Care · By concern
Periods that keep you in bed, pain that returns every month, sometimes difficulty conceiving: endometriosis affects about one woman in ten and is still too often diagnosed late. At the practice, 42 avenue Mozart, Dr Chaima Gatri — OB-GYN and gynecological (gynaecological) surgeon — makes the diagnosis, leads the treatment and operates, when necessary, at the Clinique de la Muette. English-speaking practice.
Recognizing it
Endometriosis is the presence, outside the uterus, of tissue similar to its lining. With each cycle, this tissue responds to hormones, causes inflammation and, over time, lesions and adhesions. Signs vary from one woman to another, and their intensity says nothing about the extent of the disease.
Pain that prevents you from living normally is not normal: it can be investigated and treated.
Diagnosis
Diagnosis begins with listening: the history of your pain, its rhythm, its impact, any plans for pregnancy. It continues with a gynecological examination and a pelvic ultrasound performed on site, during the consultation, on a latest-generation ultrasound system — targeted ultrasound now detects most endometriosis lesions, ovarian as well as deep. A pelvic MRI completes the mapping of the lesions when deep lesions are suspected, and before any surgery.
Dr Gatri also sees patients referred by their gynecologists and general practitioners for the diagnosis and management of endometriosis. She works within Resendo, the Paris community-hospital network dedicated to endometriosis. When assisted reproduction is needed, she refers her patients to the fertility (IVF) team of the Clinique de la Muette.
Management
Endometriosis is a chronic disease: it is not “removed” once and for all, it is controlled, and treatment adapts to your pain, your age and your plans for pregnancy.
Information documents are given to you at the consultation: understanding endometriosis, laparoscopy.
Frequently asked questions
It is a chronic disease, which evolves in flare-ups and most often subsides at menopause. It can be controlled: the great majority of patients return to a normal life with appropriate treatment.
Too long, on average — several years between the first symptoms and the diagnosis. At the practice, the ultrasound performed during the first consultation often allows progress that very day; an MRI, if useful, is prescribed straight away.
In most cases, yes, when it is targeted and performed by a gynecologist trained in this search. MRI completes the work-up when deep lesions are suspected, and always before surgery.
Surgery has precise indications: pain that resists medical treatment, certain lesions, certain infertility situations. It is performed by laparoscopy, through small incisions, and is decided with you.
Say so at the first consultation: plans for pregnancy change the strategy. Depending on your age, your lesions and your work-up, Dr Gatri proposes the most favorable order — surgery, natural attempts or referral to the fertility (IVF) team of the Clinique de la Muette.
Yes, the practice offers it to patients suffering from endometriosis-related pain, as a complement to treatment. The protocol is that of pelvic floor rehabilitation: six sessions of 20 to 30 minutes over three weeks, fully clothed, without a probe.
Consultations, ultrasound, MRI and surgery are covered by the French health insurance (Assurance maladie) under the usual sector 2 conditions; in certain forms, endometriosis may qualify for 100% coverage. StarFormer sessions are not covered. The full picture is in “Fees and reimbursement”, further down.
On Doctolib, with Dr Gatri, choosing a gynecology consultation or the endometriosis follow-up consultation, or by telephone through the secretariat.
Fees
Consultations, examinations and surgical procedures are covered by the Assurance maladie under sector 2 (non-OPTAM) conditions; depending on its form, endometriosis may qualify for 100% coverage; magnetic stimulation sessions are outside the official schedule and are not reimbursed; a quotation is provided before any operation. Fees are listed in the fee schedule and displayed at the practice. The information framework of this site is described on the Patient information and ethics page.
Appointments
Appointments can be booked online via Doctolib or by telephone through the secretariat.
Doctolib — Dr Chaima GATRI