Ask an Endo Surgeon | Introducing Dr. Madhu Bagaria (Background & Approach to Care)

At Pelvic Rehabilitation Medicine, our pelvic pain specialists provide a functional, rehab approach to pelvic pain. When you visit one of our offices, you spend an hour with your doctor reviewing in detail your medical history and symptoms. Then, we perform an internal exam (no speculum) to evaluate your nerves and muscles. Together, we'll discuss an individual treatment plan that gets to the root cause of your pain and helps you to feel better. The best part: you can begin treatment the same day!

At PRM, our mission is to decrease the time patients are suffering from pelvic pain symptoms.


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 My name is Dr. Madhu Bagaria, and my background is I did my medical school from India. I also did a residency in India, believe it or not, and then worked there for two years before I decided to come to United States because I was interested in practicing evidence based medicine. And I got accepted at Mayo Clinic Arizona.

I was very fortunate, I was very lucky because it empowered me with all the skill sets, which I needed to help women with chronic pain, which is very, very important. And now I feel like I'm very comfortable in taking care of women who, who are dealing with it and can help them navigate their path.

I found that this was an organization which was passionate about serving women with chronic pelvic pain. Surgery is one aspect and, but when you see pain patients, it's just not the surgery they need. They need a compassionate, you need a team of compassionate people who can bring up all the avenues for the treatment.

Here in our office, I do feel that we have, we have a very good physiatrist team of physicians, and they're very expert in diagnosing women with a lingering pain, which can happen after even after endometrosis excision surgery. And we also help them deal with the pain on an emotional level.

So we have a very good psychologist here on the team. We have nutritional counseling for the team. Our motto is not to abandon you after you come here, you get surgery. Our motto is to help you heal completely and we do it by our multidisciplinary team who is equally passionate to help you. When I talk about my approach to treating patients with endometriosis, so, most of the time when they come to see me they've already seen so many, so many providers.

So on the top of the pain they're also dealing with a lot of anxiety as to what I'm going to do or what they will find or what, what. So I try to first listen to them, listen to their journey. I need to know your story. I need to know where you're coming from and what your goal for the treatment is.

For me, it's very important to understand my patient. I need to know what treatments you had. So I, I, I usually, when I take care of these patients, I ask for the operative notes and everything, talk to them, discuss about the physiology, validate the feelings because I've seen many patients with suffering the same conditions.

So it's very important for us to recognize that your symptoms are not just in your head. You, and then make them feel comfortable in the place. If they need surgery, I will definitely recommend them undergoing surgery. But again, after surgery, we're not going to abandon you. That's, that's important. We need to battle this disease together.

So when I take patients for the surgery, I am very careful that I make sure that I look all around the abdomen. My surgery, it goes with small insertion, but my first point of contact or first point of look is to the diaphragm or the liver area just to make sure there's no endometriotic lesion because some lesions could be there.

I also run your bowel, I look at your appendix, and if it's abnormal. I do cancel it before the surgery so that it can be, if it's abnormal, it will be removed, so we remove that. I also look inside. I bring the camera closer in the pelvis, look in every nook and corner of the pelvis and try to locate and excise all these lesions.

And working with experts at Mayo Clinic, I have learned to recognize these lesions. When a patient comes to see me, they already have gone through so many things. Some of them have already have operative note saying that. They have been diagnosed with endometriosis and I reviewed the operative now to see what was performed and how are things there.

Whether it's done by ablation or excision surgery. I also look at their symptoms. I look at the symptoms of the patient. They continue to have pain, which is with their bowel movements, with their constant pain in the pelvic areas. And if I've seen, that, you know, if I feel that they would benefit from surgery, I'll take them for surgery.