Konstantinos Kyriakopoulos Endometriosis Surgeon-Advanced Laparoscopist

🇬🇧 This condition, known as sciatic endometriosis, can lead to pain, numbness, or tingling in the legs, often worsening during menstruation. The pain can be severe and may radiate from the lower back or pelvis down to the legs, sometimes even affecting mobility.

🇬🇷 Αυτή η κατάσταση, γνωστή ως ενδομητρίωση του ισχιακού νεύρου, μπορεί να οδηγήσει σε πόνο, μούδιασμα ή μυρμήγκιασμα στα πόδια, που συχνά επιδεινώνεται κατά τη διάρκεια της εμμήνου ρύσεως. Ο πόνος μπορεί να είναι έντονος και μπορεί να αντανακλά από το κάτω μέρος της πλάτης ή τη λεκάνη μέχρι τα πόδια, επηρεάζοντας μερικές φορές ακόμη και την κινητικότητα.

🇬🇧 After endometriosis surgery, you can expect some pain and discomfort, especially in the abdomen, which can be managed with pain medication. You'll likely experience bloating and gas pain due to the gas used during the procedure. Fatigue and mild nausea are also common as your body recovers from anesthesia. You'll need to take it easy for a few weeks, avoiding heavy lifting and strenuous activities, but light walking is encouraged to aid circulation and recovery. Proper care of the surgical incisions is essential to prevent infection.

🇬🇷 Μετά την χειρουργική επέμβαση ενδομητρίωσης, μπορείτε να αισθανθείτε κάποιο πόνο και δυσφορία, ειδικά στην κοιλιακή χώρα, η οποία μπορεί να αντιμετωπιστεί με παυσίπονα. Πιθανότατα θα αντιμετωπίσετε φούσκωμα, λόγω του αερίου που χρησιμοποιήθηκε κατά τη διάρκεια της διαδικασίας. Η κόπωση και η ήπια ναυτία είναι επίσης κοινά καθώς το σώμα σας αναρρώνει από την αναισθησία. Θα χρειαστεί να χαλαρώσετε για μερικές εβδομάδες, αποφεύγοντας τις βαριές άρσεις και τις επίπονες δραστηριότητες, αλλά το ελαφρύ περπάτημα ενθαρρύνεται για να βοηθήσει την κυκλοφορία και την ανάρρωση. Η σωστή φροντίδα των χειρουργικών τομών είναι απαραίτητη για την πρόληψη της μόλυνσης.

🇬🇧 While there's a chance of the condition returning, it’s relatively rare, and surgery can provide significant and lasting relief for many people. A well-executed surgery by an experienced doctor can greatly reduce symptoms and improve quality of life, making it a valuable option in managing endometriosis.

🇬🇷 Αν και υπάρχει πιθανότητα να επιστρέψει η κατάσταση, είναι σχετικά σπάνιο και η χειρουργική επέμβαση μπορεί να προσφέρει σημαντική και διαρκή ανακούφιση σε πολλούς ανθρώπους. Μια καλά εκτελεσμένη χειρουργική επέμβαση από έναν έμπειρο χειρουργό μπορεί να μειώσει σημαντικά τα συμπτώματα και να βελτιώσει την ποιότητα ζωής, καθιστώντας την πολύτιμη επιλογή για τη διαχείριση της ενδομητρίωσης.

🇬🇧 Trust your body and advocate for yourself. Advocating for yourself is crucial when dealing with endometriosis. If your pain or symptoms are being dismissed or overlooked, trust your instincts and persist in seeking the care you deserve. Don't hesitate to ask questions, seek second opinions, and find a healthcare provider who takes your concerns seriously. Remember, you know your body best, and your voice is essential in getting the diagnosis, treatment, and support you need.

🇬🇷 Εμπιστευτείτε το σώμα σας και υπερασπιστείτε τον εαυτό σας. Η υπεράσπιση του εαυτού σας είναι ζωτικής σημασίας όταν πάσχετε ενδομητρίωση. Εάν ο πόνος ή τα συμπτώματά σας αγνοούνται ή υποβαθμίζονται, εμπιστευτείτε το ένστικτό σας και επιμείνετε στην αναζήτηση της φροντίδας που σας αξίζει. Μη διστάσετε να κάνετε ερωτήσεις, να αναζητήσετε δεύτερες γνώμες και να βρείτε έναν γιατρό που θα λαμβάνει σοβαρά υπόψη τις ανησυχίες σας. Θυμηθείτε ότι γνωρίζετε καλύτερα το σώμα σας και η φωνή σας είναι απαραίτητη για τη διάγνωση, τη θεραπεία και την υποστήριξη που χρειάζεστε.

