Understanding Pelvic Organ Prolapse

Pelvic organ prolapse (POP) occurs when one or more pelvic organs — such as the uterus, bladder, or rectum — shift or descend into the vaginal canal due to weakened pelvic floor muscles and ligaments. This condition can cause discomfort, pressure, or bulging, and may affect bladder and bowel function as well as sexual health. At New York Gynecology Surgery & Endometriosis (NYGSE), our specialists diagnose and treat all types of prolapse using the most advanced, minimally invasive techniques available.

Restoring Strength, Comfort, and Confidence

Our team understands that pelvic organ prolapse can impact both physical comfort and emotional well-being. We approach every case with precision and compassion — beginning with a thorough evaluation and personalized treatment plan. Whether through pelvic floor therapy, non-surgical support devices, or advanced laparoscopic and robotic repair procedures, our goal is to restore your body’s natural balance and help you regain confidence in your daily life.

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COMMON QUESTIONS ABOUT Pelvic Organ Prolapse

Understanding Pelvic Organ Prolapse

Pelvic organ prolapse (POP) is a condition in which one or more of the pelvic organs, such as the uterus, bladder, or rectum, protrude or “fall” into the vagina due to weakened or damaged pelvic floor muscles and ligaments.

Pelvic organ prolapse can cause a variety of symptoms, including a feeling of heaviness or pressure in the pelvis, urinary incontinence or difficulty emptying the bladder, fecal incontinence or difficulty with bowel movements, pain or discomfort during sex, and vaginal bulging or protrusion.

There are different types of pelvic organ prolapse depending on which organ or organs are involved. Treatment for pelvic organ prolapse depends on the severity of the condition and the individual’s symptoms, but may include pelvic floor exercises, lifestyle changes, pessaries (devices inserted into the vagina to support the pelvic organs), or surgery.

Types of Pelvic Organ Prolapse

There are several types of pelvic organ prolapse, which are classified based on which organ or organs are involved:

Cystocele: This type of prolapse occurs when the bladder bulges into the front (anterior) vaginal wall.
Rectocele: This type of prolapse occurs when the rectum bulges into the back (posterior) vaginal wall.
Uterine prolapse: This type of prolapse occurs when the uterus falls into the vaginal canal.
Vaginal vault prolapse: This type of prolapse occurs when the top of the vagina prolapses into the vaginal canal after the uterus has been removed.
Enterocele: This type of prolapse occurs when a portion of the small intestine bulges into the vaginal canal.
Pelvic floor dysfunction: This type of prolapse is a general term used to describe a weakness or dysfunction in the muscles, ligaments, and connective tissue that support the pelvic organs.

It’s worth noting that many women with pelvic organ prolapse have a combination of these types of prolapse. Treatment for pelvic organ prolapse will depend on the specific type and severity of the prolapse, as well as the individual’s symptoms and medical history.

What are the Symptoms of Pelvic Organ Prolapse?

Symptoms of pelvic organ prolapse can vary depending on the severity of the prolapse and which organs are affected, but some common symptoms include:

A sensation of pressure or fullness in the pelvic region, as if something is falling out or dropping down
A feeling of heaviness in the lower abdomen or pelvis
Discomfort or pain during sexual intercourse
Urinary problems, such as difficulty emptying the bladder completely, frequent urination, or urinary incontinence (leakage of urine)
Bowel problems, such as constipation or fecal incontinence (leakage of stool)
Lower back pain
Vaginal bleeding or discharge

If you experience any of these symptoms, it is important to schedule an appointment with NYGSE, who can help diagnose and treat pelvic organ prolapse.

How is Pelvic Organ Prolapse Diagnosed?

Pelvic organ prolapse (POP) is typically diagnosed through a combination of medical history, physical examination, and additional testing as needed.

During a physical examination, a healthcare provider may ask you to bear down (as if having a bowel movement) or cough, which can help reveal any bulging of the pelvic organs through the vaginal opening. They may also perform a pelvic exam to assess the degree of prolapse, check for any abnormalities or changes in the vaginal walls or cervix, and evaluate the strength of the pelvic floor muscles.

Additional testing may include:

Imaging tests, such as a pelvic ultrasound or MRI, which can help visualize the prolapsed organs and any associated abnormalities or damage.
Urodynamic testing, which assesses how well the bladder and urethra are functioning and can help diagnose any associated urinary problems.
Colposcopy, which involves using a special instrument to examine the cervix and vaginal walls in more detail.

It is important to note that pelvic organ prolapse can often be diagnosed through a physical examination alone, and additional testing is only necessary if there are concerns about other potential underlying conditions or associated symptoms. It is always best to consult with a healthcare provider if you are experiencing symptoms or concerns about pelvic organ prolapse.

What is Prolapse Repair Procedure?

Prolapse repair procedure refers to the surgical procedures used to correct pelvic organ prolapse (POP), which is the condition in which one or more of the pelvic organs (such as the bladder, uterus, or rectum) bulge or descend into the vaginal wall or outside the body.

The specific prolapse repair procedure recommended will depend on the severity and type of prolapse, as well as the individual’s medical history and other factors. Common procedures include:

Vaginal mesh surgery: In this procedure, a synthetic mesh is used to support the prolapsed organ and hold it in place. This surgery may be recommended for severe cases of POP or for women who have experienced a recurrence of POP after previous surgery.
Sacrocolpopexy: This procedure involves using a mesh to attach the prolapsed organ to the sacrum (lower spine), providing support and preventing further descent.
Hysterectomy: In some cases, a hysterectomy (surgical removal of the uterus) may be recommended as a treatment for POP, particularly if the prolapse involves the uterus.
Colporrhaphy: This procedure involves repairing the vaginal wall and supporting tissues to correct the prolapse. In some cases, additional materials such as a synthetic mesh or the patient’s own tissue may be used to reinforce the repair.

It is important to note that prolapse repair procedures are generally considered safe and effective, but all surgical procedures carry some risk.

How Much is the Treatment of Pelvic Organ Prolapse ?

The cost of treatment for pelvic organ prolapse in the United States can vary widely depending on several factors such as the severity of the condition, the type of treatment needed, the location, and the healthcare provider.

For mild cases, conservative treatments such as pelvic floor exercises or pessaries may be recommended. The cost of pessaries ranges from $50-$500, and pelvic floor therapy can cost between $150-$350 per session.
For moderate to severe cases, surgical intervention may be required. The cost of surgery for pelvic organ prolapse can range from $5,000-$20,000 or more, depending on the type of surgery, the length of hospital stay, and other factors. The cost of surgical treatment also includes pre-operative and post-operative care, diagnostic tests, and any medications or medical supplies required.
According to a 2021 report by the Healthcare Bluebook, the fair price range for laparoscopic pelvic organ prolapse repair surgery in the United States is between $11,958 and $27,427. This estimate includes the cost of the surgery, anesthesia, and facility fees, but does not include pre- or post-operative care or any additional charges that may be incurred.

It is important to note that health insurance may cover some or all of the cost of treatment, depending on the individual policy and the specific treatment recommended. It is always a good idea to check with your insurance provider to understand your coverage and potential out-of-pocket costs.

Service Areas

At NYGSE, we provide advanced pelvic organ prolapse treatment for patients in Babylon, Bay Shore, and surrounding Long Island communities

Pankaj Singhal, MD, MS, MHCM

With over 12 years of experience in both academic and private healthcare, Dr. Singhal has trained more than 45 gynecologic surgeons and fellows in minimally invasive and oncologic procedures. He has pioneered new surgical techniques for endometriosis and laparoscopic surgery, completing more than 5,700 robotic-assisted cases nationwide. Renowned for taking on the most complex cases other centers turn away, Dr. Singhal continues to advance the standard of women’s surgical care.

