CIGC Study Highlights Challenges In Diagnosing Adenomyosis

New Data Adenomyosis

The Center for Innovative GYN Care announced new data on women’s health issues, in advance of National Women’s Health Month. A CIGC study highlights the challenges in diagnosing adenomyosis in women. Results showed that 56 percent of hysterectomy patients had adenomyosis in their pathology, and yet, in patients with no other pathology, adenomyosis was identified in only 11 percent of MRIs and 16 percent of transvaginal ultrasounds – the current standard of care in diagnosis of this condition. As a result, OBGYNs often have a difficult time diagnosing adenomyosis with certainty, especially before surgery, or before pathology results become available.

It is important that doctors don’t dismiss the diagnosis of adenomyosis or endometriosis prior to surgical intervention, especially for women who are experiencing chronic pelvic pain, abnormal uterine bleeding or infertility, as it may result in untreated or inadequate treatment. Improper diagnosis can result in suboptimal treatment, and may require additional surgeries for patients. Our data further highlights the need for patients and doctors, both primary care physicians and specialists, to be aware of the different pathologies that relate to each of these health issues, especially when fertility can be compromised.

Read the full press release here: The Center for Innovative GYN Care Announces New Data on Women’s Health Issues

To schedule an appointment with a CIGC surgical specialist Dr. Natalya Danilyants or Dr. Paul MacKoul, call 888-SURGERY or reach out online. Patient feedback is available on our website under Patient Testimonials, and on doctor review sites: Dr. Natalya Danilyants Reviews | Dr. Paul MacKoul Reviews.

The Case for ASCs: Less Cost, Better Outcomes for Patients

In a recent Health and Hospital Management article, I explore how Ambulatory Surgery Centers (ASCs) have expanded tremendously in recent years, with orthopedics, ophthalmology, general surgeons and otolaryngology physicians composing the majority of these centers. By contrast, GYN surgery continues to be performed overwhelmingly at hospital centers with obstetrics-focused OB/GYNs rather than GYN surgical specialists. Patients deserve the best possible care and should research their options beyond open, hospital-bound surgery.

Hospital and Healthcare Management

From the article:

Regardless of where they live or what they do, patients should never have to undergo any open procedure when there is a better option that dramatically decreases recovery time, pain, incision size and complications – all at a lower cost to the patient and healthcare system. Patients need to seek out these highly specialized centers and look for surgeons beyond their OBGYN generalist to ensure the highest quality of care possible. This self-advocacy approach by the patient is absolutely essential to obtain the best quality of care and is very much needed in this era of patient advocacy and the search for value-based care. Patients who take the time and effort to seek out practices such as The Center for Innovative GYN Care and others will achieve that goal of the best possible surgery at the lowest possible cost. This is, after all, what value based care should be all about.

Read the full article: “ASC Expansion of GYN Surgery to Patients in Rural Areas

CIGC Co-founders Dr. Natalya Danilyants and Dr. Paul MacKoul developed advanced laparoscopic procedures that help women recover faster, with less pain, after GYN surgery. To schedule a consult, give us a call at 888-SURGERY or reach out online. Patient testimonials are available on the CIGC website, and on doctor review sites: Natalya Danilyants, MD Reviews | Paul MacKoul, MD Reviews.

Heavy Monthly Bleeding Can Be A Sign of A Complex GYN Condition. When Is It Too Much?

Heavy monthly bleeding can be a real nuisance: soaking through menstrual pads or super tampons can interrupt a woman’s work, school, and even social life. Many women aren’t aware that a GYN condition such as fibroids or adenomyosis could be the underlying cause, and if left untreated these conditions can worsen or lead to anemia. 


Anemia can lead to fatigue, dizziness, irregular heart rhythms, and cognitive problems. Moreover, anemia must be managed using iron supplements or infusions, or even blood transfusions. A blood test can reveal if you’re anemic, but treating the anemia won’t solve the underlying issue.

Read more about abnormal bleeding, what causes it, and how to treat it on WTOP: Heavy monthly bleeding: When is it too much?

Women don’t have to settle for a life of pain, fatigue, and embarrassment. Minimally invasive options exist that will safely treat the cause. CIGC surgical specialists Dr. Natalya Danilyants and Dr. Paul MacKoul use the advanced LAAM technique for minimally invasive fibroid removal to preserve fertility, and the DualPortGYN technique for hysterectomy to treat adenomyosis. Hear from our patients: read testimonials in our patient spotlight section, and on third party review sites: Dr. Natalya Danilyants Reviews | Dr. Paul MacKoul Reviews.

To schedule an evaluation with a CIGC physician, call 888-SURGERY or reach out online. Women residing outside the Washington DC area can also learn about our travel program.

Raynelle’s Journey to Motherhood: From Fibroids to Fertility

Fibroid symptoms commonly present as severe pain, heavy bleeding, or even anemia. Some women, like Raynelle, don’t experience any of these obvious signs, but fibroids can be silently keeping them from conceiving. Raynelle wasn’t aware of her fibroids until she had issues getting pregnant, but with minimally invasive surgery at CIGC she was able to  have a child.

Fibroids and Fertility Raynelle's Journey to Motherhood

“I realized that I needed to get checked out. My OBGYN said that the fibroids were now the size of a small grapefruit…and there would be no room in my torso for them and a baby. She recommended an open myomectomy. I went for a second opinion and that doctor said the same, open myomectomy, 4-6 week recovery.”

Raynelle wanted better options than a 4-6 week recovery from open surgery: “My mother, my husband, my sister, my mother-in-law – anyone who had a stake in me getting pregnant – all started doing research and talking to friends. Two separate sources recommended CIGC. Finding a more convenient, less invasive approach was the perfect solution at the right time.”

