Liselotte Mettler by Jim Tsaltas
Dr. Jim Tsaltas
Hi, it is Jim Tsaltas from the ISGE Board. Welcome to the ISGE website. I am very privileged and very honored to have Professor Liselotte Mettler, a dear friend and really a pioneer in endoscopic surgery. Liselotte, welcome to the ISGE website. Professor Mettler we are here in Brazil at a fantastic endometriosis meeting run by our colleague Professor Abrao. One of the issues that was discussed today at the lectures that we read was the need for early diagnosis of endometriosis, what are your thoughts in this area?
Prof. Dr. Liselotte Mettler
Well, I had the honor to be a student of Dr. Kurt Semm and dealt with endometriosis classification, I would say 1970 onwards. We have developed a classification called EEC, endoscopic endometriosis classification which is a very good basic classification, but of course it does not help us to take all the aspects that we have nowadays into consideration for the treatment by other patients. So I think we are really in a time 2009 that we should incorporate the nice NCM classification of our Austrian group of ________ that we have worked on that with other aspects into some listing or something that we can compare our data.
Dr. Jim Tsaltas
Yes, and I know that you are being dealt with, some work with Professor Abrao and his colleagues in trying to look at modifying the classification when using. With respect to young patients, Professor ________ mentioned today that the average age, the average time to diagnosis is between 9 and 12 years and that many of these young patients will actually have symptoms in their adolescence years. How do we encourage these patients to present to their physician earlier?
Prof. Dr. Liselotte Mettler
We just have to listen to painful menstruations, because dysmenorrhea is an early symptom and we have for instance made an up count, if you count a young girl, let’s say from 17 years on till 25, she has pain for five days, every month, for 12 months a year, for 25-30 years. So she has five years of pain. That has to be recognized as chance of onset early and we have to try treatment early.
Dr. Jim Tsaltas
Yes. In these young women, do you feel earlier on I was fortunate enough to be sitting in with Dr. Miller was being interviewed and there are many more women who are going into the practice of obstetrics and gynecology, do you think that that will allow young female patients in the adolescent years to present with, do you think they are far more comfortable, discussing these issues with female gynecologists as opposed to coming to somebody of my age and a male?
Prof. Dr. Liselotte Mettler
That might be impossible and as I can see in Germany now in schools.
Dr. Jim Tsaltas
Yes.
Prof. Dr. Liselotte Mettler
We are being asked as a female doctor who come and talk to young kids and many girls are coming later to this kind of lectures.
Dr. Jim Tsaltas
Yes.
Prof. Dr. Liselotte Mettler
Present their pain they had at menstruation, what they can do, how they can diagnose this, and of course that is easy in the Western world, but is very difficult in Arabic world whether there cannot be vaginally examined if they are virgins. So, there the question is much more difficult, how to diagnose, how to help them. I think, we in this conference we really compare all the strategies from the surgical side, from the immunological hormonal side, and we hope to find some new pathways.
Dr. Jim Tsaltas
Yes. You are talking about hormonal manipulation, for these young patients, particularly as you mentioned, I know that you do a lot of work and a lot of teaching in the Middle East, what do you think the first line treatment can be to help some of these young women?
Prof. Dr. Liselotte Mettler
At the present time, I do not think we have much else than hormonal treatment.
Dr. Jim Tsaltas
Yes.
Prof. Dr. Liselotte Mettler
We can see they are responsive to it and of course ultrasound from the abdominal view with better quality, we can also see a lot, and as soon as we see that there is a good response, then we might have to subject into a laparoscopy early and to just take some consequences of all the surgical _ if endometriosis is found.
Dr. Jim Tsaltas
Fantastic. At the end of the day it is about education, informing the patients and Professor Mettler thank you very much for coming on to the ISGE website and I am truly honored and inspired by everything I can do. Thank you very much.
Prof. Dr. Liselotte Mettler
I do hope that ISGE website is really going to everyone in the world.
Dr. Jim Tsaltas
Yes. Thank you.
Prof. Dr. Liselotte Mettler