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Gynecologic Oncology

Comprehensive Care for Gynecologic Cancers

At New York Gynecology Surgery & Endometriosis (NYGSE), we provide expert diagnosis and treatment for cancers affecting the uterus, cervix, ovaries, fallopian tubes, vagina, and vulva. Using advanced imaging, minimally invasive surgical techniques, and personalized treatment planning, our team delivers care that’s both precise and compassionate. Every case is approached with the goal of preserving health, comfort, and peace of mind — from early detection to long-term follow-up.

Precision, Experience, and Compassion in Every Step

Personalized Treatment. Proven Results.

Our gynecologic oncology specialists combine decades of surgical expertise with the latest advancements in robotic and laparoscopic surgery. This integrated approach allows us to treat even the most complex cancers while minimizing pain, scarring, and recovery time. We understand that a cancer diagnosis can feel overwhelming — which is why our team guides each patient through every step with clarity, empathy, and unwavering support.

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COMMON QUESTIONS ABOUT GYNECOLOGIC ONCOLOGY

What is Gynecologic Cancer?

Gynecologic cancer refers to any cancer that originates in a woman’s reproductive system, including the cervix, uterus, ovaries, fallopian tubes, vagina, and vulva. These types of cancer can occur in women of all ages, but the risk increases as a woman gets older.

What are the different Types of Gynecologic Cancer?

Cervical cancer: The origin of cervical cancer is the cervix, which is the lower and narrow part of the uterus, also known as the womb.
Ovarian cancer: The ovaries, located on both sides of the uterus, are where ovarian cancer typically originates. However, some types of ovarian cancers may also develop in the fallopian tubes or peritoneum.
Uterine cancer: The uterus, a pear-shaped organ located in a woman’s pelvis, is where uterine cancer begins. It is the organ where a fetus grows during pregnancy.
Vaginal cancer originates in the vagina, which is a hollow, tube-like structure that connects the bottom of the uterus to the outside of a woman’s body.
Vulvar cancer is a type of cancer that begins in the vulva, which is the external part of a woman’s genital organs. The vulva includes the inner and outer labia, the clitoris, and the vaginal opening. Vulvar cancer can occur in any part of the vulva, but most commonly develops on the labia minora or majora, the two folds of skin surrounding the vaginal opening.
Fallopian tube cancer is a rare type of gynecologic cancer that originates in the fallopian tubes, which connect the ovaries and the uterus. It is a relatively uncommon form of cancer, accounting for only 1 to 2 percent of all gynecologic cancers. There have been approximately 1,500 to 2,000 reported cases of fallopian tube cancer worldwide. Symptoms of fallopian tube cancer may include abdominal pain, bloating, and vaginal bleeding, but they are often nonspecific and may be mistaken for other conditions.

Gynecologic cancers are distinct from one another, having varied signs and symptoms, diverse risk factors, and distinct preventive measures. Every woman is susceptible to gynecologic cancers, with the likelihood increasing with age. Early detection of gynecologic cancers is crucial for effective treatment.

What are the Symptoms of Gynecologic Cancer?

Being mindful of your body and recognizing what is typical for you is essential to identify the symptoms or warning signs of gynecologic cancer, such as cervical, ovarian, uterine, vaginal, and vulvar cancers.

If you experience unusual vaginal bleeding, it is critical to seek medical attention promptly. Any vaginal bleeding after menopause should be reported to your doctor immediately. If you have not yet reached menopause and observe that your periods are heavier, longer than usual, or if you notice abnormal bleeding between periods, talk to your doctor.

If you experience any other warning signs that persist for more than two weeks and are not typical for you, it is important to see a doctor. While symptoms may be attributed to something other than cancer, consulting with a doctor is the only way to confirm the cause.

Signs and symptoms differ among individuals, and each gynecologic cancer manifests with its own distinct set of warning signs and symptoms.

The symptoms of gynecologic cancers vary depending on the type of cancer, the stage of the cancer, and other individual factors. However, some common symptoms that women with gynecologic cancers may experience include:

Abnormal vaginal bleeding, such as bleeding between periods or after menopause
Unusual vaginal discharge that may be bloody, foul-smelling, or discolored
Pain or discomfort during sexual intercourse
Pelvic pain or pressure
Abdominal swelling or bloating
Changes in bowel or bladder habits
Fatigue, weakness, or unexplained weight loss

It is important to note that these symptoms can also be caused by other conditions or infections. However, if you experience any of these symptoms that are unusual for you and persist for more than two weeks, it is important to see a doctor for evaluation and diagnosis. Early detection of gynecologic cancers can significantly improve treatment outcomes.

what are the Causes of Gynecologic Cancer?

Gynecologic cancers occur when there is a change in the cells lining one of the reproductive organs, leading to abnormal cell growth and multiplication. Despite ongoing research, the exact cause of cancer remains unknown to health experts.

However, certain risk factors have been identified that can increase the likelihood of developing various types of gynecologic cancers.

There are several risk factors that may increase a woman’s likelihood of developing gynecologic cancers. These risk factors include:

Age: The risk of developing gynecologic cancers increases as women get older, with the majority of cases occurring in women over the age of 50.
Family history: Women with a family history of gynecologic cancers, particularly ovarian or breast cancer, may have a higher risk of developing these cancers.
Inherited genetic mutations: Some genetic mutations, such as BRCA1 and BRCA2, increase the risk of developing ovarian and breast cancers.
Human papillomavirus (HPV) infection: Certain types of HPV can increase the risk of developing cervical cancer.
Smoking: Smoking has been linked to an increased risk of cervical and vulvar cancers.
Obesity: Women who are obese have a higher risk of developing endometrial cancer.
Hormonal factors: Factors such as early menstruation, late menopause, and never having children have been linked to an increased risk of some gynecologic cancers.
Previous cancer treatment: Women who have undergone radiation therapy to the pelvic area or chemotherapy may have an increased risk of developing certain gynecologic cancers.

It is important to note that having one or more risk factors does not necessarily mean that a woman will develop gynecologic cancer. Many women who develop gynecologic cancers have no known risk factors, and many women with risk factors do not develop these cancers.

How is gynecologic cancer detected?

Early detection of gynecologic cancer is important for improving outcomes and increasing chances of successful treatment.

Here are some common ways to detect gynecologic cancer:

Pap smear: A Pap smear is a test that checks for abnormal cells in the cervix, which can be a sign of cervical cancer. Women should begin getting Pap smears at age 21 and continue every 3 years until age 29. After age 30, women can get a Pap smear and HPV test every 5 years.
HPV test: An HPV test checks for the presence of human papillomavirus (HPV) in the cervix, which can lead to cervical cancer. Women over age 30 may be tested for HPV in combination with a Pap smear.
Pelvic exam: A pelvic exam is a physical exam that allows a healthcare provider to examine the uterus, ovaries, cervix, and other pelvic organs for signs of cancer or other abnormalities.
Ultrasound: An ultrasound uses sound waves to create images of the reproductive organs, allowing healthcare providers to look for signs of cancer.
Biopsy: A biopsy is a procedure in which a small sample of tissue is removed from the reproductive organs and examined for signs of cancer.
Blood tests: Some gynecologic cancers, such as ovarian cancer, can be detected through blood tests that look for specific tumor markers.

It’s important for women to schedule regular gynecologic exams and discuss any concerns with their healthcare provider.

What are the Stages of Gynecologic Cancer?

The stages of gynecologic cancer refer to the extent to which the cancer has spread within the body. The stage of the cancer plays an important role in determining the appropriate treatment plan and predicting the prognosis for the patient.

Most cancer teams use the system developed by the American Joint Committee on Cancer, known as the TNM staging system.

The TNM staging system is a widely used system for staging cancer. It stands for Tumor, Node, and Metastasis, and is based on three key pieces of information about the cancer:

Tumor (T): This refers to the size and extent of the primary tumor.
Node (N): This refers to whether or not the cancer has spread to nearby lymph nodes.
Metastasis (M): This refers to whether or not the cancer has spread to other parts of the body.

