet with your endometriosis excision surgeon and know how to prepare and care for yourself before, during, and after your operation.

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What to Expect

Surgery Process from Start to Finish

We will discuss available surgery dates, physician fees, facility fees, anesthesiologists, and coordinating any other surgeons or members of your care team that are deemed necessary based on your evaluation. This is where we will also schedule your pre-op and post-op appointments. During this phone call, you will also learn more about our complimentary online self-guided courses for endometriosis patients, such as Thriving with Endo and Eating with Endo.

This is typically a week prior to surgery. This is a complimentary visit (no charge). In this appointment, we will review your health history and complete a physical. This is where your surgeon will discuss the surgery in detail with you – when, where, and what to expect. You will also receive a packet at this appointment that gives you insight into post-op steps and what to expect so you can prepare.

Our surgical coordinator will go over when to arrive, where to go, and specifics on how your surgeon would like you to prepare. In general, plan to get a good night’s sleep and let us handle everything.

For the first 3 days post-op you will receive calls from your surgeon to check in and see how you feel. We believe at PRM that our patients deserve a white-glove level of care. Six to eight weeks after your surgery, all patients of PRM excision surgeons will follow up with our pelvic pain specialists. We truly believe that endo patients benefit from our unique, office-based approach to pelvic pain and this visit is a step in that journey to ensure patients know their options when it comes to post-hab and ensuring there is no pain post excision.

About Endometriosis Surgery

What to Expect

Preparing for Excision Surgery

Endometriosis affects the pelvic nerves and muscles. This pain and dysfunction can be treated through the PRM Protocol™.

Those suffering with endometriosis not only feel the pain directly from the lesions, but also the pain and discomfort that these lesions have caused on the nerves and muscles within the pelvic floor.

Because inflammation and nerve dysfunction are common in endometriosis patients, even after endo excision of the endometriosis lesions, treating the nerves and muscles themselves directly is the only way to treat it this discomfort, pain, and dysfunction.

Watch as Dr. McHale explains how endometriosis affects the nerves and muscles in the pelvic floor.

Surgery FAQ

Endometriosis & the Pelvic Floor

Pre-Habilitation for Surgery Patients

Pre-hab refers to optimizing your pelvic nerves and muscles before surgery, making them the best they can be so that you can bounce back faster after surgery.

When your nerves are inflamed and irritated from having the endometriosis in your pelvis, this can cause persistent pain you may be experiencing. The importance of the PRM Protocol™ prior to surgery is that we are calming the nerves and decreasing as much inflammation as possible, so you will respond to your surgery better and have smoother recovery.

This means using less medications, returning to your normal daily activities such as work, intercourse, exercise, and even sleeping – as soon as possible.

Watch as Dr. Ally explains how treatment for the pelvic floor nerves and muscles prior to your excision can help with your recovery after surgery. 

More About Pre-Hab

Our Treatment Works for Endo Patients

Endometriosis & The PRM Protocol™

At PRM, we understand the direct connection between endometriosis and its affects on the nerves and muscles within the pelvic floor.

When treating endometriosis, our pelvic pain specialists use a comprehensive approach through the PRM Protocol™to target inflammation in the pelvis, nerve pain and pelvic floor muscle spasm.

Watch as Dr. Ally explains the connection between endometriosis and the pelvic floor, and our treatment benefits those patients with endo.

About the PRM Protocol™

What to Expect

Endometriosis Excision Surgery

Excision surgery involves cutting out the lesions, implants, or fibrosis (scar tissue) caused by endometriosis.

Although excision surgery is more effective, the procedure is more technically difficult and time-consuming. Complete removal of all visible diseased tissue makes this the best treatment currently available. Furthermore, with this type of surgery, the specimen removed from surgery can be sent to the pathology department where confirmation can be made that it is indeed endometriosis and not a different type of disease. Our Endometriosis Excision Surgeons have completed extensive Mayo Clinic fellowships and are experts in their field of diagnosis and treatment.

Watch as Dr. Haverland explains the difference between ablation and excision, and why our team of surgeons excises lesions during surgery.

