Mr. Trehan is a specialist in the treatment of endometriosis and has helped countless endometriosis patients across the globe achieve pain relief and pregnancy. Mr. Trehan has innovated three surgical techniques in order to improve the outcome associated with endometriosis treatment surgery. Mr. Trehan removes all endometriosis, endometrioma (chocolate) cysts and adhesions from the pelvis completely and under no circumstances removes the pelvic organs (such as the uterus, ovaries, bowel, bladder and ureters) in order to treat endometriosis, as he has demonstrated that a hysterectomy (removal of the uterus) and oophorectomy (removal of the ovaries) are not the solution to treating endometriosis. Mr. Trehan performs all endometriosis surgery with no exceptions, no matter how advanced the endometriosis via laparoscopic (keyhole) surgery as it offers numerous advantages to the patient. Mr. Trehan’s endometriosis surgical complication rates are amongst the lowest reported in the medical literature and 90% of his patients leave the hospital after just one night’s stay following surgery, despite many of his patients having the most complicated cases of endometriosis and numerous previous failed, unsuccessful and abandoned operations.
Mr. Trehan is a consultant gynaecologist, a Fellow of both the Royal College of Surgeons (FRCS) and the Royal College of Obstetricians and Gynaecologists (FRCOG) and a specialist in the treatment of endometriosis. Having practiced in the National Health Service (NHS) for over 30 years (of which 20 years were as a consultant), Mr. Trehan now practices solely within the private sector.
Mr. Trehan is vastly experienced in the treatment of patients with endometriosis and has helped many reach their primary end goals of a reduction or elimination of pain and an increase in fertility resulting in pregnancy. Many of Mr. Trehan’s patients have the most complicated and advanced stages of endometriosis and/or have had previous unsuccessful medical and surgical treatments and travel from other parts of the United Kingdom and abroad in order to see him. Mr. Trehan’s clinic was one of the first British Society for Gynaecological Endoscopy (BSGE) accredited centres for the treatment of advanced endometriosis, and remains the only private clinic in the country to have achieved this accreditation. Additionally, Mr. Trehan frequently presents at international conferences on the surgical management of endometriosis and has organised national conferences in order to train other doctors on the management of endometriosis and has acted as a supervisor for doctors studying Masters of Science degrees on treating endometriosis.
Mr. Trehan has innovated, pioneered and implemented three surgical techniques for the treatment of endometriosis:
- Total Pelvic Peritoneal Excision – an extension of conventional surgical excision of endometriosis. In this procedure the entire pelvic peritoneum, not just the region which visibly appears to contain endometriosis is removed in order to improve patient outcome in terms of pain, infertility and post-surgical endometriosis recurrence. By performing Total Pelvic Peritoneal Excision, Mr. Trehan has demonstrated that there is no need for a bilateral oophorectomy (removal of both ovaries) in the treatment of endometriosis. This is associated with numerous advantages for the patient as bilateral oophorectomy results not only in a permanent, irreversible state of infertility but also in a loss of ovarian hormone secretion, resulting in damaging long term effects on almost every system of the body.
- Temporary Ovarian Suspension – following any gynaecological surgery including treatment for endometriosis, the ovaries are particularly susceptible to forming adhesions (scar tissue which holds organs together). These ovarian adhesions can in turn themselves cause symptoms similar to endometriosis (such as pelvic pain and infertility). Mr. Trehan innovated the Temporary Ovarian Suspension technique in order to prevent the formation of such adhesions following the surgical treatment of endometriosis.
- Laparoscopic Post-Hysterectomy Vaginal Vault Excision – following a hysterectomy in patients with endometriosis, it is possible for endometriosis to ‘bury’ in the scar of the vaginal vault/apex, resulting in chronic pelvic pain and dyspareunia (pain during sexual intercourse). Mr. Trehan developed Laparoscopic Post-Hysterectomy Vaginal Vault Excision in order to remove the endometriosis from this scar by excising (cutting out) the scar and surrounding region and then restitching the vaginal vault/apex.
Mr. Trehan was the first to practice these three techniques and further information can be found on the Surgical Treatments of Endometriosis page. Mr. Trehan’s pioneering endometriosis work and services have been the subject of numerous awards and significant national and international media interest.
Mr. Trehan has successfully treated and operated on many patients with endometriosis ranging from those with mild stages of endometriosis to those with the most advanced stages of endometriosis who have previously been refused surgical treatment or had incomplete/abandoned previous surgeries on the basis of the complexity of their endometriosis and pelvic pathology.
Mr. Trehans performs all surgery for endometriosis with no exceptions via laparoscopic (keyhole) surgery as it is associated with numerous advantages for the patient in terms of magnification of the endometriosis lesion and its complete removal, post-operative complications, pain, recovery and cosmetic appearance when compared to laparotomy (open surgery). Furthermore, despite the complicated nature and advanced stage of endometriosis of many of Mr. Trehan’s patients, his surgical complication rates, conversion to open surgery rates and post-surgery hospital readmission rates are amongst the lowest reported in the medical literature.
Mr. Trehan appreciates that many women have in the past not had their endometriosis taken seriously or treated effectively. He hopes to address these issues by not only providing the latest surgical treatment, but also listening to patients, fully explaining their condition and the cause for their symptoms, allowing patients to understand their condition and treatment (for instance by providing pictures taken at the time of diagnosis and operation), and providing substantial and regular follow-up care both in person and over the telephone.
This website contains information on the causes & symptoms of endometriosis, how Mr. Trehan diagnoses and treats endometriosis, and general information on Mr. Trehan’s practice. If you would like to make an appointment to see Mr. Trehan, please click here.