Dr. Rami Kaldas

Patient Feedback

Patterns Across Patient Feedback

Endometriosis Focus

Endometriosis Within a General OB/GYN and Fertility Practice

Dr. Kaldas is a board certified obstetrician and gynecologist who has practiced in the Fox Valley area of Wisconsin since 1996 and later opened his own practice, the Kaldas Center for Fertility, Surgery and Pregnancy, in Appleton. The practice describes itself as a center for fertility, surgery, and pregnancy, and its published services are organized into fertility, surgical solutions, and counseling and support. He describes himself and his colleagues on video as obstetrician gynecologists who are also classified as primary care doctors, and notes that no referral is needed to be seen. Physician directories list him as an obstetrician gynecologist and describe his focus as including fertility surgery and pregnancy care.

Endometriosis is a visible part of that practice. It appears first among the conditions named on the practice surgery page, it has its own category on the practice blog, four of the videos on his physician page address endometriosis or living with it, and physician directories that rank conditions by how often a provider treats them place endometriosis and adenomyosis at the top of his list. That ranking is drawn from billing data rather than from any assessment of surgical approach, so it indicates volume rather than technique. Endometriosis does not have its own service page on the practice website, and a web address for one redirects to the homepage, while fertility has a full section of its own.

A 2019 article published by another local practice reports that he had performed more than 5,000 minimally invasive laparoscopic procedures for endometriosis. That figure is his own, reported in an interview, and no independent record of surgical volume is publicly available. 

Multidisciplinary Approach

Limited Public Information Beyond a Documented Urology Collaboration

One detailed 2018 patient account describes a urologist operating alongside Dr. Kaldas during endometriosis surgery. In that account the urologist confirmed a bladder condition during the same procedure and placed a lighted stent so that the ureters, the tubes running from the kidneys to the bladder, could be seen clearly while disease was removed from around them.

Other accounts describe additional physicians within the practice participating in follow-up care.

No public information has been found on whether colorectal or thoracic surgeons are involved for disease outside the reach of gynecologic surgery, or on whether pelvic floor physical therapy is recommended and whether there are providers the practice refers to. Patients whose disease may involve the bowel, the diaphragm, or areas beyond the pelvis should ask directly how those cases are handled.

Diagnosis Methods

Surgery Described as the Only Definitive Test, With Emphasis on the Pelvic Exam

Dr. Kaldas has stated publicly that laparoscopy is the only way to definitively diagnose endometriosis. He also places unusual emphasis on the physical examination, describing the area behind the uterus as the most common site of disease and stating that nodules there can often be felt on a pelvic exam. He has said that of the many patients he has examined and found disease in this way, almost none reported that a previous physician had examined that area at all. He notes that he does not generally perform pelvic exams on patients younger than seventeen or eighteen who are not sexually active.

Family history is treated as a significant signal. He describes a roughly sevenfold increase in likelihood when a mother or older sister has endometriosis, and states that severe period pain in a teenager with that family history warrants investigation rather than dismissal.

No public information has been found on whether a negative ultrasound or MRI is treated as sufficient to rule out disease.

Educational Presence

A Public Presence Built Almost Entirely on Practice-Produced Content

Dr. Kaldas received his medical degree from the University of North Carolina at Chapel Hill School of Medicine in 1992 and completed a four year residency in obstetrics and gynecology at Stanford from 1992 to 1996. No fellowship appears on any source reviewed. 

One of his bios states that during his training at Stanford he was taught by Dr. Camran Nezhat, a widely recognized pioneer of operative and video laparoscopy. The timeline supports the possibility: Nezhat came to Stanford in 1993, which overlaps with three of the four residency years. It is worth understanding what that relationship is. A resident rotates through the services of many faculty members over four years of general training. A fellowship is a separate year or more of training taken after residency, under a named surgeon, in one narrow field. The first is exposure. The second is specialization. What is documented here is the first. No publication, presentation, or other public record links the two physicians, and the account of the relationship comes from the practice itself.

Three publications appear under his name, dated 1989 to 1992. All predate his residency, none in obstetrics or gynecology, and none concerns endometriosis. No publications of any kind were found after 1992. No conference presentations, society talks, surgical video sessions, or course faculty listings were found in the endometriosis field. His only listed professional membership is the American College of Obstetricians and Gynecologists, where he holds fellow status. No appearances on endometriosis podcasts were found.

His public presence in the endometriosis space is mostly produced by his own practice. That includes a practice blog with an endometriosis category, a practice YouTube channel, a Facebook question and answer session on endometriosis, four videos embedded on his physician page, and practice accounts on Facebook and Instagram. He does not maintain a personal Instagram or X account that was found. The practice also holds a recurring sponsored slot on a Green Bay television station, under which four endometriosis segments have aired. Those are paid placements within a local expert series rather than news coverage. There was one substantial piece of writing about him published elsewhere is a 2019 article on another local practice's website.

Post-Surgical Care

Hormonal Suppression Recommended After Surgery to Delay Recurrence

Dr. Kaldas has stated publicly that there is roughly a fifty percent chance of endometriosis returning after surgery, and that stopping periods after surgery is the best way to slow that and keep symptoms away. He describes GnRH medication, a class of drug that switches off the ovaries, as a reasonable option after excision, and notes that the higher dose cannot be taken for long because of bone loss, that even the lower dose should not be used beyond a couple of years, and that disease can become active again once it is stopped. He describes the medication as more useful for patients whose surgeon did not remove disease properly. Patient accounts reflect this in practice, including a hormonal intrauterine device placed during surgery, and offers of hormonal medication or birth control when pain returned afterward.

Several accounts describe him personally checking on patients in recovery and reviewing surgical photographs at the follow-up appointment. One 2015 account describes follow-up care moving to a colleague after surgery, with the patient told he was simply busy. No public information has been found on how soon the first follow-up appointment takes place or how long patients continue to be seen after surgery.

Philosophy and Fit

Endometriosis Described as an Immune and Nerve Disease

Dr. Kaldas describes endometriosis as beginning with menstrual blood traveling backward through the fallopian tubes into the pelvis, something he says happens in everyone, and taking hold in the small share of people whose immune system does not clear it away. On that basis he describes endometriosis as fundamentally an immune disease, and links it to higher rates of thyroid disease, rheumatoid arthritis, multiple sclerosis, and inflammatory bowel conditions. He also describes it as having a nerve component, citing higher levels of a pain-signaling chemical in patients with painful disease, and states plainly that the pain is real and not in a patient's head. He suggests an anti-inflammatory diet may help some people with symptoms while being clear it is not a treatment.

He estimates that fewer than one percent of surgeons perform excision, and says he is not troubled when a general gynecologist declines to operate on disease near the bowel or ureters, on the grounds that a surgeon who judges a case too dangerous in their own hands is right about that. The recurring theme in his public statements is that patients who have been told nothing can be done for them can usually be helped.

He also states that patients do not need a referral to be seen, on the basis that obstetrician gynecologists are classified as primary care providers.