Each of these factors is assigned a number, and the combination of numbers determines the stage of the cancer. The stages are typically numbered from 0 to IV, with higher numbers indicating more advanced cancer.

For example, in the TNM staging system for cervical cancer, the stages are as follows:

Stage 0: Tis, N0, M0 (carcinoma in situ)
Stage I: T1, N0, M0 (cancer confined to the cervix)
Stage II: T2, N0, M0 (cancer has spread beyond the cervix, but not to the pelvic wall or lower third of the vagina)
Stage III: T3-T4, any N, M0 (cancer has spread to the pelvic wall, lower third of the vagina, or causing kidney problems)
Stage IV: Any T, any N, M1 (cancer has spread to distant organs, such as the bladder or rectum)

The TNM staging system is used for many types of cancer, including gynecologic cancers, and helps doctors plan appropriate treatment and make prognostic predictions.

Treatment of Gynecologic Cancer

It is advisable to request a referral to a gynecologic oncologist if your doctor diagnoses you with gynecologic cancer. These specialists are specifically trained to manage cancers affecting a woman’s reproductive system and will collaborate with you to develop an appropriate treatment strategy.

What are the treatment options for gynecologic cancer?

The types of treatment for gynecologic cancer depend on the type and stage of the cancer, as well as the patient’s overall health and preferences. Here are some common types of treatment:

Surgery: Surgery is often the first line of treatment for gynecologic cancer. It involves removing the cancerous tissue and can range from a simple procedure to remove a small tumor to a more extensive surgery to remove the uterus, ovaries, and other organs.
Chemotherapy: Chemotherapy is a type of treatment that uses drugs to kill cancer cells. It can be administered intravenously or orally and may be used alone or in combination with other treatments.
Radiation therapy: Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells. It can be given externally or internally, and may be used alone or in combination with other treatments.
Hormone therapy: Hormone therapy is used to treat some types of gynecologic cancer that are sensitive to hormones, such as some types of breast and ovarian cancer. It involves taking medication that blocks or lowers hormone levels in the body.
Targeted therapy: Targeted therapy is a type of treatment that targets specific molecules or pathways that are involved in the growth and spread of cancer cells. It may be used in combination with other treatments.
Palliative care: Palliative care focuses on relieving the symptoms and improving the quality of life for patients with advanced or incurable gynecologic cancer. It may involve pain management, symptom relief, and emotional and spiritual support.

The treatment plan for gynecologic cancer is highly individualized, and patients should discuss their options with their healthcare team to determine the best approach for their particular situation.

NYGSE Approach

We understand that a cancer diagnosis can be overwhelming and scary. Here at NYGSE, we build our teams around you. Our expert oncologists will help guide you through this difficult time, answering any questions you may have along the way. We are here for you and will do everything in our power to meet your specific needs and exceed your expectations.

If you or a loved one is experiencing symptoms that may be related to cancer, please call us as soon as possible.

At NYGSE, we provide expert gynecologic oncology care for patients in Babylon, Bay Shore, and surrounding Long Island communities.

Types of Gynecologic Cancer

Fallopian tube cancer

Pankaj Singhal, MD, MS, MHCM

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Laparoscopy Surgery

Minimally Invasive Laparoscopic Surgery

At New York Gynecology Surgery (NYGS), we specialize in advanced laparoscopic procedures designed to diagnose and treat a wide range of gynecologic and pelvic conditions with minimal disruption to the body. Through tiny incisions and precision-guided instruments, laparoscopy allows our surgeons to perform complex procedures with less pain, scarring, and downtime compared to traditional open surgery.

Precise, Personalized Surgical Care

Personalized Treatment. Proven Results.

Our surgeons use state-of-the-art imaging and minimally invasive techniques to treat conditions such as endometriosis, ovarian cysts, fibroids, and certain cancers. With extensive experience in both diagnostic and therapeutic laparoscopy, the NYGS team delivers care that prioritizes precision, safety, and rapid recovery—helping women return to their daily lives with confidence and comfort.

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COMMON QUESTIONS ABOUT LAPAROSCOPY

What is Laparoscopy?

Laparoscopy, also known as diagnostic laparoscopy or keyhole surgery, is a minimally invasive surgical technique that is used to diagnose and treat a variety of conditions in the abdomen and pelvis.

During a laparoscopy, a surgeon makes several small incisions in the abdomen and inserts a thin, flexible tube called a laparoscope. The laparoscope contains a camera and a light source, which allow the surgeon to see the inside of the abdomen on a video monitor. The surgeon can also insert other surgical instruments through the incisions to perform procedures such as removing a damaged organ or taking a biopsy.

Laparoscopy is often used to diagnose and treat conditions such as endometriosis, ovarian cysts, ectopic pregnancy, fibroids, and certain types of cancer. Because it is less invasive than traditional surgery, laparoscopy can result in less pain and scarring, shorter recovery times, and a reduced risk of complications.

What are the Benefits of Laparoscopy?

Laparoscopy offers several advantages over traditional open surgery, including:

Less invasive: Laparoscopy requires only small incisions, compared to the larger incision required for open surgery. This results in less trauma to the body, less pain, and less scarring.
Faster recovery time: Because laparoscopy is less invasive, the recovery time is generally shorter than for open surgery. Patients are typically able to return to their normal activities more quickly.
Reduced risk of complications: Because laparoscopy is less invasive, there is less risk of complications such as bleeding, infection, and other surgical complications.
Improved accuracy and visualization: Laparoscopy provides the surgeon with a magnified view of the surgical site, allowing for more accurate and precise surgical procedures.
Reduced hospital stay: Laparoscopy is often performed on an outpatient basis, meaning that patients can go home on the same day as the surgery. Even when an overnight hospital stay is required, it is typically shorter than for open surgery.
Reduced costs: Laparoscopy may be less expensive than open surgery due to the reduced hospital stay, reduced need for pain medication, and faster recovery time.

Overall, laparoscopy is a safe and effective alternative to traditional open surgery for many procedures. However, not all procedures can be performed laparoscopically, and the suitability of laparoscopy for a given patient and procedure should be determined by a qualified surgeon.

How Safe is Laparoscopy?

Laparoscopy is generally considered a safe and effective surgical technique. It offers several advantages, including smaller incisions, reduced blood loss, shorter hospital stays, faster recovery times, and lower post-operative pain compared to traditional open surgery. The minimally invasive nature of laparoscopy typically results in less tissue trauma and scarring, contributing to a generally quicker return to normal activities. However, like any surgical procedure, there are potential risks, such as the small possibility of organ injury, infection, bleeding, and anesthesia-related complications. These risks are generally lower than with open surgery, but they still exist.

Overall, the safety of laparoscopy depends on the expertise of the surgical team, the patient’s health, and the specific procedure being performed. Patients should thoroughly discuss the potential risks and benefits with their healthcare provider before undergoing laparoscopic surgery.

How Much Does Laparoscopy Cost?

The cost of laparoscopy can vary widely depending on a number of factors, including the location of the procedure, the specific type of laparoscopy being performed, and the individual patient’s health insurance coverage. Without knowing these details, it’s difficult to provide an accurate estimate of the cost.

In general, however, the cost of a laparoscopy in the United States can range from several thousand dollars to tens of thousands of dollars, depending on the factors mentioned above. According to a 2020 report by the Healthcare Bluebook, the average cost of a laparoscopy in the United States was $7,840, with a range of $2,250 to $25,500.

In New York, the cost of laparoscopy can also vary widely depending on the same factors. According to data from the New York State Department of Health, the average cost of a laparoscopy in New York State in 2019 was $17,392, but this figure may not accurately reflect the cost of a specific procedure in a specific location.

It’s important to note that many health insurance plans cover laparoscopy, but the out-of-pocket cost for the patient may still vary depending on the specifics of the plan. It’s always a good idea to check with your insurance provider to understand your coverage and any potential costs you may be responsible for.

