CENTRE OF EXELLENCE
ABOUT DR THOMAS
Dr Viju Thomas is an endometriosis specialist heading a multidisciplinary team with the primary focus of improving the quality of life among patients living with this debilitating condition.
Currently, he spends nearly all of his time focused on endometriosis.
Unlike other centres that treat endometriosis his unit exclusively deals with patients living with endometriosis, an interest that began during his fellowship in England when he realized how poorly managed it was in South Africa.
Dr Thomas decided to focus solely on endometriosis, and this has become a philosophy believing that unlike other specialists one cannot give less than one hundred percent to endometriosis if one still practices general obstetrics and gynaecology.
Dr Thomas has hosted numerous workshops for gynaecologists in both endometriosis and laparoscopic surgery. His work also includes supporting patient groups and patient advocacy groups who try and bring awareness to this neglected area of medicine.
Having qualified as an Obstetrician and Gynaecologist from the University of Cape Town, Dr Thomas started working at Tygerberg hospital in 2010. Laparoscopy was always the route he knew he would take and this led him to study in the United Kingdom where he was accepted for a 3-year fellowship in Minimal Access Gynaecological Surgery. He completed his degree in Masters of Minimally Invasive Gynaecological Surgery with merit.
Once this was accomplished Dr Thomas was inspired to start a training centre in South Africa because such a centre was not available in South Africa. This led to the creation of the Minimal Access Gynaecological Surgery Unit (MAGS) which is accredited by the South African Qualification Authority and still remains the only accredited training centre in the Country. Since its inception in 2016, Dr Thomas has trained fellows wishing to improve their skills in endoscopic surgery.
Dr Thomas’ work in training gynaecologists to perform advanced laparoscopic surgery led to demand among patients who do not attend Tygerberg hospital. This calling resulted in the creation of an endometriosis centre.
"Turn your wounds into wisdom"
The Thomas Center for Endometriosis and Endoscopy brings together internationally recognized leaders in the field of endometriosis from renowned local and international hospitals. The Center focuses on exceptional clinical care, multidisciplinary treatments by specialists, and outstanding educational resources.
In addition to diagnosing and managing teen/adult women’s endometriosis, the Center is a hub for research advancement.
Right now there are promising approaches that are in urgent need of funding. We believe that someday we will be able to conquer endometriosis
With your support, Dr. Thomas and his research team at the Thomas Center for Endometriosis can:
- Improve early diagnosis of endometriosis
- Identify better treatments to decrease pain and progression
- Determine if vitamin supplements and an anti-inflammatory diet can suppress symptoms
- Make progress on a noninvasive test to monitor disease progression and severity
- Answer fundamental questions that could lead to a cure
Endometriosis Symptoms, Diagnosis and Treatment
Endometriosis occurs in some women when the cells that normally line the inside of the uterus (endometrial cells) are found in other parts of the body. These cells are typically found in areas around the uterus in the pelvic organs—the ovaries, fallopian tubes and the lining of the abdomen (peritoneum), but they can be found in other parts of the body such as the bowel and/or bladder. Since they are the same type of cells that are usually just on the inside of the uterus, they respond to estrogen and grow a little each month and sometimes bleed slightly. The small amount of growth and bleeding each month causes endometriosis. Women who have endometriosis may experience significant endometriosis symptoms including pain, infertility or both. It is unclear, however, why many women may have no endometriosis symptoms at all and find out they have endometriosis because they develop a cyst on their ovary or they have surgery for another reason.
There is a wide range of endometriosis symptoms. Usually these symptoms occur at regular times that are often before, during or after monthly periods.
Endometriosis symptoms may include:
- Painful menstrual cramps
- Pelvic pain can radiate to the back, down the legs or into the vagina or rectum.
- Bloating, constipation and/or diarrhoea
- Pain with urination
- Pain with a bowel movement
- Pain during or after sexual intercourse
An experienced gynaecologist may suspect endometriosis based on a woman’s symptoms and the findings during a pelvic exam. Currently, the only way to diagnose endometriosis is through laparoscopy—a minor surgical procedure that is done under general anaesthesia (while the patient is asleep). Using the laparoscope (which is equipped with a tiny camera on the end), the surgeon can look inside the pelvic cavity and other areas to see if endometrial cells/lesions are present.
There is no cure for endometriosis nor one perfect endometriosis treatment. Most women will need to try many different endometriosis treatments that can include medications, behavioural therapy and surgery. Endometriosis treatment requires trial and error to find the best combination for any one person.
If endometriosis is seen at the time of diagnosis, it is removed by laser (intense light energy) or excision (surgical removal). In general, surgery of this type will lessen pelvic pain associated with endometriosis and will enhance fertility.
Often non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen or naproxen are prescribed first for endometriosis treatment. An evaluation at a Pain Treatment Program can often be very helpful to manage pain. Some women find that alternative therapies such as acupuncture, physical therapy or bio-feedback can be helpful.
Other treatment options include hormonal therapies. Birth control pills that contain estrogen and progestins (progesterone hormone) are usually prescribed first. Combinations of estrogen and progestin may also be prescribed as a patch or a ring that is inserted into the vagina. Other options for endometriosis treatment include progestin alone, Gonadotropin-Releasing Hormone Agonists (drugs that lower estrogen)
Not being able to conceive is a common but not a universal problem among all women with endometriosis. Some women will be able to become pregnant without endometriosis treatment. Since all hormonal treatments prevent pregnancy, medical treatments for endometriosis are not used in women who are attempting to conceive.
Treatment options to improve fertility outcomes include:
- Laparoscopic surgery has been shown to improve fertility and thus is considered a treatment of choice for women with endometriosis symptoms who wish to start a family or have more children.
- Intrauterine inseminations (IUI), fertility drugs in the form of pills or injections or in vitro fertilization (IVF). IVF is a procedure in which a woman takes fertility drugs to make multiple eggs. The eggs are removed from her ovaries and then fertilized with her partner’s sperm in the laboratory. The fertilized eggs (embryos) grow in the IVF Lab for 3-5 days until the embryo(s) are ready to be implanted into the uterus.