Laparoscopic Assisted Abdominal Myomectomy (LAAM) myomectomy is a uterus sparing procedure, performed on patients who are able to retain fertility, that can be performed in outpatient settings. CIGC surgeons use 2 small incisions to remove fibroids of any number and size. The uterus is repaired by hand in layers so that, as it heals, it is strong enough to carry a baby to term. Women recover faster, with less pain, and are usually back to work in less than 2 weeks.

Women with fibroids trying to get pregnant can find experienced, state-of-the-art options at CIGC. CIGC advanced laparoscopic specialists Dr. Paul MacKoul and Dr. Natalya Danilyants have provided minimally invasive surgical treatment for thousands of fibroid patients. To schedule an evaluation, give us a call at 888-SURGERY or reach out online. Patient testimonials are available on the CIGC website, and on doctor review sites: Natalya Danilyants, MD Reviews | Paul MacKoul, MD Reviews.

CIGC Hysterectomy Patients Recover Faster, Have Less Pain, With DualPortGYN

Using two 5-mm incisions placed in the midline, the CIGC surgical specialists are able to avoid the abdominal muscles and minimize scarring, not to mention reducing pain. Advanced techniques, RP Dissection and Uterine Artery Ligation (UAL), allow the surgeon to get a full view of the pelvic cavity and reduce blood loss. All procedures are performed as outpatient surgery, so patients are discharged after surgery on the same day. Recovery is about 1 week, compared with 6-8 weeks for an open procedure.


While open procedures account for the overwhelming majority of hysterectomies performed across the United States, most women are candidates for a DualPortGYN hysterectomy, even those:

  • with an enlarged uterus or large fibroids.
  • who have had prior cesarean section or other prior pelvic surgical procedures.
  • who are not candidates for vaginal hysterectomy.

The Center for Innovative GYN Care, with offices in the Washington DC area, provides advanced surgical treatment for complex GYN conditions. CIGC specialists Dr. Natalya Danilyants and Dr. Paul MacKoul have innovated highly advanced techniques such as DualPortGYN and LAAM, to treat fibroids and endometriosis using only two small incisions. Women recover faster, with less pain. To schedule an evaluation, call 888-SURGERY or reach out online.

Innovations in GYN Care: An Interview with Authority Magazine on the Future of Healthcare

In a recent Q&A with Authority Magazine writer Christine D. Warner, I discuss the lack of expertise when it comes to minimally invasive GYN surgery as well as the potentially adverse outcomes women may face as they seek to heal from complex GYN conditions.

Future of HealthCare PJM_compressed

In the U.S., the OBGYN generalist is the patient’s “go to” source for GYN surgery. Patients build a “bond of trust” with their OB, and when surgery is needed, that trust translates into the same OB performing surgery. But is that OB really a surgical expert, and one that can provide the best possible care?

During my residency training, this problem became clear. Many of the OBGYNs responsible for training me were having difficulty. If a bladder was inadvertently injured — call the Urologist. The bowel was “stuck” to the uterus — call the General Surgeon. The patient had large fibroids and was bleeding during a myomectomy, or there was extensive Endometriosis making every pelvic organ including the uterus, tubes and ovaries adherent to each other — call the GYN Oncologist. It was obvious that the GYN Oncologist was indeed the OBGYN’s surgeon, and was often “on call” for difficult cases that the OBGYN could not handle. As I began to see GYN Oncologists at work, I realized I had no choice but to try and become one of them. I focused the remainder of my residency on surgery as much as I could, and moved on toward a fellowship program in GYN Oncology.

Read the full Q&A with Medium Magazine author Christine D. Warner: The Future of Healthcare: “A New Way to Perform Laparoscopic Surgery” with Dr. Paul MacKoul

Advanced laparoscopic procedures provided by CIGC Co-founders Dr. Natalya Danilyants and Dr. Paul MacKoul, help women recover faster after GYN surgery, with less pain. To schedule an evaluation, give us a call at 888-SURGERY or reach out online. Patient testimonials are available on the CIGC website, and on doctor review sites: Natalya Danilyants, MD Reviews | Paul MacKoul, MD Reviews.

There Are 12 Days Left in Endometriosis Awareness Month. Do You Have All The Facts?

Imagine living with debilitating and disruptive pain for up to 10 years before a doctor accurately diagnoses what is happening to you. For nearly 300 million women worldwide, this is what it’s like living with endometriosis.

March is Endometriosis Awareness Month, and women everywhere should get the facts about endo pain and how to find relief. Early detection and intervention can minimize the pain and damage endometriosis can cause.

Endo Awareness Month Blog 1200x628

Endometriosis is more than just painful or heavy periods; it occurs when endometrial cells implant in other parts of the body outside of the uterus, causing painful inflammation and bleeding that coincides with a woman’s period. These cells have been found on the bowel, in the lungs, even in the brain.

The only way to diagnose endometriosis it is through laparoscopy, a procedure by which an endoscope, or small camera, is inserted into the pelvic cavity via a small incision. Removing endometriomas requires the skill of an advanced-trained GYN laparoscopic specialist who can repair delicate structures in the uterus, bowel, or other areas of the pelvic cavity.

Although there is currently no cure for endometriosis, relief from endo pain is possible with the GYN specialists at CIGC.

Read more about endometriosis treatment success stories and treatment options in this recent CIGC article: March Is Endometriosis Awareness Month

To get in touch with an advanced CIGC surgical specialist Dr. Natalya Danilyants or Dr. Paul MacKoul, call 888-SURGERY, or reach out online. Women residing outside the Washington DC area, who consider traveling for advanced GYN surgery, can look into CIGC’s travel program.