Bucharest Endometriosis Center-Dr Gabriel Mitroi

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Bucharest Endometriosis Center-Dr Gabriel Mitroi

An integrated multidisciplinary endometriosis center founded by Dr Gabriel Mitroi
(1)

Endometriosis is a whole-body disease which often requires a multidisciplinary approach. Bucharest Endometriosis Centre is an integrated center for diagnosing and surgical treatment of the disease. With over 12 years expertise in minimal invasive gynecological surgeries, with extensive knowledge of the pelvic anatomy and with 6 years of performing complex excision surgery, doctor Gabriel Mitroi fo

unded the Bucharest Endometriosis Centre. We are striving to offer the best possible medical care, having a multidisciplinary team able to operate any kind of endometriosis involvement, and state of the art medical equipment. Centered on patient care and raising awareness, the Bucharest Endometriosis Centre has joined the fight against old medical practices that have been disproved by research. We perform excision surgery always keeping in mind the patients’ wants and needs, preserving fertility and focusing on excising all of the disease. Our Centre is located in Bucharest, Romania, in the Monza Oncology Hospital and we welcome patients from all over the world.

10/07/2025

𝐍𝐚𝐧𝐭𝐞𝐬 𝐃𝐢𝐚𝐠𝐧𝐨𝐬𝐭𝐢𝐜 𝐂𝐫𝐢𝐭𝐞𝐫𝐢𝐚 𝐟𝐨𝐫 𝐏𝐮𝐝𝐞𝐧𝐝𝐚𝐥 𝐍𝐞𝐮𝐫𝐚𝐥𝐠𝐢𝐚
Pudendal neuralgia is a significant cause of pelvic pain and is often diagnosed only after a long period of painful symptoms. These symptoms can easily be mistaken for other conditions. Therefore, to ensure an accurate diagnosis, the following criteria are applied:

Essential Criteria:
➡️ Pain in the area served by the pudendal nerve
➡️ Pain predominantly felt while sitting
➡️ Pain does not awaken the patient during the night
➡️ Pain without objective sensory impairment
➡️ Pain relieved by a diagnostic pudendal nerve block

Complementary Diagnostic Criteria:
➡️ Burning, shooting, stabbing pain, or numbness
➡️ Presence of allodynia or hyperpathia
➡️ Sensation of a foreign body in the re**um or va**na
➡️ Pain that worsens as the day progresses
➡️ Pain predominantly unilateral
➡️ Pain triggered by defecation
➡️ Localized tenderness upon palpation of the ischial spine

Exclusion Criteria:
❌ Pain limited only to the coccyx, gluteal, p***c, or hypogastric regions
❌ Pruritus
❌ Exclusively paroxysmal pain
❌ Abnormalities on imaging that may explain the pain

Associated Signs That Do Not Exclude the Diagnosis:
➡️ Buttock pain while sitting
➡️ Referred sciatic pain
➡️ Pain radiating to the medial thigh
➡️ Suprap***c pain
➡️ Frequent urination or pain with a full bladder
➡️ Dyspareunia or post-coital pain

29/05/2025

𝐏𝐮𝐝𝐞𝐧𝐝𝐚𝐥 𝐍𝐞𝐮𝐫𝐚𝐥𝐠𝐢𝐚 is a significant cause of pelvic pain, usually being diagnosed after many years of painful symptoms. The delay in diagnosis occurs because there is not yet a well-established specialty for this pathology. It is caused by irritation, inflammation, or entrapment of the pudendal nerve, a key nerve that supplies feeling to the lower pelvis, including the ge****ls, perineum, and a**s. When this nerve becomes damaged or compressed, it can cause severe and persistent pain that significantly impacts daily life.

Many patients suffer for years without a correct diagnosis because the symptoms for this condition can be misdiagnosed as a series of other conditions (e.g., gynecological, urological, gastrointestinal issues).

A few of the causes of the pudendal neuralgia are:
✅Childbirth injuries due to stretching of the pelvic musculature from the fetal head;
✅Chronic constipation;
✅ Direct trauma, including falls, motor vehicle accidents, and pelvic surgeries (pelvic organ prolapse repair with mesh);
✅Prolonged sittings (sewists, computer operators, office workers, judges, concert pianists, commercial drivers, chess players and locomotive engineers).

The diagnosis is made following a discussion with the patient. This conversation may reveal a combination of specific symptoms that could suggest the presence of the condition. MRI investigation and clinical examination can rule out other pathologies such as endometriosis or adenomyosis

22/05/2025

Two years ago, we issued an announcement on our page regarding the difficulties we were facing in recording the surgeries. Ever since then, we have changed our policy regarding the surgery videos. From 2023, the video surgery is an optional service that we provide, WHEN it is possible. We have always informed our patients that this is not guaranteed anymore.

