AMA Dr. Ally | How the PRM Protocol™ Helps Patients After Endometriosis Excision Surgery

Dr. Ally explains how endometriosis impacts the pelvic nerves and muscles, and how a direct treatment to those nerves and muscles through the PRM Protocol™ can help patients heal, following endometriosis excision surgery.
Dr. Allyson Shrikhande is a board certified Physical Medicine and Rehabilitation specialist, Chief Medical Officer of Pelvic Rehabilitation Medicine, and an expert in women’s and men’s health and sexual health. A leading expert on pelvic health and a respected researcher, author and lecturer, Dr. Shrikhande is a recognized authority on female and male pelvic pain diagnosis and treatment.
At Pelvic Rehabilitation Medicine™, we believe that the millions of women and men who suffer from pelvic pain should have access to care that provides relief. We don’t believe “a glass of wine will fix it” or that “it’s all in your head”. We will never abandon you - and from leadership to the front office to every pelvic pain specialist you meet, so much of our team has been in your shoes and believes the pelvic pain patient deserves better. This belief is what unifies us all at PRM.
Since 2017, PRM has provided an innovative solution to a health crisis that affects 15% of women and 10% of men. Persistent pelvic pain is often overlooked, untreated, and misguided. At PRM, our mission is to decrease the time patients are suffering from pelvic pain symptoms.
We offer a proprietary, simple, office-based procedure to treat the symptoms of chronic pelvic pain. The PRM Protocol™ consists of a series of pelvic nerve and muscle treatments to directly target inflammation in the pelvis and nerve pain. Depending on the condition causing your pelvic pain, other modalities may be needed in addition to our treatment.
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So the benefit of the PRM Protocol™ is to help patients with post endometriosis excision pain. Endometriosis, it is important to remove it, right? That's the primary pain generator. So you have to go in and remove all the different cells. However, it's been there for quite some time in the majority of our patients, right?
The average duration before patients get a surgery and diagnosis is seven to ten years. So with it being in presence for so long in a patient's pelvis, it can wreak havoc on the nerves and the muscles of the pelvis so that when it's there, the muscles of the pelvis go into a chronic guarding state and the nerves start to fire when they shouldn't and get inflamed and start to cause pelvic pain, symptoms, pain with intercourse, bladder urgency, bowel issues, pain and constipation.
So with that even when the endometriosis lesions are properly removed, with a excellent surgery, sometimes the nerves and the muscles have been in that state for so for so many years that they also then need to be treated and rehabilitated. It's more of a calm, relaxed state. So conceptually, that is what we were doing.
In addition, there are comorbidities with endometriosis, and with that we talk about issues around the bladder, around the bowel and, intercourse, that sometimes also can be, need to be treated even once the endometriosis is properly removed. We will address the comorbidities, and we will address the, the nerve irritation and inflammation and spastic health and so on, that happens even with the best endometriosis of excision surgery.