“We wished it was cancer”. A strong statement that shows the reality of having endometriosis. Vicky and Despoina, two of our patients, who struggled with endometriosis for years. At the screening of Below the Belt in Athens, during an exchange of information, both have confessed that during the time when they were searching for an answer and they were ignored, they wished it was cancer, because then they might have been taken seriously.

A commentary of Ray Garry published in the British Journal of Obstetrics and Gynecology in 1997 highlights a few important aspects of endometriosis overall.

Named “Laparoscopic excision of endometriosis: the treatment of choice?”, the said article talks about diagnosis and treatment of endometriosis. In the attached slides there are parts from the article exactly as they are written. Although in one paragraph the author refers to endometriosis as being ectopic endometrium, located outside the uterus, the overall article makes a point about medication, ablation and hysterectomy being ineffective in endometriosis. The author also mentions that the uterus is not involved in endometriosis, as such removing it does nothing if endometriosis is left behind.

Titles in inverted commas belong to us.

Source: Garry R. Laparoscopic excision of endometriosis: the treatment of choice? Br J Obstet Gynaecol. 1997 May;104(5):513-5. doi: 10.1111/j.1471-0528.1997.tb11523.x. PMID: 9166188.

🇬🇧 Chronic inflammation, common in endometriosis, can contribute to heart disease, and studies have found an increased incidence of cardiovascular issues in women with the condition.

🇬🇷Η χρόνια φλεγμονή, κοινή στην ενδομητρίωση, μπορεί να συμβάλει σε καρδιακές παθήσεις και μελέτες έχουν βρει αυξημένη συχνότητα καρδιαγγειακών προβλημάτων σε γυναίκες με την πάθηση.

Hormonal medication has proven to be inefficient in treating endometriosis in many cases. A short story of a patient who ended up having urgent surgery with us. Diagnosed in her home country with a 6cm ovarian cyst, she was put on birth control pills to treat it. However, it did not work and within three months the cyst grew to 9 cm.

Meet our surgeons:
Dr Konstantinos Kyriakopoulos, gynecologist and endometriosis surgeon
Dr Konstantinos Konstantinidis, thoracic surgeon
Dr Nikos Brattis, urologist surgeon
Dr Nikos Georgopoulos, general surgeon

🇬🇧 The pain experienced by women with endometriosis is real and not imagined or exaggerated. It’s important to emphasize the need for greater awareness and empathy towards those suffering from this condition. The pain and symptoms of endometriosis are often misunderstood or dismissed, leading to inadequate support and treatment. Acknowledging the legitimacy of this pain is crucial for providing proper care and support to those affected.

🇬🇷 Ο πόνος που βιώνουν οι γυναίκες με ενδομητρίωση είναι πραγματικός και όχι φανταστικός ή υπερβολικός. Είναι σημαντικό να τονίσουμε την ανάγκη μεγαλύτερης ευαισθητοποίησης και ενσυναίσθησης προς όσες υποφέρουν από αυτήν την πάθηση. Ο πόνος και τα συμπτώματα της ενδομητρίωσης συχνά παρεξηγούνται ή αγνοούνται, οδηγώντας σε ανεπαρκή υποστήριξη και θεραπεία. Η αναγνώριση της σημαντικότητας αυτού του πόνου είναι ζωτικής σημασίας για την παροχή της κατάλληλης φροντίδας και υποστήριξης στις πάσχουσες.

Endometriosis is considered to be an oestrogen dependent disease as such medical treatment aims to suppress the oestrogen, as a way of treating the symptoms, or, to treat the disease, depending on the philosophy of the specialist. Hormonal medication can be birth control pills or medication that puts activity of the o***y on hold, inducing therefore a temporary menopause.

Estrogens are a group of hormones that play an important role in female health. In addition to its reproductive role, oestrogen contributes to bone health and other essential bodily processes. When suppressed organs that require oestrogen will be affected. A well-known example is loss of bone density leading to osteoporosis.

