Not Every Gynaecologist Can Do Fibroid Surgery – Dr. Osagie

Dr. Edmond Eddie Osagie is a United Kingdom based consultant on reproductive health care services of Aurora who is set to relocate to Nigeria to help women with pelvic pains, fibroids and miscarriages with advanced laparoscopic surgery to treat infertility without complications. In this interview with CHIOMA UMEHA he speaks on the technology and expertise he is bringing. Excerpts:

What is passion as a reproductive medicine expert?
I am a consultant and have lived in the UK for the past 25 years. I did my undergraduate medical training at the University of Benin where I graduated in 1985, but I came to the United Kingdom in 1993 to do my post graduate service in reproductive medicine and surgery.
I have been working as a consultant here in Manchester for 15 years now and I have developed extensive reproductive medicine services. My desire now is to take some of the expertise back to Lagos, Nigeria, to help women who have reproductive issues and to help women with Endometriosis, pelvic pain, fibroid and so on because part of what I do is advanced laparoscopic surgery.
I know that some of the women visit UK in search of treatments and so part of my plan is to take the treatment to them. They do not need to travel abroad every time to get treatment.
Endometriosis is something that the cure is very new in Nigeria; what are your plans to create awareness because those who have it do not even know that they have it?
Exactly, the biggest problem in managing Endometriosis is lack of awareness. Even in Western societies, the awareness is very limited and beyond that, the people who have the skill to treat Endometriosis properly with laparoscopic surgery are very few. I run the biggest laparoscopic service for treatment of Endometriosis in the northern part of England and I feel this skill is what the women of Nigeria are really crying out for. So my plan is to set up an advanced laparoscopic service centre in Lekki where women can come and get a test and sophisticated laparoscopic service on treatment for Endometriosis, for fibroid, to support the womb.
So there is lot of stuffs that we can do with laparoscopic surgery that women will really benefit from and because as you know they have very few scars with laparoscopic surgery and healing is excellent with laparoscopic surgery, these are things that women will really benefit from.
The issue of Endometriosis is something that young girls are undergoing in Nigeria without knowing it, how can diagnosis help?
The problem with Endometriosis is that the commonest symptom is painful period and women are always told to get on with it like it is a normal thing for them. The message I am trying to pass out now is that it is not true. Any woman who is always going through a painful period, who cannot go to school because of painful period, who cannot go to work because of painful period or any woman who cannot have a reasonable or enjoyable sex with her partner or husband because of pelvic pain, such a woman has a very high chance of having endometriosis.
My advice to women like that is to get checked out and the way to check women out is to take a history to find out the nature of the pain they are experiencing; then do a simple internal examination and in that way, in more than 90 per cent of women that are affected we would be able to detect the cause of the pain. Ultimately, the final diagnosis is done by a simple medical procedure which is done with a camera through the tummy into the pelvic to have a look; once you diagnose it you can treat it in the same way.

Is there a way mothers can play a role in the early identification of endometriosis in young girls?
Absolutely, mothers, guardians, people who look after young children and teachers have a big role in the early identification of Endometriosis. As I said previously, the key thing is that it is not normal for period pain to stop people from functioning.
So, any young girl who have repeated period pain month after months and it is interfering with her ability to go to school or her ability to leave the house or her ability to go to work is not normal and such young people should be taken to see a gynaecologist who specialises in Endometriosis at a very early stage so that the diagnosis can be made. If the diagnosis is made early, then it would help to get an early treatment that would transform the girl’s life. So, anybody who looks after young children whether they are teachers, parents, guardians definitely has a role in the early diagnosis of Endometriosis.
Is there any relationship between Endometriosis and infertility?
That is a really good question. Infertility affects about one per cent of women who are infertile, 40 per cent of them have Endometriosis and we know that Endometriosis because of the pain it causes in the pelvic makes the egg and sperm not to come together to lead to pregnancy, it can also cause damage or get them blocked. Beyond that, Endometriosis can also affect the development of the lining of the womb and so that the lining of the womb develops abnormally and it does not allow the fertilised egg to attach properly to lead to pregnancy and even when it leads to pregnancy, because of the abnormal development of the lining it leads to miscarriage, Endometriosis is a very bad news for infertility.