Laparoscopy in Gynecology and Cancer Treatment

Laparoscopy is commonly used in gynecology and cancer treatment for both diagnostic and therapeutic purposes. Here are some examples:

Gynecology: Laparoscopy is often used to diagnose and treat conditions such as endometriosis, ovarian cysts, uterine fibroids, and infertility. During a laparoscopy, the surgeon can visualize the pelvic organs, take biopsies, and remove or treat any abnormalities. Laparoscopic hysterectomy (removal of the uterus) and oophorectomy (removal of the ovaries) are also common procedures performed in gynecology.
Cancer treatment: Laparoscopy is increasingly used in the diagnosis and staging of various cancers, including gastrointestinal, gynecologic, and urologic cancers. For example, laparoscopic lymph node dissection is a minimally invasive procedure used in the staging of some types of cancer. Laparoscopy may also be used in the treatment of certain cancers, such as ovarian cancer. In some cases, laparoscopy may be used to remove cancerous tissue or perform other types of cancer surgery.

In both gynecology and cancer treatment, laparoscopy is generally associated with less pain, shorter hospital stays, and faster recovery times compared to open surgery. However, not all patients or conditions are suitable for laparoscopy, and the suitability of laparoscopy for a given patient and procedure should be determined by a qualified surgeon.

Service Areas

At NYGSE, we provide minimally invasive laparoscopic gynecologic surgery for patients in Babylon, Bay Shore, and surrounding Long Island communities.

Pankaj Singhal, MD, MS, MHCM

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Robotic Surgery

Advanced Robotic Care for Women’s Health

At New York Gynecology Surgery & Endometriosis (NYGSE), we specialize in providing advanced, minimally invasive surgical options for women facing complex gynecologic conditions. Using the latest robotic-assisted technology, our surgeons can perform procedures with unmatched precision—reducing blood loss, minimizing scarring, and speeding recovery. This modern approach allows many women to return home the same day, resume daily activities sooner, and experience significantly less discomfort than with traditional surgery.

Excellence in Every Procedure

Personalized Treatment. Proven Results.

Led by Dr. Pankaj Singhal, one of the nation’s most experienced robotic gynecologic surgeons, our team has performed thousands of successful robotic surgeries. Whether treating fibroids, endometriosis, or other complex conditions, we combine expertise, compassion, and advanced technology to deliver the highest standard of care—helping women heal faster, feel better, and live fully.

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COMMON QUESTIONS ABOUT ROBOTIC SURGERY

What is Gynecologic Robotic Surgery?

Gynecologic robotic surgery employs robotic-assisted technology to perform various gynecological procedures with minimal invasiveness. This surgical technique involves a highly trained surgeon operating a specialized surgical robot from a console. The robot’s arms are equipped with small instruments that are used to conduct the surgery through small incisions in the patient’s abdomen.

This innovative approach is utilized for a range of gynecologic procedures, including hysterectomy, myomectomy, removal of ovarian cysts, and excision of endometriosis, among others. By harnessing robotic technology, this technique enables greater surgical precision and accuracy, reduces blood loss, and leads to decreased postoperative pain and quicker recovery times for patients.

At NYGSE, we offer advanced robotic procedures in gynecology, and our surgeons possess extensive specialization and experience in performing these procedures. With a track record of thousands of successful cases, our patients can rest assured knowing that they will receive the best possible outcomes.

How Does the Robotic Surgical System Work?

The functioning of the Robotic surgical system involves creating small openings in the body and introducing miniaturized instruments and a high-definition three-dimensional camera. From a nearby console, the surgeon operates the instruments, akin to maneuvering in a video game. The surgeon’s movements are translated into precise actions within the body through the master controls. This grants the surgeon full command over the system during the entire procedure. In certain cases, it may be possible to perform the surgery without any skin incisions at all.

Is a Robot Operating On Me?

While patients might harbor concerns regarding robotic surgery, it’s important to note that the Robotic Surgical System is under the direct control of the surgeon. The surgeon guides the machine to execute precise movements, and the robot itself does not autonomously make decisions or conduct incisions. Instead, it responds to the surgeon’s commands, thereby enhancing precision. Ultimately, the surgeon retains complete control over the procedure at all times.

Robotic Surgery: What to Expect

During a Robotic-assisted surgery, your surgeon operates from a nearby console instead of directly standing over you as in traditional surgery. The procedure typically involves the following steps:

Your surgeon creates small incisions in your body, typically measuring one to two centimeters.
Miniature robotic instruments and a high-quality camera are then inserted into your body by the surgeon.
Your surgeon takes a seat at the nearby console, where a magnified view of the surgical site with exceptional resolution is displayed.
From the console, your surgeon manipulates the controls, which accurately translate into precise movements within your body in real-time.
The robotic instruments possess enhanced dexterity and a broader range of motion compared to a human, enabling your surgeon to successfully perform intricate surgeries in challenging-to-access areas.

What are the Benefits of Robotic-assisted Surgery?

Robotic-assisted surgery presents numerous advantages, which include:

Reduced pain and scarring: The smaller incisions employed in robotic-assisted surgery result in decreased pain and scarring compared to traditional open surgery.
Shorter hospital stays: Patients undergoing robotic-assisted surgery typically have shorter hospital stays in comparison to those undergoing traditional open surgery.
Quicker recovery times: The use of smaller incisions and limited tissue damage in robotic-assisted surgery can contribute to faster patient recovery compared to traditional open surgery.
Enhanced precision and accuracy: The robotic instruments utilized in these procedures offer superior precision and accuracy, surpassing the capabilities of a surgeon’s hands. This enables the performance of delicate and intricate procedures with greater efficacy.
Reduced risk of complications: Robotic-assisted surgery, being less invasive than traditional open surgery, carries a lower risk of complications such as infections and bleeding.
Improved visualization: The utilization of a high-definition 3D camera in robotic-assisted surgery provides enhanced visualization of the surgical site, leading to more accurate and precise procedures.

Overall, robotic-assisted surgery provides a multitude of benefits when compared to traditional open surgery, making it an appealing option for many patients.

Can any Doctor Perform Robotic Surgery?

Proficiency in performing robotic surgery requires specific training and expertise, and not every doctor possesses the necessary skills. However, with the appropriate training, any doctor can master the Robotic Surgical System. At NYGSE, we prioritize our patients’ well-being and strive to provide a positive experience.

Our surgeons have made significant investments in training, ensuring that our robotic surgeons, as well as the entire surgical team, are well-prepared.

Is Robotic Surgery Safe?

Robotic surgery is deemed safe when carried out by a proficient and well-trained surgeon. Nonetheless, akin to any surgical procedure, there are inherent risks involved, including the possibility of bleeding, infection, or complications related to anesthesia. Nevertheless, research indicates that robotic surgery may exhibit lower rates of complications and expedited recovery times compared to traditional surgery, particularly for specific procedures.

It is crucial to recognize that the safety of robotic surgery is contingent upon various factors, such as the patient’s overall health and the complexity of the operation. Therefore, it is essential for patients to consult their surgeon and engage in a comprehensive discussion regarding the potential benefits and risks associated with robotic surgery. This collaborative conversation will assist in determining whether robotic surgery is the most suitable option for their specific circumstances.

How Does the Robotic Surgeon See What He or She is Doing?

The Robotic System integrates an internal camera that captures real-time images from inside your body and transmits them to your surgeon at the console. The images viewed by your surgeon through the Robotic System offer greater magnification and enhanced resolution compared to what they would perceive while physically positioned over you.

How Many Days Will I Miss from Work?

The duration of the recovery period following surgery can differ for each patient, making it crucial to engage in a detailed discussion with your doctor regarding your specific case. Typically, patients may expect to stay in the hospital for one to two nights before being released to return home. In general, patients can anticipate a complete recovery within six weeks following the surgery.