Research has shown that gonadotropin-releasing hormone agonists cause significant bone density loss as early as 3 months of treatment, in particular trabecular bone loss of the vertebrae and hip. Recovering from bone loss may take up to 1 year after discontinuation of therapy (Dawood, M. Yusoff, 1993).

A study published in 2020 looked at the impact of hormonal treatment for endometriosis in teenagers, on bone density. The authors note that since esterogen is the main regulator of bone physiology, hormonal therapies may affect bone remodeling in this age group, concluding that hormonal administration may expose them to bone fragility later on.

Peak bone mass takes place during puberty, with oestrogen being a major determinant of bone mass. It decreases bone remodeling whilst maintaining its formation. In women, the bone mass reaches its peak around the age of 22, and the bone density is reached in the third decade of life. The peak bone mass of the spine is reached between the age of 33 and 40. As such, when interfering with the development of peak bone mass, it may impact the bone mineral density, increasing the risk of osteoporosis and fractures in the future. The lumbar spine is more sensitive to hormonal changes and pathologies and is one place that should be monitored for bone density loss (Naomi Guedj, 2020).

🇬🇧 Endometriosis can cause significant damage to organs. When endometrial-like tissue grows outside the uterus, it can form adhesions and scar tissue that bind organs together, leading to complications. In severe cases, these lesions can invade organs such as the bladder, bowel, and ovaries, causing pain, dysfunction, and sometimes requiring surgical intervention to repair or remove the affected tissues.

🇬🇷 Όταν ιστός παρόμοιος με ενδομήτριο αναπτύσσεται έξω από τη μήτρα, μπορεί να σχηματίσει συμφύσεις και ουλώδη ιστό που συνδέει τα όργανα μεταξύ τους, οδηγώντας σε επιπλοκές. Σε σοβαρές περιπτώσεις, αυτές οι εστίες μπορούν να εισβάλουν σε όργανα όπως η ουροδόχος κύστη, το έντερο και οι ωοθήκες, προκαλώντας πόνο, δυσλειτουργία και μερικές φορές απαιτούν χειρουργική επέμβαση για την αποκατάσταση ή την αφαίρεση των προσβεβλημένων ιστών.

🇬🇧 The rate at which endometriosis grows can vary widely among individuals. Some people may experience rapid progression of the disease, with symptoms worsening over a short period, while others may have a slower progression with stable symptoms for years. Factors influencing the growth rate include hormonal levels, genetic predisposition, immune system function, and individual health factors.

🇬🇷 Ο ρυθμός με τον οποίο αναπτύσσεται η ενδομητρίωση μπορεί να ποικίλλει ευρέως μεταξύ των ατόμων. Μερικοί άνθρωποι μπορεί να εμφανίσουν ταχεία εξέλιξη της νόσου, με συμπτώματα να επιδεινώνονται σε σύντομο χρονικό διάστημα, ενώ άλλοι μπορεί να έχουν πιο αργή εξέλιξη με σταθερά συμπτώματα για χρόνια. Οι παράγοντες που επηρεάζουν τον ρυθμό ανάπτυξης περιλαμβάνουν τα ορμονικά επίπεδα, τη γενετική προδιάθεση, τη λειτουργία του ανοσοποιητικού συστήματος και μεμονωμένους παράγοντες υγείας.

Dr Konstantinos Kyriakopoulos is a consultant gynaecologist and an endometriosis specialist. Dr Kyriakopoulos is a video-vetted excision endometriosis surgeon. Dr Kyriakopoulos is also certified in neuropelveology, level 2, after attending Prof Possover courses.

His formation in endometriosis surgery took place in the UK busiest endometriosis centre, BSGE accredited, seeing severe and complex cases. He brought his training and expertise back home, creating the only centre dedicated exclusively to excision in the area. Together with his colleagues, Dr Kyriakopoulos operates on patients from all over the world and his patients highly recommend him for his care and empathy.

🇬🇧 While ultrasounds are useful for diagnosing many conditions, endometriosis is not always visible through this method. Endometriosis lesions can be small, hidden, or located in areas not easily located on the ultrasound. Therefore, endometriosis specialists often rely on laparoscopy, a minimally invasive surgical procedure, to definitively diagnose endometriosis. During a laparoscopy, a camera is inserted through a small incision to visually inspect the pelvic organs, allowing for a more accurate identification of endometriosis that might be missed on standard imaging tests.