Endometriosis Excision Surgery

What to Expect

Recovery After Surgery

Your recovery process depends on your baseline health and fitness, plus the severity of your disease – but we are here to help you through it.

In general, for the first couple of days after surgery, you may experience bloating and discomfort from the gas that was used to distend your abdominal cavity for the laparoscopy.

You will also have some cramping and post-operative soreness/tenderness. This should improve by the third day, after which you should be feeling better. It is very important that you call us after surgery if you don’t feel better each day compared to the previous day.

Within two weeks, you should be feeling almost 90% back to normal. At this time, you will have a follow-up office visit to ensure all is well and to check your abdominal incisions, which by this time should be almost completely healed. Your surgeon will discuss with you the surgical findings and the follow-up treatment plans.

Watch as Dr. Bagaria explains how to care for yourself at home post-surgery.

Post-Hab at PRM

Endometriosis & the Pelvic Floor

Post-Habilitation for Surgery Patients

Post-habilitation through the PRM Protocol™ helps patients recover from surgery and prolongs the positive effects of excision.

Post-hab refers to post-operative rehabilitation, and it can be after an endometriosis surgery, or any surgery from the belly button to the mid thigh, where there is a trauma or an insult to the pelvis.

Unlike temporary band-aids that give short-term relief, our treatment is a restorative approach to create an optimal environment for the nerves and muscles to heal.

With treatment following surgery, we help your pelvic floor muscles get back to their baseline – less spastic, stronger to support the pelvic structures, and for the nerves to become less irritated and functioning better.

Watch as Dr. Ally explains how treatment for the pelvic floor nerves and muscles after excision can help with your recovery after surgery. 

About the PRM Protocol™

Take These With You

Questions to Ask Your Endometriosis Excision Surgeon

We know that many endometriosis patients have suffered for years with their pain, sometimes multiple surgeries, and the life-altering symptoms that accompany this disease. When meeting with our endometriosis specialists, we want to ensure all of your questions are answered that you understand the full surgical and treatment process. Be sure to ask these questions during your visit!

 

Your Safety is Our Priority

Our data proves not only the efficacy of our treatment but shows that patients see exceptional outcomes.

96%

Reduction in ER Visits

88%

Patients Stated They Missed 0 Days of Work Due to their Pain

75%

PRM Patients Note a Statistically Significant Improvement in Pain and Function

68%

Reduction in Opioid Use

Meet Our Team

PRM Endometriosis Excision Surgeons

Based in Texas

Dr. Rachael Haverland

Dr. Rachael Haverland, MD, MS FACOG is passionate about helping women feel their best by resolving their infertility and pelvic pain through endometriosis excision surgery. Possessing an extensive educational background including a Mayo Clinic fellowship, Dr. Haverland is uniquely qualified in pelvic pain, endometriosis, fibroids, and pelvic floor issues. She believes that the most important aspect of her role in women’s health is inspiring confidence and assisting patients in their journey to become the best version of themselves.

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Based in The Tri-State Areaa

Dr. Madhu Bagaria

Dr. Madhu Bagaria, MD, FACOG is board-certified in Obstetrics and Gynecology and Laparoscopic Surgery and Mayo Clinic trained. As an expert in women’s health, she has extensive experience treating pelvic pain conditions, abnormal uterine bleeding, and endometriosis. Dr. Bagaria believes in listening to her patients, understanding their experiences and their individual needs, and working with them on a treatment plan that works best for their condition and lifestyle.

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Based in The Greater DC Area

Dr. Melissa McHale

Dr. Melissa McHale, M.D., is a Gynecologic Surgeon and Endometriosis Excision Specialist. She has performed over 300 complex excision of endometriosis cases and she has extensive experience with sacral neuromodulator implants, transvaginal ultrasound diagnostics, and the management of pain and fertility in endometriosis patients. Dr. McHale completed her OB/GYN residency at Johns Hopkins before completing a two-year fellowship with Dr. Andrea Vidali, a world-renowned surgeon specializing in endometriosis, miscarriage, and reproductive immunology at Braverman Reproductive Immunology and Endometriosis Surgery.

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