The issue of recording the surgeries was and is out of our control, as the hospital is either constantly facing technical difficulties with the recording device, or the staff responsible for the process is not always available. This applies to the laparoscopic surgeries, as well as to the robotic surgeries. In both cases, there is a separate device used for recording. Contrary to some rumors that the DaVinci robot has a built-in recording function, the XI model that the hospital owns does not have this function available.

As this service cannot be guaranteed anymore, and since transparency is one of our core principles, we will provide patients with pictures of the surgeries. But since there are technical limitations, there might still be cases where this will also not be possible. Please consider that all patients receive, upon discharge, a detailed report of the surgery, where every surgical gesture is documented. Patients also have direct access to Dr. Mitroi by phone and email, from the first contact, and even years after surgery. We provide medical reports and letters as needed, in addition to the standard discharge report.

We are doing our best to compensate for any issues that we might face. We are always available and patients can count on us for any clarification they might need.

10/04/2025

Another milestone reached in the continuous process of learning and improvement. We are very proud of our Dr. Mitroi!

12/03/2025

𝐏𝐫𝐞𝐠𝐧𝐚𝐧𝐜𝐲 𝐚𝐟𝐭𝐞𝐫 𝐞𝐧𝐝𝐨𝐦𝐞𝐭𝐫𝐢𝐨𝐬𝐢𝐬 𝐬𝐮𝐫𝐠𝐞𝐫𝐲 - 𝐝𝐨𝐞𝐬 𝐬𝐮𝐫𝐠𝐞𝐫𝐲 𝐢𝐦𝐩𝐫𝐨𝐯𝐞 𝐟𝐞𝐫𝐭𝐢𝐥𝐢𝐭𝐲?
In our center’s experience the answer is YES. But don’t take our word for it. By browsing the medical literature we find a lot of studies that confirm what our patients are reporting after surgery:

A study from 2020 - A total of 456 patients who underwent stage III/IV endometriosis surgery. After surgery, 65.8% (79/120) of patients who wished to have children became pregnant. (https://pmc.ncbi.nlm.nih.gov/articles/PMC7358195/)
A study from 2023 - A subgroup of patients who desired to be pregnant after laparoscopic intervention (102 patients) was followed up for 36–197 months after the surgery. 71 (69.9%) and 60 (58.8%) of the patients achieved pregnancy and live birth, respectively. In the group of patients who became pregnant, the duration of infertility was significantly lower (2.7 ± 2.1 years vs. 4.7 ± 3.2 years). The median time until pregnancy after laparoscopic intervention was 8 months (the average was 10 months). After 38 months, no pregnancy occurred.(https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/ijgo.14849)
A study from 2024 - A retrospective analysis was conducted on clinical records and 1-year postoperative pregnancy outcomes of 335 patients diagnosed with endometriosis-related infertility via laparoscopic surgery. The overall pregnancy rate for patients with endometriosis (EMs) related infertility 1-year post-surgery was 57.3 %, with the highest pregnancy rate observed between 3 to 6 months after surgery. Factors such as Body Mass Index (BMI) (P = 0.515), presence of dysmenorrhea (P = 0.515), previous pelvic surgery (P = 0.247), type of EMs pathology (P = 0.893), and preoperative result of serum carbohydrate antigen 125 (CA125)（P = 0.615）had no statistically significant effect on postoperative pregnancy rates. The duration of infertility (P = 0.029), coexistence of adenomyosis (P = 0.042), surgery duration (P = 0.015), intraoperative blood loss (P = 0.050), preoperative result of serum anti-Müllerian hormone (AMH) (P = 0.002) and age greater than 35 (P = 0.000) significantly impacted postoperative pregnancy rates. The post-surgery pregnancy rate in patients with mild (Stage I-II) EMs was notably higher than those with moderate to severe (Stage III-IV) EMs (P = 0.009). Age (P = 0.002), EMs stage (P = 0.018), intraoperative blood loss (P = 0.010) and adenomyosis (P = 0.022) were the factors that affected the postoperative live birth rate. (https://www.ejog.org/article/S0301-2115(24)00209-4/fulltext)

01/03/2025

Another year, another March, another opportunity to bring awareness on endometriosis. Every year, in March, we celebrate the international month of endometriosis. Let’s talk about endometriosis, as surgeons, as patients, as the family and friends of women with endometriosis. The more we talk about it the harder it becomes to be gaslighted. Be your own advocate and don’t get discouraged by the false and toxic opinions that you are too sensitive, that you are complaining too much, that it’s all in your head.