Pain Management Options after Robotic Surgery

At NYGSE, our utmost priority is to prioritize the effective management of pain following surgical procedures, including robotic surgery. Our dedicated team conducts comprehensive research on pain management techniques, guaranteeing that your pain is sufficiently addressed throughout every stage of the surgical process—from preoperative to intraoperative and postoperative periods. We acknowledge that pain may persist even after your hospital discharge, and therefore, we will work closely with you to develop a personalized pain treatment plan to effectively manage your pain at home.

NYGSE Approach

At NYGSE, we understand that undergoing robotic surgery can be an intimidating and anxiety-inducing experience. To ensure your comfort and peace of mind, we assemble teams that are specifically designed to cater to your unique requirements.

Our experienced robotic surgeons will offer unwavering support during this challenging period and address any apprehensions or questions you may have. We are fully committed to meeting your individual needs and exceeding your expectations throughout your surgical journey.

We offer advanced robotic gynecologic surgery for patients in Babylon, Bay Shore, and surrounding Long Island communities.

How is robotic gynecologic surgery different from traditional laparoscopy?

Both robotic and traditional laparoscopy are minimally invasive, but in robotic surgery the surgeon operates from a console controlling robotic instruments with enhanced range of motion, 3D visualization, and tremor filtration, while in traditional laparoscopy the surgeon manually manipulates instruments at the bedside. The robot is not autonomous, the surgeon controls every move.

When is robotic surgery recommended for gynecologic conditions?

Robotic gynecologic surgery is often recommended for complex conditions like advanced endometriosis, fibroids, ovarian masses, pelvic adhesions, prolapse, and hysterectomy when enhanced precision and 3D visualization aid delicate dissection. The best approach depends on disease severity, prior surgeries, uterine size, fertility goals, patient health, and surgeon experience.

Is robotic surgery effective for treating endometriosis?

Yes, robotic surgery can effectively treat endometriosis, especially deep infiltrating disease and adhesions, using precise excision with 3D visualization and articulated instruments, with outcomes comparable to advanced laparoscopy when performed by experienced surgeons. Effectiveness depends on disease stage, symptom goals, and surgeon expertise.

Can robotic surgery be used for hysterectomy?

Yes, robotic-assisted hysterectomy is a common minimally invasive option using small incisions and enhanced precision, often reducing pain, scarring, blood loss, and recovery time compared with open surgery. Candidacy depends on uterine size, pathology, prior surgeries, and individual patient factors.

Who is a good candidate for robotic gynecologic surgery?

Good candidates are patients needing minimally invasive treatment for conditions like endometriosis, fibroids, ovarian cysts, adhesions, prolapse, or hysterectomy, when anatomy and health permit. Candidacy depends on diagnosis, prior surgeries, fertility goals, and overall health.

Can robotic surgery help with complex pelvic adhesions or scar tissue?

Yes, robotic surgery can help manage complex pelvic adhesions and scar tissue by providing enhanced 3D visualization and precise dissection, though the best approach depends on the extent and location of adhesions. Adhesions from prior surgery, endometriosis, or infection can complicate procedures and cause pain.

Pankaj Singhal, MD, MS, MHCM

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Uterine Fibroids

Uterine Fibroids in Long Island New York

We take pride in providing an accessible and efficient solution through our minimally invasive, robotic-assisted treatment of uterine fibroids, and it’s worth noting that numerous patients come from distant locations to undergo this procedure with us.

Don’t hesitate to reach out to Dr. Pankaj Singhal for a thorough evaluation of your suitability for the procedure. To arrange your consultation for uterine fibroids treatment at our private office in Bay Shore, Long Island, New York, please feel free to get in touch by dialing (631) 533-9733 or simply submit your appointment request via our secure online form.

Comprehensive, Compassionate Care for Every Woman

Personalized Treatment. Proven Results.

At New York Gynecology Surgery & Endometriosis (NYGSE), our mission is to make advanced treatment options accessible to every woman seeking relief from fibroid-related symptoms. Using the latest robotic and laparoscopic techniques, we’re able to minimize recovery time, preserve fertility when possible, and deliver consistent, long-lasting outcomes. Our patients trust us for precision, compassion, and a level of expertise that few centers can match.

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COMMON QUESTIONS ABOUT UTERINE FIBROIDS

Understanding Uterine Fibroids

Uterine fibroids, also known as leiomyomas, are noncancerous growths that develop in the muscular wall of the uterus. They are the most common type of noncancerous tumor in women of reproductive age.

Fibroids can range in size from small, pea-sized growths to large tumors that can distort the shape of the uterus. They can be located within the uterine wall, on the outer surface of the uterus, or protruding into the uterine cavity.

Fibroids are often asymptomatic, but they can cause heavy menstrual bleeding, prolonged periods, pelvic pain or pressure, frequent urination, constipation, and backache. In some cases, they can also cause infertility or complications during pregnancy.

The exact cause of fibroids is unknown, but they are thought to be related to hormonal imbalances and genetics. Treatment options for fibroids include medication, surgery, or minimally invasive procedures such as uterine artery embolization or magnetic resonance-guided focused ultrasound.

How to Diagnose Uterine Fibroids?

Uterine fibroids can be diagnosed through a combination of medical history, physical examination, and imaging tests. Here are some common diagnostic procedures for uterine fibroids:

Medical history and physical examination: Your doctor will ask you about your symptoms and medical history. They will also perform a pelvic examination to check for the size and location of fibroids.
Ultrasound: This imaging test uses high-frequency sound waves to create images of the uterus and ovaries. It can help identify the size, number, and location of fibroids.
Magnetic resonance imaging (MRI): An MRI scan can provide detailed images of the uterus and surrounding organs. It is especially useful in identifying small fibroids or those located deep within the uterine wall.
Hysteroscopy: In this procedure, a thin, lighted tube with a camera on the end is inserted into the uterus through the vagina to directly visualize the uterine cavity and identify fibroids.
Endometrial biopsy: This involves removing a small sample of tissue from the lining of the uterus to check for abnormal cells or signs of cancer. It is usually performed if there is abnormal vaginal bleeding or if there is a suspicion of cancer.
Blood tests: Certain blood tests, such as a complete blood count or thyroid function test, may be ordered to rule out other conditions that can cause similar symptoms.

Based on the results of these tests, your doctor will be able to diagnose whether you have uterine fibroids and develop a treatment plan based on your individual needs.

What are the Symptoms of Uterine Fibroids?

Not all women with uterine fibroids experience symptoms. When symptoms do occur, they may vary in intensity and frequency depending on the size, number, and location of the fibroids. Some common symptoms of uterine fibroids include:

Heavy menstrual bleeding: This is the most common symptom of fibroids, and it can result in prolonged periods or bleeding between periods.
Pelvic pain or pressure: Fibroids can cause discomfort or pain in the lower abdomen, back, or legs. They can also cause pressure on the bladder or rectum, leading to frequent urination or constipation.
Enlarged abdomen: Large fibroids can cause the uterus to expand, resulting in a swollen or enlarged abdomen.
Pain during sex: Fibroids located near the cervix or in the uterine wall can cause pain or discomfort during sex.
Infertility: In some cases, fibroids can interfere with implantation or block the fallopian tubes, leading to difficulty getting pregnant.
Miscarriage: Fibroids can increase the risk of miscarriage, especially if they are located near the cervix or in the lower part of the uterus.

If you experience any of these symptoms, it is important to speak with Dr Pankaj Singhal to determine if uterine fibroids are the cause and discuss appropriate treatment options.

What is the Cost of Uterine Fibroids Treatment in Long Island, New York?