Apart from Endometriosis, the care and the treatment, what other areas of reproductive health are you specialising in that is really needed here in Nigeria?
One of the things that are rife in Nigeria is fibroid; 50 per cent of Nigeria women have fibroid and a lot of people do not know they have fibroid and traditionally people have gone to gynaecologist who do not specialise in laparoscopic surgery and they have big open operation to remove the fibroid and there is a risk from this operation because a lot of these women who are young and are within the reproductive age group want to have children but when they have the operation it can complicate things for them. It can lead to damage of the tube and blockage of the tube.
What we do in Aurora is that we specialise in giving laparoscopic surgery which has a better way of not complicating anything. Beyond the laparoscopic surgery that we do surgery through the tummy and also through the vagina where we do not do any cut in the tummy to remove some types of fibroid that are interfering in the womb. We will be providing such services. There are other aspects of fibroid surgery one of the areas we do not see in Nigeria is women who have recurrent miscarriages because of deficiency of the pelvic and some of these woman has had attempt of putting stitches in pregnancy and they have failed What we do at Aurora is that we put a stitch around the neck of the womb before the woman gets pregnant and that stitch help to maintain pregnancy and stops the reoccurrence of miscarriages and that is one of the services that we will be bringing to Nigeria.

The issue of fibroid surgery is associated with a lot of complications. There are conceptions and also misconceptions about fibroid and some of the conceptions are that the existence of fibroid has nothing to do with pregnancy and a woman can still become pregnant even with fibroid, how true is that?
This is true; the presence of fibroid does not really mean that a woman cannot get pregnant. What the presence of the fibroid do is that it makes it more difficult for a woman to get pregnant and when she gets pregnant it makes it easier for her to get a miscarriage. The bigger the fibroid, the number of the fibroid and the closer the fibroid is to the womb will determine the level of risk that the pregnancy has. Although the presence of fibroid will not stop a woman from getting pregnant but it can cause a high risk of delay of pregnancy and miscarriage. So what we recommend is that any woman who is struggling to get pregnant who have fibroid should have the fibroid removed, any woman who has a reoccurrence of miscarriage and has fibroid should make sure that the fibroid is removed. But I get your point that women who have fibroid still get pregnant and carry it successfully.

Sometimes when the surgery is done the casualty is usually high, what can you do as an expert concerning the issue of improper surgery?
Unfortunately, we have people who are not trained or who do not have the skill to do fibroid surgery and have been inflicting harm on our women and because our women do not know better they go to these people and they get their bodies damaged.
I think the message I will pass across is that we need expertise that can handle a fibroid surgery. Not every gynaecologist can do fibroid surgeries. Women also should do their findings well before undergoing any surgery. We at Aurora we have a tracking record and we update our services. Everything we do is transparent. We have record that people can inspect, so we can only reassure people who come to us that they will get a positive care and it is not every type of fibroid that we jump into. We have the expertise to know how to operate, when to operate and how to operate successfully so that women can come out from their infertility problem. The benefit we have at Aurora is that we do both fertility and reproductive surgery; so we are in reproductive and fertility medicine unit and in our reproductive service, everything we do is to remove infertility.

Does your specialties include maternal medicine?
We do not do any maternal medicine; we do only fertility and reproductive medicine.
What has several hairs on a woman’s body got to do with their reproductive health?
You know it is the hormones that are produced that give right to excessive transformation so my advice to women with excessive hair is to see a gynaecologist as that specialises on this and we provide these services comprehensively in Aurora because such women will definitely find it had to reproduce. It is proper that these women are examined properly because different things causes’ excessive hair and it is proper that when we examine these women we find out what the main cause is. When this is done the next thing to do is for these women to start receiving treatment. There are different ways of treating women with excessive hairs. The important part of this is for women to see an expert and know what the underline cause of the excessive is before any treatment.

You mentioned that you manage conditions like menopause. Many women go to the hospital and they still do not get help. How do you hope to address this?
Yes, we talk about the menopause, menopause can be managed and the key thing women should know is that menopause is a natural thing for women, what i found out is that in Nigeria, a lot of women do not expect menopause because they have not been told that it is something that have to the key thing is for information to be passed across to women that menopause is a natural thing for women when they get to a certain age.

What is the key thing that Aurora will do in addressing the issue of menopause in Nigeria?
That is a very good question; part of what we are doing in Aurora is that we are not just giving treatment, but we are also doing public enlightenment. So, we are going to do road shows of lectures so that women who are in this condition will be aware of necessary things that they should know. As I said there are lot of women in Nigeria who have menopause, Endometriosis but they do not know many things about it. Our aim is to have an educative segment where women with these syndromes are well informed and expertise that is treating them will also learn from it. We are still working on that but, they should be expecting it in the beginning of the New Year.

What should a woman that starts seeing menopausal sign do?
The best thing is for her to see a gynaecologist because it is important that the gynaecologist examines her and know if it is actually menopause. Some of the signs they see might be irregular bleeding and that is why they need to be examined to know if there is an underline cause for it.

What will Aurora do for Nigeria in the area of gynaecology?
I am not a gynaecological gynaecologist, but what I do is that if women come to me with symptoms that they might need a gynaecologist counselling, I can help them make a diagnosis and take them to experts who can help them. The key thing we need to pass across is one person cannot be a master of it all, people specialises on one thing now and you cannot be the best in everything and that is why I do the reproductive medicine and surgery but I can make diagnosis of cancer.