24/02/2025

Historically adenomyosis was considered to be a disease affecting premenopausal women over 40 because the diagnosis was based on surgical reports from hysterectomies performed on women who did not want any more children. With the advancement of imaging techniques such as MRI and ultrasound, the age of women diagnosed with adenomyosis dropped significantly. We now know that the prevalence of this disease is much higher and it affects women of all ages, including teenagers.
We also know that in most cases, adenomyosis and endometriosis coexist and when diagnosing one we must consider the other will also be found. The pathogenesis involves s*x steroid hormone abnormalities, inflammation, fibrosis and neuroangiogenesis, even though the proposed mechanisms are not fully understood (https://pubmed.ncbi.nlm.nih.gov/32097456/)
Despite the high prevalence of this disease, establishing a clear diagnosis is not as straightforward as one might believe. Adenomyosis is still widely confused with uterine fibroma or other tumours.
Getting a correct diagnosis is a combination of the physician’s experience and familiarity with the disease and the patient’s awareness of the symptoms and the necessity to be evaluated by an expert in endometriosis/adenomyosis.

20/02/2025

𝐓𝐨𝐨 𝐫𝐢𝐬𝐤𝐲 𝐭𝐨 𝐫𝐞𝐦𝐨𝐯𝐞 𝐞𝐧𝐝𝐨𝐦𝐞𝐭𝐫𝐢𝐨𝐬𝐢𝐬 𝐟𝐫𝐨𝐦 𝐭𝐡𝐞 𝐛𝐨𝐰𝐞𝐥!! 𝐈𝐟 𝐭𝐡𝐢𝐬 𝐢𝐬 𝐭𝐡𝐞 𝐦𝐞𝐝𝐢𝐜𝐚𝐥 𝐨𝐩𝐢𝐧𝐢𝐨𝐧 𝐲𝐨𝐮 𝐫𝐞𝐜𝐞𝐢𝐯𝐞, 𝐲𝐨𝐮 𝐧𝐞𝐞𝐝 𝐚 𝐬𝐞𝐜𝐨𝐧𝐝 𝐨𝐩𝐢𝐧𝐢𝐨𝐧 𝐀𝐒𝐀𝐏!
In our 7 years of experience we’ve often had patients with bowel endometriosis who were refused surgery because it was considered too dangerous to remove the lesions. Other patients reported that they were told a stoma would be required. These are red flags, warning signs that tell you a second opinion is required.
Removing endometriosis lesions from the bowel is done by standard surgical techniques that we’ve been using ever since 2018. Of course there are risks, like in any surgery, but the surgeon’s experience reduces those risk considerably.
In some cases bowel resection is not even needed. If there is another safer and more conservative way of removing the lesions, an experienced surgeon will choose it.
A radical and safe approach will improve the patient’s life quality and will minimize the risk of recurrence.

12/02/2025

Într-una din sâmbetele fiecărei luni, în intervalul orar 9:00 – 15:30, dr.Gabriel Mitroi fondatorul

24/01/2025

🎗This week marks the prevention of cervix cancer in Europe. According to the World Health Organization (WHO), cervical cancer is the third most common type of cancer among women aged 20-40 globally. Multiple studies have identified persistent infection with the human papillomavirus (HPV) as the most important cause of cervical cancer. HPV infection is quite common, and most s*xually active people contract the virus.
⛔️Cervical cancer prevention involves adopting behavioral measures, getting vaccinated, and getting regular screening tests. Currently, there are two FDA-approved vaccines for the prevention of HPV infection and cervical cancer: a quadrivalent vaccine against subtypes 6, 11, 16, 18) and a bivalent vaccine against subtypes 16, 18. The effect of HPV vaccination is expected to reduce the incidence of cervical cancer by approximately 70%. Breastfeeding women can benefit from the vaccine, but not during pregnancy.
✅In early stages, surgical treatment may be an option. This may include procedures such as conization (excision of a portion of the cervix), radical trachelectomy (removal of the cervix, upper va**na, and adjacent tissues), radical hysterectomy (removal of the uterus, upper va**na, and adjacent tissues), and radical pelvic lymphadenectomy (removal of the pelvic lymph nodes).

15/01/2025

This is the case of C. who came to our center with suspicion of endometriosis, one previous surgery and extreme pain. Unable to get a diagnosis or to find a solution to her pain, C. traveled from Sweden and had surgery at our center 3 months ago. The diagnosis was left genital-femoral neuralgia.
During surgery, we performed: adhesiolysis, fibrotic tissue excision, left genital-femoral and left obturatory nerves release, left ilio-obturatory lymphadenectomy, and bilateral salpingectomy.
We thank her for this beautiful message and for trusting us to find an answer where so many had failed.

09/01/2025

✨Obtaining the International School of Neuropelveology accreditation was the next step in guaranteeing our patients the best possible surgical treatment for pudendal neuralgia. Dr. Mitroi’s official specialization in pelvic neurosurgery recognizes our 3 years of activity in this field. We have operated around 300 cases with spectacular results. Some patients had a more difficult recovery and others have struggled with the post-operative symptoms. Still, most have experienced instant relief after surgery and an extraordinary improvement in their quality of life.
🦾The robotic approach offers invaluable advantages and allows us to perform extremely complex surgical gestures, minimizing the risks and the complication rate.

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https://bucharestendometriosiscenter.com/

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