The cost of uterine fibroids removal in the United States can vary widely depending on the type of treatment and the location where the procedure is performed. Here are some estimated costs for common treatments:

Myomectomy: This surgical procedure involves removing the fibroids while leaving the uterus intact. The cost of myomectomy can range from $5,000 to $15,000, depending on the complexity of the surgery and the hospital or clinic where it is performed.
Hysterectomy: This surgery involves removing the entire uterus and is a permanent solution for fibroids. The cost of hysterectomy can range from $10,000 to $20,000 or more, depending on the type of surgery and the hospital or clinic where it is performed.
Uterine artery embolization (UAE): This minimally invasive procedure involves blocking the blood supply to the fibroids, causing them to shrink and die. The cost of UAE can range from $8,000 to $15,000, depending on the hospital or clinic where it is performed.
Magnetic resonance-guided focused ultrasound (MRgFUS): This noninvasive procedure uses focused ultrasound waves to heat and destroy the fibroids. The cost of MRgFUS can range from $10,000 to $15,000, depending on the hospital or clinic where it is performed.

It’s important to note that these costs are estimates and can vary significantly depending on individual factors such as the location, the type of procedure, insurance coverage, and other factors. It is recommended to schedule an appointment with the NYGSE team and insurance provider to get a more accurate estimate of the cost of uterine fibroids removal.

Service Areas

At NYGSE, we provide advanced uterine fibroid treatment for patients in Babylon, Bay Shore, and surrounding Long Island communities.

When do uterine fibroids require surgery?

Uterine fibroids typically require surgical intervention when they cause debilitating symptoms that significantly impact a patient's quality of life or when conservative treatments have failed to provide adequate relief.

Key surgical indications include:

Heavy menstrual bleeding that leads to anemia, requires blood transfusions, or cannot be controlled with medication
• Severe pelvic pain, pressure, or cramping that interferes with daily activities and work performance
• Urinary symptoms such as frequent urination, urgency, or difficulty emptying the bladder due to fibroid pressure
• Bowel dysfunction including constipation or difficulty with bowel movements from large fibroids
• Fertility issues when fibroids distort the uterine cavity or block fallopian tubes
• Recurrent pregnancy loss attributed to fibroid location or size
• Rapid fibroid growth that raises concern for malignancy
• Failure of medical management including hormonal therapies, NSAIDs, or other medications

Surgical timing considerations:

When fibroids grow larger than 10-12 centimeters or cause significant uterine enlargement
• If minimally invasive options like uterine artery embolization are not suitable due to fibroid characteristics
• When imaging suggests potential malignancy requiring tissue diagnosis
• Patient age and reproductive goals influence surgical approach selection

Your surgeon will evaluate fibroid size, number, location, symptoms severity, previous treatments, fertility desires, and overall health to determine if surgery is appropriate. Surgical options range from fertility-preserving myomectomy to definitive hysterectomy, with minimally invasive approaches preferred when feasible for optimal recovery outcomes.

What are the surgical options for fibroid removal?

Several surgical approaches are available for treating uterine fibroids, with the optimal choice depending on fibroid characteristics, patient age, fertility goals, and symptom severity.

Myomectomy - Fibroid Removal with Uterine Preservation

Abdominal myomectomy - Open surgical approach through an incision in the lower abdomen; best for multiple large fibroids or those in difficult locations
• Laparoscopic myomectomy - Minimally invasive technique using small incisions and a camera; suitable for fibroids on the uterine surface or within the muscle wall
• Robotic myomectomy - Advanced laparoscopic approach with enhanced precision and 3D visualization; ideal for complex cases requiring intricate suturing
• Hysteroscopic myomectomy - Removes fibroids protruding into the uterine cavity through the vagina and cervix without external incisions; excellent for submucosal fibroids

Hysterectomy - Complete Uterine Removal

Vaginal hysterectomy - Uterus removed through the vagina; fastest recovery when anatomically feasible
• Laparoscopic hysterectomy - Minimally invasive approach with small abdominal incisions; reduced pain and shorter hospital stay
• Robotic hysterectomy - Enhanced laparoscopic technique offering superior visualization and precision
• Abdominal hysterectomy - Traditional open approach; reserved for very large uteri, extensive scar tissue, or surgical complexity

Specialized Procedures

Laparoscopic radiofrequency ablation - Heat energy destroys fibroid tissue while preserving surrounding healthy uterus
• Hysteroscopic fibroid morcellation - Mechanical removal of submucosal fibroids through specialized instruments

Factors influencing surgical choice:

Fibroid size, number, and location within the uterus
• Desire for future fertility - myomectomy preserves reproductive potential
• Patient age and proximity to menopause
• Previous surgical history and pelvic anatomy
• Symptom severity and treatment urgency
• Surgeon expertise and hospital capabilities

Your surgeon will recommend the most appropriate technique based on your individual circumstances, ensuring optimal outcomes while minimizing surgical risks and recovery time.

Can fibroids be removed with minimally invasive surgery?

Yes, many uterine fibroids can be successfully removed using minimally invasive surgical techniques, which offer significant advantages over traditional open surgery including smaller incisions, less pain, shorter hospital stays, and faster recovery times.

Minimally Invasive Fibroid Removal Options

Laparoscopic myomectomy - Fibroids removed through small abdominal incisions using a camera and specialized instruments; ideal for fibroids on the uterine surface or within the muscle wall
• Robotic myomectomy - Advanced laparoscopic technique providing enhanced precision, 3D visualization, and improved suturing capabilities; particularly beneficial for complex cases
• Hysteroscopic myomectomy - Fibroids protruding into the uterine cavity removed through the vagina without external incisions; excellent option for submucosal fibroids
• Laparoscopic radiofrequency ablation - Heat energy destroys fibroid tissue while preserving surrounding healthy uterine muscle

Minimally Invasive Hysterectomy Options

Laparoscopic hysterectomy - Complete uterine removal through small incisions with camera guidance
• Robotic hysterectomy - Enhanced laparoscopic approach offering superior precision and visualization
• Vaginal hysterectomy - Uterus removed entirely through the vagina when anatomy permits

Candidacy for Minimally Invasive Surgery

Fibroid size typically under 10-12 centimeters for laparoscopic approaches
• Limited number of fibroids - usually fewer than 4-6 for myomectomy
• Favorable fibroid location - not deeply embedded in uterine muscle
• Absence of extensive pelvic scar tissue from previous surgeries
• Normal uterine size or only moderate enlargement

Benefits of Minimally Invasive Approaches

Reduced postoperative pain and narcotic requirements
• Shorter hospital stay - often same-day or overnight discharge
• Faster return to normal activities and work
• Lower infection and complication rates
• Minimal visible scarring
• Reduced blood loss during surgery

Limitations

Very large fibroids may require open surgery for safe removal
• Multiple fibroids in difficult locations may necessitate abdominal approach
• Surgeon expertise and experience with advanced techniques required

Your surgeon will evaluate fibroid characteristics, medical history, and individual anatomy to determine if minimally invasive surgery is appropriate for your specific situation.

What is the difference between myomectomy and hysterectomy for fibroids?

Myomectomy and hysterectomy represent two distinct surgical approaches for treating uterine fibroids, with the fundamental difference being preservation versus removal of the uterus.

Myomectomy - Fibroid Removal with Uterine Preservation

Removes only the fibroid tumors while preserving the healthy uterine tissue
Maintains the uterus, cervix, and reproductive anatomy intact
Preserves fertility and menstrual function
Can be performed through various approaches: hysteroscopic, laparoscopic, robotic, or open surgery
Allows for future pregnancies and childbearing
Maintains hormonal balance as ovaries and uterus remain functional

Hysterectomy - Complete Uterine Removal

Removes the entire uterus, eliminating all fibroids permanently
Ends menstrual periods and eliminates possibility of future pregnancy
May include cervix removal depending on surgical type chosen
Can be performed vaginally, laparoscopically, robotically, or through open surgery
Provides definitive cure with no risk of fibroid recurrence
Ovaries typically preserved in premenopausal women to maintain hormone production

Key Considerations for Treatment Choice

Age and Fertility Goals

Myomectomy preferred for women desiring future pregnancy
Hysterectomy often chosen by women who have completed childbearing
Proximity to menopause may influence decision making

Fibroid Characteristics

Multiple large fibroids may favor hysterectomy for complete symptom resolution
Single or few fibroids often suitable for myomectomy
Fibroid location impacts surgical complexity for both procedures

Symptom Severity and Recurrence Risk

Myomectomy carries 10-30% chance of fibroid regrowth requiring future treatment
Hysterectomy eliminates all fibroid-related symptoms permanently
Severe symptoms affecting quality of life may warrant definitive hysterectomy

Recovery and Risks

Both procedures have similar recovery times when performed with equivalent techniques
Myomectomy may have slightly higher bleeding risk during surgery
Hysterectomy carries small risk of surgical menopause if ovaries affected

Long-term Outcomes

Myomectomy allows preserved reproductive function and natural hormonal cycles
Hysterectomy provides permanent symptom relief but ends fertility permanently

Your surgeon will discuss your individual circumstances, reproductive goals, symptom severity, and fibroid characteristics to help determine which approach best meets your specific needs and preferences.

