Colette takes her skills and knowledge to the next level by regularly assisting with laparoscopic surgery. The combination of gynaecological surgery, pathology, and ‘internal’ osteopathy opens up new perspectives that help us better understand conditions like endometriosis. I’m thankful to the surgeon and his team for guiding me through the surgeries during the last four years.
The gold standard, instructed in numerous publications and guidelines, is a blend of diagnostic laparoscopy with histological authentication of endometrial glands to diagnose endometriosis (Wykes 2004) (Dunselman et al. 2014). Early diagnosis of this pathology is important, preventing chronic pain and infertility. It is a clinical challenge to recognize and treat endometriosis and related functional problems with vaginal, rectal, and abdominal osteopathic techniques (osteopathic internal manipulative treatment = OIMT).
The central hypothesis: is what we feel the same as what we see during surgery? Decreased range of motion in the female pelvis minor, due to endometriosis / fibrotic tissue, can cause Chronic Pelvic Pain (CPP), infertility, and dyspareunia.
CPP is a clinical challenge for osteopaths due to the large number of potential causes. It is a matter of utmost importance for osteopaths to encounter endometriosis in the differential diagnosis of CPP in female adolescents and adults to provide adequate help (Gallagher 2018) (Sinaïï et al. 2002) (Dunselman et al. 2014) (Sultan 2012) (Suvitie 2016) (Geysenbergh 2017).
The additional importance of OIMT not only lies in diminishing chronic pain and infertility, but also in the paradigm behind the internal treatment policy, which is to re-establish visceral range of motion in endometriosis patients.