🇬🇷 Ενώ οι υπέρηχοι είναι χρήσιμοι για τη διάγνωση πολλών παθήσεων, η ενδομητρίωση δεν είναι πάντα ορατή μέσω αυτής της μεθόδου. Οι εστίες της ενδομητρίωσης μπορεί να είναι μικρές, κρυφές ή εντοπισμένες σε περιοχές που δεν ανιχνεύονται εύκολα από το υπερηχογράφημα. Ως εκ τούτου, οι ειδικοί ενδομητρίωσης συχνά βασίζονται στη λαπαροσκόπηση, μια ελάχιστα επεμβατική χειρουργική επέμβαση, για την οριστική διάγνωση της ενδομητρίωσης. Κατά τη διάρκεια μιας λαπαροσκόπησης, μια κάμερα εισάγεται μέσω μιας μικρής τομής για την οπτική επιθεώρηση των πυελικών οργάνων, επιτρέποντας την ακριβέστερη διάγνωση της ενδομητρίωσης που μπορεί να παραλείπεται στις τυπικές απεικονιστικές εξετάσεις.

We had a question in the comments recently that highlights once again an important question, how do we correctly treat endometriosis?

Endometriosis is a disease that can be found pretty much everywhere in the body, with some areas being most frequently affected. It can be symptomatic, causing a variety of symptoms, or asymptomatic.

When it comes to endometriosis treatment one of the main indications is symptoms. Depending on their severity, symptoms can be managed, in some cases, with life-style changes, medication, acupuncture and so on. In terms of medication this can be painkillers or hormonal medications. Hormonal medication is also divided into various types; from birth control pills to the ones that induce menopause. These methods might need to be followed/taken on a long-term basis. None of them gets rid of the cause of the symptoms.

So there is a difference between symptom management using non-surgical options, and removal of the disease, which will lead to symptoms eradication. Hormonal medication is, in some cases, a way of managing symptoms, while the disease stays in place. On the other hand, excision removes the disease meaning that the cause of pain and other symptoms has been removed.

In short, so far the best method for endometriosis is excision. Any other methods, including ablation do not remove the disease.

🇬🇧 When seeking a doctor for endometriosis, it's crucial to find one who listens and takes your concerns seriously. Look for a specialist in endometriosis with experience in treating the condition. Don't hesitate to ask questions about their experience and approach to managing endometriosis. It's also helpful to seek recommendations from support groups or trusted friends who have faced similar health issues. Remember, a good doctor should validate your symptoms, explore comprehensive treatment options, and work collaboratively with you to manage your condition effectively.

🇬🇷 Όταν αναζητάτε γιατρό για ενδομητρίωση, είναι σημαντικό να βρείτε κάποιον που ακούει και λαμβάνει στα σοβαρά τις ανησυχίες σας. Αναζητήστε έναν ειδικό στην ενδομητρίωση με εμπειρία στη θεραπεία της πάθησης. Μη διστάσετε να κάνετε ερωτήσεις σχετικά με την εμπειρία και την προσέγγισή τους στη διαχείριση της ενδομητρίωσης. Είναι επίσης χρήσιμο να αναζητάτε συστάσεις από ομάδες υποστήριξης ή έμπιστους φίλους που έχουν αντιμετωπίσει παρόμοια προβλήματα υγείας. Θυμηθείτε, ένας καλός γιατρός θα πρέπει να επικυρώνει τα συμπτώματά σας, να διερευνά ολοκληρωμένες επιλογές θεραπείας και να συνεργάζεται μαζί σας για να διαχειριστεί αποτελεσματικά την κατάστασή σας.

They say it takes a village to raise a child, a saying that depicts the efforts involved in many important matters. In endometriosis, it takes doctors and patients working together to improve care for endometriosis sufferers. By giving a voice to the ones who are gaslit, mistreated, wait years for diagnosis, told their pain is not real, it will help them, and others, to fight for their rights to proper diagnosis and care.

🇬🇧 Endometriosis can cause sudden, sharp pains that feel like stabbing sensations and significantly disrupt patients' daily life. These sharp pains can come on unexpectedly and vary in intensity, making it difficult for those affected to predict or manage their symptoms.