When should someone see a gynecologic surgeon for fibroids on Long Island?

You should consider seeing a gynecologic surgeon for uterine fibroids when your symptoms begin significantly impacting your daily life or when other treatments haven't provided the relief you need.

The most common reason women seek surgical consultation is heavy menstrual bleeding that causes fatigue, anemia, or interferes with work and social activities. If you're changing pads or tampons every hour, bleeding for more than seven days, or passing large clots, it's time to discuss surgical options. Similarly, if you're experiencing severe pelvic pain, pressure, or cramping that limits your ability to exercise, work comfortably, or sleep well, a gynecologic surgeon can evaluate whether surgery might help.

Fertility concerns also warrant surgical consultation. If you're having difficulty conceiving and imaging shows fibroids that could be interfering with implantation or blocking your fallopian tubes, a specialist can determine whether fibroid removal might improve your chances of pregnancy. The same applies if you've experienced recurrent pregnancy losses that might be related to fibroid location.

Sometimes the decision to see a surgeon is driven by failed medical treatments. Perhaps hormonal therapy isn't controlling your bleeding, or the side effects from medications like GnRH agonists are intolerable. Maybe you tried uterine artery embolization but didn't get the symptom relief you hoped for. When conservative approaches aren't working, it's reasonable to explore surgical alternatives.

Certain situations require more urgent surgical evaluation. If imaging shows rapid fibroid growth, if you develop sudden severe pain, or if large fibroids are causing urinary retention or bowel problems, prompt consultation is important. Additionally, if your primary gynecologist suggests that your fibroids are too large or numerous for them to manage, seeking care from a specialist with advanced surgical training makes sense.

On Long Island, you have access to our experienced gynecologic surgeons who specialize in both traditional and minimally invasive fibroid treatments. We offer robotic and laparoscopic options that can reduce recovery time compared to open surgery. The key is not waiting until symptoms become unbearable - early consultation allows you to understand all your options and plan treatment around your schedule and life goals.

Pankaj Singhal, MD, MS, MHCM

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Endometriosis

Expert Care for Complex Endometriosis

At New York Gynecology Surgery & Endometriosis (NYGSE), our team is nationally recognized for treating even the most advanced cases of endometriosis with precision and compassion. Led by Dr. Pankaj Singhal, MD, MS, MHCM, one of the country’s most experienced robotic and minimally invasive gynecologic surgeons, we specialize in managing complex cases involving the bowel, bladder, ureters, and nerves — conditions often turned away elsewhere.

Our approach combines surgical expertise with a deep understanding of women’s health, ensuring every patient receives care that restores comfort, fertility, and quality of life.

Specializing in Complex Endometriosis Surgery

Performed more than 10,000 robotic gynecologic, endometriosis and cancer surgeries.
Known for taking on the most challenging surgery cases that other doctors/centers turn away.

Endometriosis Treatment

Sciatic Endometriosis

Infertility Caused by Endo

Rectal Endometriosis

Peritoneal Endometriosis

Bladder Endometriosis

Ureteral Endometriosis

Pelvic Endometriosis

Comprehensive, Compassionate Care for Every Woman

Personalized Treatment. Proven Results.

At NYGSE, our multidisciplinary team brings together decades of surgical expertise and patient-centered care. We focus on understanding each woman’s unique symptoms and goals to create a treatment plan that restores comfort, confidence, and quality of life. From advanced robotic procedures to fertility-preserving therapies, every step of your care is guided by compassion and precision.

Schedule an appointment to discuss your symptoms, explore treatment options, and take the next step toward lasting relief.

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COMMON QUESTIONS ABOUT ENDOMETRIOSIS

Understanding Endometriosis

Endometriosis is a chronic disorder characterized by the presence of tissue resembling the endometrial lining outside the uterus. This tissue often leads to menstrual bleeding and is commonly associated with abnormally painful and heavy periods, pelvic pain, intense cramping, and painful sexual intercourse (dyspareunia). The growth of these lesions is influenced by estrogen, noncancerous in nature, inflammatory, driven by stem cells, and may occasionally worsen as time goes on.

It is believed that around 176 million women worldwide are affected by this condition, which plays a significant role in infertility and long-lasting pelvic pain. Endometriosis has also been linked to various other medical conditions, including autoimmune disorders, fibroids, adenomyosis, interstitial cystitis, and even certain types of cancer. In the United States, endometriosis ranks among the top causes of laparoscopic surgery and hysterectomy. The economic implications of this condition are substantial, with businesses facing significant losses in productivity and increased absenteeism due to the disease.

Endometriosis is commonly categorized into four stages or types, which are determined by the location, extent, and severity of the growth of endometrial tissue, as well as the presence of associated scar tissue or adhesions:

Stage I or Minimal: During this stage, there are small implants or lesions found on or in close proximity to the organs within the pelvic cavity, and there is minimal or no scarring or adhesions.
Stage II or Mild: During this stage, there is a higher number of implants or lesions, and there may be the presence of scar tissue or adhesions surrounding the organs in the pelvic cavity.
Stage III or Moderate: During this stage, numerous deep implants or lesions are observed, and there is considerable scarring and the presence of pelvic adhesions within the pelvic cavity.
Stage IV or Severe: During this stage, a multitude of deep implants or lesions are present, and there is extensive scarring and adhesions that can affect multiple organs within the pelvic cavity, such as the bladder, bowel, and uterus.

It is important to recognize that the severity of symptoms does not necessarily align with the stage of endometriosis. Certain individuals with severe endometriosis may only experience mild symptoms, whereas others with minimal endometriosis may endure intense pain and other symptoms. Diagnosis and classification of endometriosis rely on various factors, including symptoms, findings from physical examinations, and imaging tests or laparoscopy, which are best determined by healthcare professionals.

Where does Endometriosis Occur?

Endometriosis is a condition characterized by the presence of tissue resembling the endometrium (the uterine lining) outside the uterus. This tissue can be found in different areas of the pelvic cavity, including the ovaries, fallopian tubes, bladder, bowel, and the lining of the pelvic cavity. Although rare, there have been instances where endometrial tissue has been detected in other areas of the body, such as the lungs, but this occurrence is highly uncommon.

The presence of endometrial tissue outside the uterus can lead to inflammation, scarring, and pain, especially during menstruation.

Causes of Endometriosis

While the precise cause of endometriosis remains unknown, several theories have been proposed to elucidate the mechanisms behind the growth of endometrial tissue outside the uterus. Here are some potential causes:

Retrograde menstruation: According to this theory, it is proposed that during menstruation, a portion of menstrual blood containing endometrial cells refluxes through the fallopian tubes into the pelvic cavity instead of being expelled from the body through the vagina. Subsequently, these cells implant and proliferate on the organs within the pelvic cavity.
Embryonic cell growth: According to this theory, it is suggested that cells present in the pelvic cavity have the potential to transform into endometrial tissue in response to hormonal or other signaling factors.
Immune system dysfunction: There is evidence linking endometriosis to immune system dysfunction, which could potentially create an environment where the growth of endometrial cells outside the uterus becomes possible.
Genetics: The familial nature of endometriosis indicates a possible involvement of specific genes in the development of this condition.
Environmental factors: There is a potential correlation between exposure to specific environmental toxins or chemicals and an elevated risk of developing endometriosis.

