Endo Battery

QC: Does Endometriosis Come Back After Surgery? The Truth About Recurrence | Dr. Gaby Moawad

Alanna Episode 226

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Does endometriosis really “come back” after surgery?

And what if what we call recurrence isn’t always recurrence at all?

In this episode of Endo Battery, we sit down with Professor Gaby Moawad, a globally recognized leader in robotic gynecologic surgery and endometriosis management, for an honest conversation about one of the biggest questions patients face after treatment:

Can endometriosis come back?

Dr. Moawad explains why endometriosis recurrence remains so poorly understood, why researchers still struggle to clearly define different disease subtypes, and how genetics, inflammation, immune factors, gene expression, and the extent of disease can all influence what happens after treatment.

We also unpack the difference between recurrence and persistent endometriosis, why surgery alone may not be the entire long-term treatment strategy, and why patients deserve realistic information instead of false reassurance.

If you’ve ever searched:
• Does endometriosis come back after surgery?
• Can endometriosis return after excision?
• What causes endometriosis recurrence?
• How successful is endometriosis surgery?
• Can endometriosis be completely removed?
• What happens after endometriosis surgery?
• How do you prevent endometriosis from coming back?

This conversation is for you.

Because managing endometriosis isn’t just about treating today’s pain. It’s about understanding the disease, knowing what science actually tells us, and asking better questions about your long-term care.

🎙️ Listen to the full conversation on Endo Battery.

Subscribe, share, and leave a review so more people living with endometriosis can find evidence-informed answers.

#Endometriosis #EndometriosisAwareness #EndometriosisSurgery #EndometriosisRecurrence #ExcisionSurgery #ChronicPain #EndoWarrior #EndoBattery

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Quick Connect Format And Disclaimer

SPEAKER_01

Life moves fast, and so should the answers to your biggest questions. Welcome to Indobatteries Quick Connect, your direct line to expert insights. Short, powerful, and right to the point. You send in the questions, I bring in the experts, and in just five minutes, you get the knowledge you need. No long episodes, no extra time needed. And just remember, expert opinions shared here are for general information and not for personalized medical advice. Always consult your provider for your case-specific guidance. Got a question? Send it in. And let's quickly get you the answers. I'm your host, Alana, and it's time to connect.

Introducing Dr. Gabby Mawad

SPEAKER_01

Today's guest is someone who is truly changing the landscape of endometriosis care. Professor Gabby Mawad is a globally recognized leader in robotic surgery and endometriosis management. He's a board-certified gynecologic surgeon and the founder of the Center for Endometriosis and Advanced Pelvic Surgery in Washington, D.C. Dr. Mawad has dedicated his career to advancing minimally invasive and robotic techniques, combining surgical innovation with deep, compassionate, patient-centered care. As director of robotic gynecologic surgery and associate professor at George Washington University, he's trained surgeons worldwide and helped redefine how we approach complex pelvic disease. He's been named Top Doctor in Washington, D.C. for nearly a decade and has authored over 125 peer-reviewed publications leading global conversations on endometriosis and surgical innovation. It's an honor to sit down and welcome a true pioneer and advocate for better outcomes for women everywhere. Please help me in welcoming Dr. Gabby Moad.

Why Recurrence Is Hard To Define

SPEAKER_01

We've talked about it being a whole lifelong journey. And going back to the lymphatic pathways, if those are involved, does this change how we think about reoccurrence?

SPEAKER_00

Reoccurrence is a very complex issue. Reoccurrence is is extremely poorly understood. Because when we do research on endometriosis, we do research on endometriosis as a whole. We don't have any subtypes of the disease. We don't have any yet well-established understanding of the phenotypes of the disease. How does the disease express it? How is it why is it deeply infiltrative in you? Why does it affect the bowel in you? Why doesn't it affect severity of the disease? The genetics and the gene expression of everybody.

Biology Behind Persistence And Risk

SPEAKER_00

Also, like the completeness of your therapy, your therapeutic approaches plays a role in persistence rather than recurrence, but we call it recurrence most of the time. So it's a multifaceted complex situation. Yes, definitely, emphatic could play a role, inflammation, understanding the inflammation. The immune system plays a tremendous role in that. So it's a it's a multifactorial. Most of the stuff cannot be answered as of now by one theory or by one causality equation. So there are multiple factors that come together that we still poorly understand that could increase the chances of recurrence for some patients versus not for other patients.

Education Over Cheerleading

SPEAKER_01

Yeah. It's it's and I think that we oversimplify it sometimes in saying if you just get the right treatment, if you just get the right surgeon, then you won't have any recurrence. And that's just not true. We're too complex for that.

SPEAKER_00

No, it's you know, there are multiple inter interventions that we can do, but the most important thing is trying to educate the patient. Because patients, when we talk about recurrence, patient understand there's no cure for this disease. And patient understand there is a chance of recurrence. But trying to help improving the quality of life and minimizing the unnecessary surgery is something, is a goal that is could help tremendously impact their quality of life. So if a patient's require another surgery in five years or ten years, but in the interim time they had a very good quality of life, patients are completely on board. They understand really well that. But if a patient has to do surgery every six months and most of them are unnecessary or emanate from the poor understanding of the disease or poor implementing of long-term therapeutic or uh approaches, this will lead to a lot of frustration and this will lead to a lot of changing doctors. And so the most important thing we can do as a healthcare provider, advocacy group, is to try to educate the patients about the real reality of the disease.

SPEAKER_01

Yes.

SPEAKER_00

Rather than taking patients' emotional vulnerability to provide them a cheerleading support. Patients with endometriosis, they need more understanding. They don't need cheerleader. Cheerleading is sometimes important. But simplifying endometriosis to go, girl, be strong, that kind of approach, which is, I agree, it's important to lift up people sometimes. But the most empowering comes from trying to understand the disease and explain it to the patient, trying to understand their body, trying to individualize their treatment, trying to provide them a longer-term strategy, how they can cope with such a disease.

Send Questions And Closing

SPEAKER_01

That's a wrap for this quick connect. I hope today's insights helped you move forward with more clarity and confidence. Do you have more questions? Keep them coming. Send them in, and I'll bring you the expert answers. You can send them in by using the link in the top of the description of this podcast episode or by emailing contact at Indobattery.com or visiting the Indobattery.com contact page. Until next time, keep feeling empowered through knowledge.