🇬🇷 Η ενδομητρίωση μπορεί να προκαλέσει ξαφνικούς, αιχμηρούς πόνους που μοιάζουν με αισθήσεις μαχαιρώματος και διαταράσσουν σημαντικά την καθημερινότητά των ασθενών. Αυτοί οι έντονοι πόνοι μπορεί να εμφανιστούν απροσδόκητα και ποικίλλουν σε ένταση, καθιστώντας δύσκολο για όσους επηρεάζονται να προβλέψουν ή να διαχειριστούν τα συμπτώματά τους.

We often see or hear questions about what it is as an endometriosis specialist? As the term suggests, in any area, a specialist is someone who has a more detailed knowledge of an issue, allowing them to fix the said problem in a proper way and with less damage. In endometriosis, a specialist is usually a gynaecologist surgeon who has dedicated their time in building their surgical skills and knowledge of endometriosis. Because it's a “niche” area, an endometriosis specialist treats mainly endometriosis. The number of surgeries varies from one surgeon to another. But the main method of treatment is excision and another important factor is their ability to recognise and remove all lesions.

Below the Belt screening photos.

A large audience, joined by the same desire; to raise awareness of a disease that for many is just period pain. Patients of Dr Kyriakopoulos from Greece, Canada, Ireland, their partners and parents, some of our lovely doctors, Shannon and her family, all under the same roof, watching the screen with interest and tears in their eyes. A documentary that had it all; pain from a young age, doctors that will not believe them, travelling from another country for life-saving surgery, infertility and miscarriage and hysterectomy. Parents and partners were on screen as well, with many tears and moments that made you wonder why the lack of care and interest for women’s health? In the documentary there is someone from Canada who travelled to the USA for surgery with her father, who is visibly upset seeing his daughter in pain.

Εύχομαι Καλό Δεκαπενταύγουστο σε όλους και όλες!

“There are far more things that we don't know about endometriosis than what we know”- Dr Kyriakopoulos

Most endometriosis case reports or studies are done on the adult population. This despite the fact that endometriosis can cause symptoms before periods starting or soon after. So far, in the literature, there are just a few reports of paediatric endometriosis. One of these cases was recently published by a team of researchers from Japan.

A 6 year old patient went to see their doctor, complaining of abdominal pain and vomiting. An ultrasound, an MRI and a CT were done showing a multilocular cystic lesion to the left of the bladder. The dimensions of it were 5.6x4.4x3 cm with partial calcification.

A laparoscopic surgery was performed, with removal of the cyst. Based on histopathological findings, the lesion was diagnosed as an ovarian endometrioma.

🇬🇧 Effective pain management is crucial for those with endometriosis to improve their quality of life. This includes using pain relievers, hormonal therapies, heat therapy and stress reduction techniques. In severe cases, surgical options may be necessary. Combining medical and holistic treatments tailored to individual needs can significantly reduce chronic pain.

🇬🇷 Η αποτελεσματική διαχείριση του πόνου είναι ζωτικής σημασίας για τις γυναίκες με ενδομητρίωση με στόχο τη βελτίωση της ποιότητας ζωής τους. Αυτό περιλαμβάνει τη χρήση αναλγητικών, ορμονικών θεραπειών, θερμοθεραπείας και τεχνικών μείωσης του στρες. Σε σοβαρές περιπτώσεις, μπορεί να χρειαστούν χειρουργικές επιλογές. Ο συνδυασμός ιατρικών και ολιστικών θεραπειών προσαρμοσμένων στις ατομικές ανάγκες μπορεί να μειώσει σημαντικά τον χρόνιο πόνο.

A powerful voice of endometriosis communities, an endometriosis specialist and three of his patients united by the same desire; to reduce the impact of endometriosis. Each with their own unique story in front of adversity, and now willing to share their struggles with others. 4 smile women with many scars on their souls and bodies, and an endometriosis surgeon, who each day brings a tiny bit of hope into one’s life.

For many, strength comes from within and in some cases, from harsh times. When you are fighting endometriosis, you are fighting years of misinformation, you are fighting doctors to take your pain seriously. For change to happen, we ought to work together. By standing together, we can better handle delay diagnosis, wrong treatments and ignorance. A small gesture can change one life.