It is important to acknowledge that while these theories provide potential explanations for the growth of endometrial tissue outside the uterus, they are not yet fully comprehended or substantiated. Further research is required to enhance our understanding of the fundamental causes of endometriosis.

How Does Endometriosis Affect Pregnancy and Fertility?

Endometriosis can have a significant impact on fertility and pregnancy. Here’s how it can affect:

Fertility: The presence of endometriosis can lead to the development of scar tissue and adhesions, which can potentially block or damage the fallopian tubes. This obstruction may impede the sperm’s ability to reach the egg, making fertilization challenging. Additionally, hormonal imbalances caused by endometriosis can disrupt ovulation, further complicating conception.
Miscarriage: Women with endometriosis may face a higher risk of miscarriage. This increased risk may be attributed to the inflammation caused by the condition in the pelvic area, which can negatively impact the successful implantation of the embryo.
Ectopic pregnancy: The likelihood of an ectopic pregnancy, where the fertilized egg implants outside the uterus, is higher in cases of endometriosis. Typically, the fallopian tubes are the site of implantation in ectopic pregnancies. This condition is considered life-threatening and necessitates immediate medical intervention.

Preterm labor: Women with endometriosis who become pregnant are at an increased risk of experiencing premature labor and delivery, which occurs before the full term of pregnancy is reached.
C-section delivery: Due to the elevated risk of complications during labor and delivery, women with endometriosis may have a greater chance of requiring a cesarean section (C-section) for the safe delivery of their baby.

It is important to emphasize that not all women with endometriosis will encounter difficulties with fertility or experience complications during pregnancy. Furthermore, various treatment options are accessible to help effectively manage the condition and enhance the likelihood of successful conception and a healthy pregnancy.

Symptoms and Diagnosis of Endometriosis

Some commonly observed symptoms of endometriosis include:

Painful periods (dysmenorrhea): This is the primary and most prevalent symptom of endometriosis. Women with endometriosis endure severe menstrual cramps that can be incapacitating.
Chronic pelvic pain: Women with endometriosis frequently experience persistent pain in the lower abdomen, pelvis, or lower back that can persist for weeks or months.
Pain during sex: Women with endometriosis may encounter pain during sexual intercourse, particularly with deep penetration.
Painful bowel movements or urination: Endometriosis can cause discomfort and pain during bowel movements or urination, particularly in conjunction with the menstrual cycle.
Infertility: The functionality of the ovaries, fallopian tubes, and uterus may be affected by endometriosis, leading to infertility.

Diagnosing endometriosis can pose challenges as its symptoms can resemble those of other conditions such as pelvic inflammatory disease or irritable bowel syndrome. Physicians employ various methods to diagnose endometriosis, including:

Pelvic exam: During a pelvic exam, the doctor can conduct a manual examination to detect any irregularities within the pelvis, such as cysts or scars.
Imaging tests: To identify potential signs of endometriosis, medical professionals may employ imaging techniques such as ultrasound, MRI, or CT scans to generate detailed images of the reproductive organs.
Laparoscopy: Laparoscopy is a minimally invasive surgical procedure that enables a doctor to visually examine the pelvic area for endometrial tissue located outside the uterus. By inserting a slender tube equipped with a camera through a small incision in the abdomen, the doctor can view the pelvic region and, if needed, perform a biopsy.

If you encounter any symptoms associated with endometriosis, it is crucial to arrange an appointment with NYGSE. This will facilitate a discussion regarding the most suitable diagnostic and treatment options tailored to your specific needs.

What Happens If my Endometriosis is Left Untreated?

If left untreated, endometriosis can give rise to various potential complications, which include:

Chronic pain: The pain associated with endometriosis can become persistent, impacting daily activities, work, and relationships.
Infertility: Scarring and adhesions caused by endometriosis can hinder fertility by blocking or impairing the functionality of the fallopian tubes and ovaries.
Ovarian cysts: Endometriosis can lead to the development of cysts on the ovaries, causing pain and potentially affecting fertility.
Bowel and bladder problems: Endometrial tissue growth on or around the bladder and bowel can result in pain, bleeding, and issues with bowel and bladder function.
Increased risk of ovarian cancer: Some studies indicate a heightened risk of ovarian cancer in women with endometriosis, though the overall risk remains low.

It is crucial to seek medical attention if you suspect you may have endometriosis or are experiencing symptoms of the condition. Early diagnosis and treatment can assist in managing symptoms, preventing complications, and improving your overall quality of life.

What Treatments are Available in Endometriosis?

There are various treatment options available for endometriosis, and the most suitable treatment plan depends on factors such as the severity of the condition, experienced symptoms, and the patient’s fertility goals. Here are some common treatments for endometriosis:

Pain medication: Over-the-counter pain relievers like ibuprofen or naproxen can be used to manage endometriosis-associated pain.
Hormonal therapy: Hormonal therapy aims to regulate menstrual cycles and reduce the growth and spread of endometrial tissue. Options include birth control pills, progestin-only contraceptives, GnRH agonists, and aromatase inhibitors.
Surgery: Laparoscopic surgery is the primary surgical procedure for treating endometriosis. It involves the removal of endometrial tissue and adhesions. In severe cases or when pregnancy is no longer desired, a hysterectomy (removal of the uterus) or oophorectomy (removal of the ovaries) may be recommended.
Fertility treatment: Women with endometriosis experiencing infertility may benefit from fertility treatments such as in vitro fertilization (IVF).

It is important to consult with a healthcare professional to determine the most appropriate treatment approach based on individual circumstances and goals.

how can diet influence endometriosis symptoms?

Diet can influence endometriosis by affecting inflammation, hormone balance, and gut health. Eating an anti‑inflammatory, whole‑food diet—rich in fruits, vegetables, fiber, omega‑3 fats (fatty fish, flax), and antioxidants—can help reduce pelvic pain and bloating, while limiting processed foods, trans fats, excess red meat, high sugar, and excessive alcohol or caffeine may lessen symptom flares. Individual responses vary, so track symptoms, consider guided elimination trials, and work with your healthcare team or a registered dietitian for a personalized plan. Learn more in our full guide.

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Pelvic Organ Prolapse

Understanding Pelvic Organ Prolapse

Restoring Strength, Comfort, and Confidence

COMMON QUESTIONS ABOUT Pelvic Organ Prolapse

Pankaj Singhal, MD, MS, MHCM

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Gynecologic Oncology

Comprehensive Care for Gynecologic Cancers

Precision, Experience, and Compassion in Every Step

COMMON QUESTIONS ABOUT GYNECOLOGIC ONCOLOGY

Types of Gynecologic Cancer

Pankaj Singhal, MD, MS, MHCM

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Laparoscopy Surgery

Minimally Invasive Laparoscopic Surgery

Precise, Personalized Surgical Care

COMMON QUESTIONS ABOUT LAPAROSCOPY

Pankaj Singhal, MD, MS, MHCM

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Robotic Surgery

Advanced Robotic Care for Women’s Health

Excellence in Every Procedure

COMMON QUESTIONS ABOUT ROBOTIC SURGERY

Pankaj Singhal, MD, MS, MHCM

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Uterine Fibroids

Uterine Fibroids in Long Island New York

Comprehensive, Compassionate Care for Every Woman

COMMON QUESTIONS ABOUT UTERINE FIBROIDS

Pankaj Singhal, MD, MS, MHCM

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Endometriosis

Expert Care for Complex Endometriosis

Specializing in Complex Endometriosis Surgery

Comprehensive, Compassionate Care for Every Woman

COMMON QUESTIONS ABOUT ENDOMETRIOSIS

Have Questions About Your Surgery or Treatment?

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