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The Endometriosis Podcast · May 1, 2025 · 45 min

Episode 5: Bowel Surgery for Endometriosis: Conservative vs. Radical Approaches

In this episode, Dr. Nicholas Fogelson and Dr. Shanti Mohling relaunch The Endometriosis Podcast with an in-depth look at one of the most crucial surgical decisions for patients with deep endometriosis: how aggressive should bowel surgery be? You'll hear their thoughts on recent meta-analysis comparing conservative techniques (like shave and discoid resection) to radical approaches (like segmental bowel resection). Dr. Fogelson and Dr. Mohling break down how disease severity, nerve preservation, and surgical judgment all shape patient outcomes — and why sometimes a more radical surgery is not only necessary, but life-changing. Along the way, they share real-world cases, challenge common assumptions, and invite listener questions. For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at newpatients@nwendometriosis.com Follow us on Instagram: @Nicholasfogelson and @drshantimohling Highlights: What the research reveals about constipation risks after conservative vs. radical bowel surgery How nerve-sparing strategies protect long-term bowel and pelvic health When a conservative approach succeeds — and when deeper excision is needed for lasting relief Why flexible decision-making during surgery leads to better outcomes than imaging alone How understanding the differences between superficial and deep disease leads to more effective treatment Download a transcript of this episode.

0:00-45:21

transcript

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show notes

In this episode, Dr. Nicholas Fogelson and Dr. Shanti Mohling relaunch The Endometriosis Podcast with an in-depth look at one of the most crucial surgical decisions for patients with deep endometriosis: how aggressive should bowel surgery be? You'll hear their thoughts on recent meta-analysis comparing conservative techniques (like shave and discoid resection) to radical approaches (like segmental bowel resection). Dr. Fogelson and Dr. Mohling break down how disease severity, nerve preservation, and surgical judgment all shape patient outcomes — and why sometimes a more radical surgery is not only necessary, but life-changing. Along the way, they share real-world cases, challenge common assumptions, and invite listener questions.

For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at newpatients@nwendometriosis.com

Follow us on Instagram: @Nicholasfogelson and @drshantimohling

Highlights:

  • What the research reveals about constipation risks after conservative vs. radical bowel surgery
  • How nerve-sparing strategies protect long-term bowel and pelvic health
  • When a conservative approach succeeds — and when deeper excision is needed for lasting relief
  • Why flexible decision-making during surgery leads to better outcomes than imaging alone
  • How understanding the differences between superficial and deep disease leads to more effective treatment

Download a transcript of this episode.

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